Mitral valve replacement in a patient with acute intermittent porphyria.
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Biomedical subjects
Publications and source records attributed to J D Kneeshaw.
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Two similar groups of patients undergoing coronary artery bypass grafting received either atracurium or vecuronium infusions for neuromuscular blockade. Both groups demonstrated a marked reduction in neuromuscular blocking requirements during hypothermic bypass at 30 C. The ratio of the dose rates at 30 C to that at 37 C was significantly less with vecuronium (p less than 0.01).
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Twenty-six patients were anaesthetised for Caesarean section using the Bain anaesthetic system for intermittent positive pressure ventilation. There was an inverse relationship between maximum end tidal carbon dioxide tension and the fresh gas flow (FGF) to the system. A significant difference existed between the patients receiving 80 ml/kg/min FGF and those receiving 120 ml/kg/min. Estimated carbon dioxide levels in the pregnant term patient were higher at each FGF rate than the levels reported in non-pregnant patients by other workers. In order to maintain maternal arterial carbon dioxide tension at or close to the normally quoted term value of 4.1-4.4 kPa, when using positive pressure ventilation with a Bain system, a fresh gas flow rate of at least 120 ml/kg body weight/minute is required.