Clinica I for1111 I 56 1 vision; the extent of any oedema and its position can then be seen and infected material can be easily removed by suction from the oro-pharynx, where it tends to pool in a patient in the Trendelenburg position. There is a theoretical risk that a nasal tube on its way through the pharynx might rupture the abscess. Some anaesthetists have used oral tubes to obviate this risk, but it does not seem to be a problem in practice and the risk can be reduced if the nostril on the opposite side from the quinsy is used for the naso-tracheal tube when possible.Suxamethonium may be used with safety to faciliatate intubation if it is first ascertained that it is possible to inflate the patient manually.There are degrees of severity of quinsies and the individual anaesthetist must decide which is the most suitable method of induction for a particular patient in his hands but, in spite of the fact that forty-three patients were induced with a barbiturate and suxamethonium for intubation without complication in the present series, this should not be regarded as the method of choice. SutntnaryA review is presented of 114 cases of quinsy tonsillectomy. This shows that this advantageous operation has a low complication rate and is safe in skilled anaesthetic hands. AcknowledgmentsThe author wishes to thank Dr Derek Wylie for his constructive criticism and the surgeons of the Ear, Nose and Throat Department of St Thomas' Hospital for their co-operation. Re ferences
2-(0-chlorophenyl)-2-methylaminocyclohexanone (CI-581), a derivative of phencyclidine, was shown to depress the cardiovascular system in conscious rats and in rats anaesthetized with pentobarbitone and urethane. In pithed animals, however, there was a substantial rise in blood pressure, suggesting that CI-581 may act on the central cardiovascular regulatory mechanisms. The pressor response to CI-581 in pithed animals was considerably reduced by phenoxybenzamine and phentolamine. In reserpinized animals, the pressor response to CI-581 was abolished but could be restored by infusions with noradrenaline. Thus, CI-581 may act indirectly by releasing catecholamines from peripheral stores. In adrenalectomized rats, the increase in blood pressure elicited by CI-581 was abolished by pre-treatment with reserpine. The data indicate that the peripheral release of catecholamines by CI-581 may be derived from more than one storage site.
The organophosphate insecticides have become widely used in agriculture and in home gardening. There has been an increase in accidental and intentional poisoning. Almost all these compounds are potent cholinesterase inhibitors, and signs of poisoning are attributable to the accumulation of acetylcholine. The local absorption of these compounds from the conjunctiva, upper respiratory tract and skill following exposure to the aerosol or dust used in agricultural work, produces mild symptoms and is rarely of consequence except in accidents due to careless handling. The severe type of poisoning is caused usually by ingestion of the compound(s), and accumulation of large amounts of acetylcholine is fatal if not antagonized rapidly by atropine in large and continuous doses, together with respiratory support. Pyridine-2-Aldoxime Methiodide (P-2-AM) has been reported to be successful in treating Parathion poisoning. There is experimental evidence that it is not of similar value in some other organophosphorus insecticide poisoning.
Myocardial metabolic, structural and functional preservation were evaluated in 44 patients who underwent open heart surgery under cardiopulmonary bypass, potassium cardioplegia and topical hypothermia. The duration of cardiac arrest varied from 14 to 87 minutes. Myocardial high-energy phosphates were not only adequately preserved but actually exceeded the control values during periods of cardiac arrest. Glycogen levels were decreased moderately and one to three fold increases in lactate/pyruvate ratios were detected. Myocardial ultrastructure was well preserved. Postoperative clinical recovery of the patients was excellent. The only patient who died from a low output syndrome showed no evidence of myocardial damage. The results of this study serve to illustrate the beneficial effects of potassium cardioplegia and topical hypothermia on myocardial preservation during prolonged periods of ischaemic cardiac arrest, as used for the correction of congenital cardiac lesions.EXPERIMENTAL studies done in recent years have indicated that global myocardial ischaemia, induced by aortic cross-clamping, results in the progressive loss of myocardial high-energy phosphates and a deterioration in myocardial functions (Stemmer et a h , 1973;Bretschneider et a h , 1975). In order to provide optimum intraoperative myocardial protection and to reduce the ischaemic damage, a number of cardioplegic solutions with different compositions have beenc described (Melrose et aiii, 1955; Kirsch et alii, 1972;Gay and Ebert, 1973).These solutions have been designed to induce diastolic arrest rapidly, and their effects on myocardial metabolism have been evaluated in animal models (Hearse et alii. 1975). We have studied the effects of a potassium -containing cardioplegic solution, combined with topical hypothermia, on myocardial metabolic, cellular and functional preservation, by subjecting right atrial and right ventricular muscles to biopsy in patients
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.