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The haemodynamic indices of three patients, who developed abdominal tamponade as a result of intra-abdominal bleeding following liver transplantation, were measured on four occasions as the increased intra-abdominal pressure was released. Hypotension followed the release of the tamponade in all patients and was the result of a decrease in systemic vascular resistance. This was treated with vasoconstrictors; the response to various agents was monitored. Treatment of hypotension following release of abdominal tamponade by volume replacement alone may be inappropriate and may lead to over-transfusion; adrenaline may be the treatment of choice. Intensive haemodynamic monitoring is advisable.

We have compared the sedative and amnesic effects of midazolam and propofol in 35 volunteers. Sedation was measured by simple reaction time immediately before and after a bolus injection and 1 h after the commencement of a subsequent continuous infusion. Memory was measured three times using two memory tests: perceptual facilitation provided an implicit memory measure and recognition provided an explicit memory measure. Propofol and midazolam had similar sedative effects both immediately after bolus doses and after 1-h continuous infusions of the drugs. In contrast, midazolam had a more profound amnesic effect than propofol on the recognition memory test. The drugs had little effect on performance with the implicit memory test. Performance on the memory tests was unrelated to sedation.

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