No abstract

Single doses of 3 ml/kg of 20% mannitol and 3% HS are safe and effective for intraoperative brain debulking during elective supratentorial craniotomy, but less effective in patients with pre-existing mass effect and midline shift.

Both sevoflurane and propofol at low dosages combined with remifentanil under comparable BIS values and partial muscle relaxation can be used when monitoring of TceMEPs and SSEPs is required for brainstem surgery.

The use of 5 mL/kg of equiosmolar solutions of 3% HS and 20% mannitol applied to reach a brain relaxation during elective craniotomy does not induce coagulation impairment as evidenced by ROTEM and standard coagulation tests.

No abstract

timeframe of onset and recovery, although we did not use sugammadex. They posed the question of whether sugammadex had played a role in the recovery of their patient and we would like to suggest that perhaps a recovery could have occurred in a dramatic way after 15 -20 min with traditional anaphylaxis treatment, as occurred in our patient. However, in our case, the cardiovascular collapse was not so severe, cardiopulmonary resuscitation was not initiated and less epinephrine was required. However, this potential use of sugammadex in anaphylaxis may help our department to get it onto our hospitals' formulary! We were also interested to learn, on further investigation, the results from the study, 2 which showed that only two out of 24 confirmed cases of rocuronium anaphylaxis had previously been exposed to rocuronium, as our patient had also never been exposed to neuromuscular blocking agents. In debating how the patient will be treated on her next anaesthetic presentation, we were also surprised to learn of the crossreactivity with not only other aminosteroid neuromuscular blocking agents but also with benzylquinoliniums.

No abstract

"Mass movement" was described at the beginning of the century by radiologists who occasionally observed how, during their explorations, barium was transported suddenly from one section of the colon to another. In the present study we wanted to center our attention on electromechanical activities accompanying large evacuations via the colostomy, as we believe that they are an expression in myoelectric and pressure terms of the "mass phenomenon" described by radiologists. To do this, we designed an electromyographic recording probe to which we attached a conventional microtransducer probe, joining them by suction. With this method we made 24-hour recordings in eight patients with sigmoid colostomy. We witnessed five large evacuations. When the electric and pressure activities that occurred a few minutes before the evacuation were analyzed, we observed that there were two clearly different phases. The first, which we call "Preliminary Phenomenon," consists of a series of contractions and spiking potentials averaging 5.6 minutes (SD 2.22); after this the "Big Contraction" appears, with mean pressure values of 127 mm Hg (SD 38.77) and mean electric values of 10.6 mV. The duration of this phenomenon averaged 24.93 seconds (SD 6.19), recorded almost simultaneously at the three recording sites studied. There is no doubt that these electro-pressure phenomena resulted in a mass transport, as we observed an intense evacuation via the colostomy in the five patients.