A study has been made comparing the surgical performances of 145 anæmic patients who had hæmoglobin levels below 10 gm/100 ml of blood with the surgical performances of 412 routine surgical cases. While there appeared to be an apparent increase in cardiac arrests or deaths during surgery or in the early postoperative period in the anæmic cases, it is doubtful whether this is significant. Other surgical or postoperative complications did not appear to occur more frequently in the anæmic cases than in the controls, nor did the complications in the anæmic patients require treatment not given to patients in the control series.
It is a common practice in many anaesthetic centres throughout the world to require a iIIillilllUllt preoperativc haemoglobin level of 109/lOO ml of blood or more, but very few references are qlloted by writers on this subject. A search of relevant medical literature has been made in a 11 attempt to establish the origin and significance of the preoperative haemoglobin requirements Tt'COII/ mended.
Observations have been made of pupil size, as affected by intravenously administered atropine and neostigmine, and by extubation, during reversal of curarization. Pulse rate and blood pressure changes were also recorded. Some degree of mydriasis was observed in 70 per cent of patients after atropine, in 86 per cent after neostigmine, and in 55 per cent at extubation. Pulse rate increased in 88 per cent after atropine and decreased in 86 per cent after neostigmine. Blood pressure rose in 70 per cent after atropine and in 58 per cent after neostigmine. Extubation caused no consistent pulse and blood pressure changes. It was considered that the pupillary changes noted would not be deleterious in intra-ocular surgery.
A prospective trial to investigate the effect of using cold irrigating solution during transurethral resection of the prostate was carried out. A control group of 44 patients was resected using irrigant at room temperature, and a trial group of 49 cases was resected using irrigant cooled to 2 degrees C. Blood loss during surgery was measured to see whether the cold irrigating solution had any effect on this loss. There was a small reduction in blood loss in the cold group, but this reduction was not statistically significant (0.5 greater than P greater than 0.3).
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