Monitoring neuromuscular blockade

A simple and inexpensive force transducer made from a stainless steel table knife is described. Construction is straightforward and utilises strain gauges that are readily available. Amongst its attributes are lightness, ease of application, low sensitivity to postural changes and linearity over extended periods of time.     

ABDOMINAL WOUND PERFUSION FOR THE RELIEF OF POSTOPERATIVE PAIN

In a double-blind trial, 50 patients with subcostal incisionsperformed for cholecystectomy or splenectomy, received 10 mlofeither 0. 5% bupi-vacaine plain or physiological saline twicedaily by woundperfusion through an indwelling drainage tubefor 3 days after operation. Analgesia, assessed by visual analoguescore (VAS) and forced vital capacity (FVC), was significantlyimproved after perfusion with bupivacaine. Perfusion with physiologicalsaline produced an analgesic effect comparable to that of bupivacaineas indicated by improvement in VAS. There was, however, no improvementin FVC, and opioid requirements were greater, in the patientswhose wounds had been perfused with saline. ^*Department of Anaesthetics, Royal Infirmary, Edinburgh. Plastic Surgery Unit, Canniesburn Hospital, Glasgow.     

DOES INJECTION OF NON-DEPOLARIZING NEUROMUSCULAR BLOCKERS BEFORE THIOPENTONE AFFECT THEIR SPEED OF ONSET?: A Study of Tubocurarine and Vecuronium

In an open sequential pharmacodynamic study in 40 patients,the rate of onset of neuromuscular blockade using tubocurarineor vecuronium was measured. Comparison was made between groupsof 10 patients who received thiopentone followed by either blockerand a "reverse" sequence where the blocker was injected beforethiopentone. There was a small difference between groups, amountingto a few seconds in rate of onset of block, but this was notsuggestive of a systematic effect of the drug sequence.     

SINGLE-SHOT I.V. ANAESTHESIA FOR OUTPATIENT DENTAL SURGERY: Comparison of 2, 6 Di-isopropyl Phenol and Methohexitone

A single i.v. bolus dose of propofol 3 mg kg^–1 was comparedwith methohexitone 2 mg kg^–1 as the sole anaesthetic agentfor simple dental extraction in outpatients. Induction of anaesthesiawas smoother with propofol, with a lower incidence of excitatoryphenomena. Pain on injection was a common complication of bothdrugs and related to the site of injection. The Leeds PsychomotorTester was used to assess psychomotor performance during therecovery. Rate of recovery from anaesthesia was similar withboth agents, and there was little residual impairment of psychomotorfunction 40 min after induction.