The successful treatment of ventricular arrhythmias occurring during anasthesia was reported by Payne et al. 1 and Johnstone2 who used pronethalol, a B-adrenergic blocking drug.The disadvantages of pronethalol, namely the production of lightheadedness, inco-ordination leading to nausea and vomiting and a carcinogenic effect in mice, led to the investigation of other similar compounds, Black et al. 3 One of these, Compound ICI 45,520, (now referred to as propranolol or by the trade name 'Inderal') was found to have a therapeutic ratio about ten times that of pronethalol and was free from carcinogenic effects in mice.The following investigation was undertaken to see whether or not propranolol was effective in the treatment of ventricular arrhythmias occurring during halothane anzsthesia.
METHODThe ECG was monitored during halothane anzsthesia on a number of patients admitted to hospital for a variety of elective operations. These included dental, ENT, orthopaedic and neurosurgical procedures.In all cases anasthesia was induced with thiopentone 200-500mg. If endotracheal intubation was necessary, it was performed with the aid of suxamethonium 30-75mg given after the thiopentone. Anasthesia was maintained with halothane using nitrous oxide 75 % and oxygen 25% as the carrier gases. If relaxation was required, tubocurarine was used, and respiration controlled using a circle absorption system. Halothane was vaporised from either a Fluotec vaporiser or a calibrated Boyle's bottle. A Fluotec, outside the circuit, was used with the circle absorption system.
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