Modified Mallampati test, thyromental distance and inter-incisor gap are the best predictors of difficult laryngoscopy in West Africans.

Purpose: To determine the ability to predict difficult visualization of the larynx (DVL) from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test (MMT), thyromental distance (TMD), sternomental distance (SMD), horizontal length of the mandible (HLM) and inter-incisor gap (IIG).

Methods: Three hundred and eighty consecutive patients undergoing general anesthesia were evaluated using the MMT, TMD, SMD, HLM and IIG and the cut-off points for the airway predictors were Mallampati III and IV; < or = 6.5 cm, < or = 13.

Open comparative study of the efficacy, safety and tolerability of midazolam versus thiopental in induction and maintenance of anaesthesia.

In a multicentre study, 145 adult Nigerian patients presenting with diverse conditions (falling into ASA1 or ASA2 classification) for short surgical procedures (< 1 hour) were given either midazolam (0.15-0.20 mg/kg) or thiopentone (4-6 mg/kg) intravenously for induction of anaesthesia.

Nitrous oxide scarcity--a spur to innovation.

For two years in succession, Lagos University Teaching Hospital witnessed scarcity of Nitrous Oxide in the early two months of the year. The anaesthetic technique changed and the volume of work fell the first time scarcity was experienced. The second time, it led to innovation and diversification of anaesthetic techniques.

Experience with intrathecal cold saline injection in the treatment of cancer pain in the Lagos University Teaching Hospital.

Effective control of terminal cancer pain is usually associated with a higher incidence of toxicities or complications. Intrathecal injection of cold normal saline offers a good option. It is easy to perform, provides good pain-relief, is cost effective, and is well accepted by patients.

Effect of suxamethonium, pancuronium, neostigmine and halothane on serum cholinesterase activity.

Serum cholinesterase (Ch E) estimations were done in 30 healthy Nigerians scheduled for elective surgical procedures and were studied in two groups. Half of the patients were given general anesthesia using a muscle relaxant technique and the other half had halothane as the main anesthetic. Suxamethonium reduced Ch E by 9%, pancuronium by 25% and neostigmine by 58% compared to preinduction levels.

Effect of anaesthesia and surgery on blood sugar and carbohydrate tolerance in African children.

The effect of pre-operative starvation, anaesthesia and surgery on blood sugar levels and the handling of carbohydrate load during operation were studied in 28 Nigerian children between 2 months and 15 years of age. (1) Age and body weight were important factors influencing the relationship between duration of pre-operative fast and the pre-induction blood sugar level in children. Hypoglycaemic values occurred in 7 per cent of the subjects studied although none was clinically hypoglycaemic.

The effect of splenectomy on circulatory adjustments to hypoxaemia in the anaesthetized dog.

Six intact and seven splenectomized dogs were subjected to a similar degree of hypoxaemia while under light anaesthesia and artificial ventilation. In the intact animals, heart rate, cardiac output, myocardial contractility and oxygen consumption were increased as a result of hypoxaemia; oxygen transport was not affected. In the splenectomized animals the changes in cardiac output and myocardial contractility were small, and oxygen availability was decreased.