The influence of hypothermia (surface cooling) on the time-course of action and on the pharmacokinetics of rocuronium in humans.

Hypothermia prolongs the time-course of action of non-depolarizing neuromuscular blocking agents. The mechanism, however, is unknown. We studied the influence of hypothermia (by surface cooling, nasopharyngeal temperature < or = 31 degrees C) on the time-course of action and on the pharmacokinetics of rocuronium in humans.

Somatosensory evoked potentials in cerebral aneurysm surgery.

Monitoring of median nerve somatosensory evoked potentials (SSEP) during surgery for a basilar artery aneurysm under moderate hypothermia revealed an unexpected loss of the first cortical peak. This was due to compression of the middle cerebral artery under the retractor during the surgical approach to the aneurysm and would have continued unnoticed for some time in the absence of monitoring, possibly resulting in infarction in the territory of the middle cerebral artery. When the surgeon was alerted the artery was released and the evoked potential returned within about 24 min.

Evaluation of results of temporal bone resection.

The results of 16 cases of temporal bone resection were evaluated. The resections, 12 of which were total and 4 partial, had mostly been performed for squamous cell carcinoma invading the temporal bone. Five patients in whom the intervention was considered radical and not followed by irradiation, were alive and well 9 years or more later.

Evoked potential monitoring and temporary clipping in cerebral aneurysm surgery.

Temporary occlusion of the parent artery greatly facilitates the dissection of large cerebral aneurysms, while much reducing the risk of intraoperative rupture and avoiding the use of profound arterial hypotension. Intraoperative somatosensory evoked potential (SEP) monitoring was carried out in 25 aneurysm cases where temporary clipping was employed electively under moderate hypothermia. Occlusion times ranged from 6.