Total intravenous anaesthesia for direct laryngoscopy: propofol infusion compared to thiopentone combined with midazolam and methohexitone infusion.

Total intravenous anaesthesia for direct laryngoscopy was investigated in 40 patients, randomized into four groups of 10 patients each. First, propofol infusion was compared to thiopentone combined with midazolam. Next, a comparison of propofol infusion with methohexitone infusion was undertaken. The propofol group showed significantly lower peroperative blood pressure compared to the thiopentone/midazolam group. The second propofol group required significantly less alfentanil to stabilize the blood pressure, compared to the methohexitone group. Completeness of recovery, assessed by means of a coin counting test, was faster in the propofol group compared to the thiopentone/midazolam group, while no difference could be demonstrated between the second propofol group and the methohexitone group. It is concluded that propofol seems to be superior to both thiopentone/midazolam and methohexitone with respect to the stability of peroperative blood pressure. Concerning recovery, propofol is superior to thiopentone/midazolam, but offers no advantage over methohexitone.

[Ignition of the endotracheal tube during CO2 laser therapy of upper airway disorders]. / Antaendelse af endotrakealtube under CO2-laserbehandling af øvre luftveje.

The patient had papillomas in larynx, trachea and the main bronchi and was treated with CO2-laser evaporation under general anaesthesia. He was intubated with a red rubber tube wrapped with aluminum tape and outermost with muslin strips. The muslin was soaked in water before intubation. After using the CO2-laser with 15W for 3-5 s a continuous smoke generation was seen. The muslin strips had glowed away. The fire was immediately extinguished with water and no damage to the airway had occurred.

Dopamine and dobutamine reduce myocardial d-propoxyphene content in experimentally intoxicated rats.

The effect of sympathomimetic intervention with dopamine or dobutamine on the myocardial uptake of d-propoxyphene was investigated experimentally in rats. The d-propoxyphene (19 mg kg-1 h-1) was continuously infused, intravenously, over 45 min. After 20 min of infusion the rats were given either dopamine (12.5 micrograms kg-1 min-1 or 25 micrograms kg-1 min-1), dobutamine (25 micrograms kg-1 min-1 or 45 micrograms kg-1 min-1) or normal saline (control). Each group consisted of eight rats. The myocardial d-propoxyphene content was significantly lower in the two groups given dopamine and in the group given dobutamine 45 micrograms kg-1 min-1 than in the control group (P less than 0.05). This finding indicates the benefit of early sympathomimetic intervention with either dopamine or dobutamine in d-propoxyphene intoxication.

[Prognosis and costs of patients with prehospital cardiac arrest treated with respirators]. / Prognose og omkostninger hos respiratorbehandlede patienter efter praehospitalt opstået hjertestop.

A retrospective study was undertaken of prehospital cardiac arrest and revealed that mechanical ventilation was employed in 132 consecutive patients after resuscitation. A total of 24 of these survived for more than three months; 14 were discharged to their homes while ten were discharged to nursing homes on account of cerebral sequelae. No patients in whom the cardiac arrest had lasted more than 25 minutes survived for more than three months and patients with cerebral sequelae were more frequently mechanically ventilated for longer than 48 hours. The total cost of treatment for the 132 patients was estimated to be 10,500,000 Danish crowns (approximately 954,000 pounds). A total of 7% of the patients survived with cerebral sequelae but these were responsible for more than 60% of the expenses.