PubMed · 5098712
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E I Eger. 1971. MAC, MAP, and euphony.. https://doi.org/10.1097/00000542-197111000-00023
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A 3-yr-old girl was scheduled to undergo surgical repair of tetralogy of Fallot. She had no sign or data indicating an infectious disease, other than a slight dry cough for a few days prior to the proposed operation. During the induction of anesthesia with nitrous oxide, oxygen and sevoflurane, transient moist rale was noticed with a precordial stethoscope. Her trachea was intubated without any difficulty after the administration of pancuronium, followed by a chest auscultation, which revealed vesicular sound bilaterally but no rale. However, a chest X-ray taken after the right subclavian vein catheterization showed a massive hypoaeration in the upper left pulmonary region. The presence of the right-to-left intracardiac shunt made it impossible to detect the occurrence of atelectasis by a decrease in SpO2. Fiberoptic bronchoscopy showed no obstruction of the bronchus and no hypersecretion initially, but physical therapy and humidification made it possible to aspirate intratracheal sputum. Because there seemed to be an imbalance between the relatively uneventful induction of anesthesia and the relative resistance of atelectasis to authentic therapies, the operation was postponed, and the antibody to mycoplasma pneumoniae was titrated. The titer in the serum was 1:80, and increased to 1:560 6 days later. Chest X-rays revealed normal lung condition 3 days later, and she was given erythromycin, 800 mg.day-1 for 2 weeks. We conclude that we should be alert to possible asymptomatic mycoplasma infection, which potentially makes patients susceptible to atelectasis during the perioperative period.
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OBJECTIVE: The objective of our study was to establish the refractive indices and the virial coefficients of the volatile anesthetic vapors. These indices and coefficients will allow refractometry to be used by manufacturers to produce accurate calibration, without requiring expensive high-precision calibration gases. METHODS: We used a precision refractometer to measure the refractive indices for five volatile anesthetic vapors. We prepared our calibration gases by mixing a gravimetrically calibrated amount of liquid agent with a constant gas flow. RESULTS: The refractive indices for the volatile anesthetic vapors are 1,603.2 for halothane, 1,540.4 for enflurane, 1,563.3 for isoflurane, 1,538.3 for sevoflurane, and 1,211.7 for desflurane. The maximum theoretical error in our measurements, due to all sensors and all uncertainty in our measurement of apparatus and physical constants, is +/- 0.56% of the reading (+/- 0.70% for desflurane). CONCLUSIONS: If refractometry replaced calibration gases in cylinders, as a calibration standard, manufacturers might avoid errors that now occur because calibration gases manufactured by numerous companies seem to differ. We propose that our values serve as an interim database.