Inhaled nitric oxide does not alter pulmonary or cardiac effects of fat embolism in dogs after cemented arthroplasty.

Purpose: We examined the effect of inhaled nitric oxide (NO) on the acute pulmonary hypertension and right ventricular (RV) dilation after fat embolism.

Methods: A bilateral cemented arthroplasty (BCA), created fat embolism in 20 dogs. In Part A, 12 dogs were randomized to an NO group (n=6, inhaled NO 40 ppm before BCA and throughout the study) or a control group (n=6).

Echocardiography and excision of lipomatous hypertrophy of the interatrial septum.

We present a case of massive lipomatous hypertrophy of the interatrial septum, in which transesophageal echocardiography was used to guide surgical resection. Tissue removal was undertaken without entering either the left or right atrium, thereby obviating the need for atrial septal reconstruction.

Large pulmonary embolus without systemic hemodynamic consequences during cemented hip arthroplasty.

A case is presented in which a large embolus was detected passing through the right side of the heart during total hip arthroplasty. Although tricuspid regurgitation and an elevated right ventricular pressure resulted, there was no perturbation in systemic hemodynamics or gas exchange. The emboli detected during total hip arthroplasty are most likely composed of fat.

Relationship of fat embolism to haemodynamic and echocardiographic changes during cemented arthroplasty.

Purpose: Pressurisation of the medullary cavity during cemented arthroplasty causes "intravasation" of marrow fat. The purpose of this study was to examine the relationship between the amount of pulmonary intravascular fat and the haemodynamic and echocardiographic changes.

Methods: Anaesthetised mongrel dogs (n = 16) underwent bilateral cemented arthroplasty (BCA) to create a large embolic load.

Echocardiographic assessment of left ventricular filling during isoflurane anaesthesia.

Purpose: To determine the effect of isoflurane on left ventricular diastolic function, as assessed by Doppler echocardiography.

Methods: Ten patients with normal cardiovascular function were enrolled. Doppler measurements of mitral inflow velocities, and pulmonary venous blood flow velocities were measured preoperatively (transthoracic echocardiography), and intraoperatively (transesophageal echocardiography) at isoflurane MAC 1 and MAC 1.

An introduction to transoesophageal echocardiography: II. Clinical applications.

Purpose: As progress has been made in the acquisition of cardiac images with transoesophageal echocardiography, the technique has moved from the confines of the cardiology laboratory into the operating room, the intensive care unit, and the emergency department. This has afforded anaesthetists the opportunity to become familiar with, and develop expertise in its practice. The purpose of this article is to present a review of transoesophageal echocardiography with reference to anaesthetic practice.

Comparative evaluation of propofol and thiopentone for total intravenous anaesthesia.

Sixty unpremedicated ASA physical status I or II patients scheduled for surgical procedures of intermediate duration (15 to 60 min) were studied to evaluate the safety and efficacy of propofol, to measure recovery times and to compare the return of psychomotor and cognitive function with thiopentone. Patients were randomly allocated into two groups. Anaesthesia was induced and maintained by either propofol (2.

Comparison of alfentanil, fentanyl and enflurane as supplements to general anaesthesia for outpatient gynaecologic surgery.

We compared two narcotic/N2O anaesthetic techniques and an inhalational anaesthesia/N2O technique for outpatient surgery in 59 women undergoing short gynaecological procedures. All patients received droperidol 0.625 mg IV, thiopentone and 70 per cent N2O in O2 plus either alfentanil (15 micrograms.

Isoflurane and primary pulmonary hypertension.

Primary pulmonary hypertension is a rare and fatal disease. These patients represent an anaesthetic challenge because of the high mortality associated with the marked intra-operative increase in pulmonary vascular resistance and right ventricular decompensation. This is a first case report which demonstrates the safe and beneficial effects of isoflurane in lowering pulmonary arterial pressure and pulmonary vascular resistance in such a patient for a short surgical procedure.

A comparison of propofol and thiopentone as induction agents in outpatient surgery.

We studied 90 healthy ASA physical status I or II female patients scheduled for outpatient therapeutic abortions. Sixty patients received induction doses of propofol (2.5 mg X kg-1) and 30 patients received thiopentone (4 mg X kg-1).

Postoperative malignant hyperthermia episodes in patients who received "safe" anaesthetics.

Three cases of postoperative malignant hyperthermia (MH) episodes, after what was considered to be a "safe" anaesthetic, are described. In each case the temperature rose in a delayed fashion after an uneventful anaesthetic. Treatment included intravenous dantrolene, surface cooling and ventilation with 100 per cent oxygen.

Anesthesia for CO2 laser surgery of the larynx.

The CO2 laser is a useful surgical tool in laryngology, but adds a significant anesthetic risk because of a constant fear of fire. This paper reviews the anesthetic problems of laryngology in general - competition for the airway between surgeon and anesthetist, circulatory changes associated with laryngoscopy, and postoperative laryngospasm and edema, as well as operating room pollution together with problems unique to laser usage. If endotracheal tubes are used, they may burn, the laser may be misaligned, endotracheal cuffs may burst, and there is a constant risk of a flash fire.

Acute and chronic microsphere loss from canine left ventricular myocardium.

We determined the effects of time, type of anesthesia, and myocardial infarction on loss of radioactive microspheres averaging 9 or 15 micrometers diameter from left ventricular myocardium. The principle used to compute losses was comparison of the number of microspheres injected directly into coronary arteries to the numbers remaining in myocardium, appearing within 2-4 min in the coronary sinus, or trapped in the lungs. Losses of 9-micrometers microspheres within 2 min of injection were significantly greater for halothane (mean 6.

Anaesthesia for day-care surgery: a symposium (II). Organization of the out-patient surgical facility.

The organization of three main types of out-patient anaesthesia facility are discussed. These are the hospital unit with independent facilities, the integrated hospital unit and the independent out-patient surgical centre. The use of an out-patient facility for minor surgical procedures has been suggested as a less expensive alternative to in-patient management.

Myocardial ischemia during non-cardiac surgical procedures in patients with coronary-artery disease.

The purpose of this study was to determine the incidence of ST-segment depression during anesthesia and operation. Graded exercise testing has demonstrated a high correlation between ST-segment depression and myocardial ischemia. Therefore, 11 patients without and 29 patients with known coronary-artery disease were monitored during surgical procedures with a commercially available exercise electrocardiographic monitor (Viagraph).