An evaluation of the gum elastic bougie

This study was designed to evaluate the routine use of a gum elastic bougie for tracheal intubation. The median time to intubation with the gum elastic bougie while simulating an 'epiglottis only' view was only 10 s longer than the time taken during conventional intubation with an optimum view. Three of the patients required a gum elastic bougie-assisted intubation after attempts at conventional visual intubation had failed. There was no significant difference in the incidence of postoperative sore throat and hoarseness between the two groups. We recommend that anaesthetists should use the gum elastic bougie whenever a good view of the glottis is not immediately obtained.     

A Comparison of the Acute Toxicity, Neuropathology, and Electrophysiology of N,N-Diethyl-m-toluamide and N,N-Dimethyl-2,2-diphenylacetamide in Rats

The insect repellent DEET and the structurally related herbicidediphenamid both cause ataxia associated with a spongiform myelinopathylargely confined to the cerebellar roof nuclei. This local myelinopathywas accompanied by the formation of neuronal cytoplasmic cleftsand was produced by a single dose of 1 to 3 g/kg N,N-diethyl-m-toluamide(DEET). These dose levels also produced a severe and often fatalprostration and clear electrophysiological signs of prolongedsuppressed seizure activity. Diphenamid produced an identicalmyelinopathy after doses of 0.8 to 1.5 g/kg but without thesevere prostration, suppressed seizures, or neuronal clefts.The effects of diphenamid were shown to be reversible over 3to 7 days by neuropathological, motor, and auditory evoked responseindices. Both compounds caused characteristic changes in auditoryevoked response which may be useful in clinical diagnosis. Sixother alkyl amides, two of which produce signs of CNS excitation,failed to produce myelinopathy at the maximum tolerated doses.Our findings show close parallels with a number of human casesof DEET poisoning and indicate that other amides, like diphenamid,also pose a potential hazard.