Oxygen free radicals generated during reoxygenation after cardiac arrest may impair recovery of cerebral blood flow and function. In a randomized study in vivo, we tested the following anti-free radical combination therapy administered at the beginning of cardiopulmonary resuscitation after apnea-induced cardiac arrest of 7 minutes: 1) ventilation with 100% nitrogen for 30 seconds to allow the delivery of therapy before oxygen, 2) 10 mg/kg i.a. superoxide dismutase followed by 10 mg/kg i.v. over 1 hour to scavenge the superoxide anion radical, and 3) 20 mg/kg i.v. deferoxamine over 1 hour to prevent membrane lipid peroxidation. We evaluated the effects of this combined treatment on the recovery of cardiovascular variables, cerebral blood flow and oxygen consumption, and somatosensory evoked potentials in 20 dogs 6 hours after resuscitation. Compared with standard treatment (n = 10), the combined treatment (n = 10) did not affect cardiovascular variables, significantly mitigated cerebral blood flow changes after cardiac arrest, and enhanced recovery of somatosensory evoked potentials. We conclude that oxygen free radicals play a role in the pathogenesis of the arrestrelated derangements of cerebral blood flow and function that are effectively reduced by this combined treatment; we recommend evaluation of its components in outcome studies. (Stroke 1987;18:869-878)
Local reactions after i.v. injection of diazepam, flunitrazepam and isotonic saline were studied in patients who received extradural analgesia or general anaesthesia. The frequency of thrombophlebitis on the 1st, 3rd and 5th days after the injection of diazepam was 2.1%, 17.0% and 14.9% respectively, after flunitrazepam 10.0%. 10.0% and 14.0%, and after saline 0%, 6.7% and 4.4%. The differences between the groups were not statistically significant (P > 0.05). One month after the injection 15.6% in the diazepam group, 8.5% in the flunitrazepam group and 9.3% in the saline group had pain or tenderness in the arm used for the injection.
Twenty children, ranging in age from 1--9 years, and one adult suffering from epiglottis acuta were treated with nasotracheal intubation performed under general anaesthesia and with ampicillin. Clinical cure was obtained in all cases with a mean intubation time of 34 hours. The diagnosis, epiglottis acuta, was suspected by the referring physician in 10 cases. The incidence of epiglottis acuta compared to laryngitis acuta was found to be 1:30. The mean hospital stay was 5.4 days. It is concluded that treatment of acute epiglottis by nasotracheal intubation in the hands of experienced anaesthesiologists and with close observation in an intesnive care unit, is a safe method of management with negligible morbidity and mortality.
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