BRITISH JOURNAL OF ANAESTHESIA
1030
Pierson, D. J., Iseman, M. D., Sutton, F. D., and Zwillich, C. W. (1974). Arterial blood-gas changes in fiberoptic bronchoscopy during mechanical ventilation. Chest, 66, 495.
typical fasciculations following the administration of suxamethonium 1 mg/kg body weight i.v. Thus it appears that (concerning the presence of atypical cholinesterase) the statement "the appearance of fasciculations excludes the presence of this abnormality" (Baraka, 1975) is not valid. J. VlBY MOGENSEN
PRESENCE OF SUXAMETHONIUM FASCICULATTONS I N PATIENTS WITH ATYPICAL PLASMA CHOLINESTERASE
Sir,—I should like to comment on the question of muscle fasciculations following suxamethonium in patients with atypical plasma cholinesterase (Baraka, 1975; Hunter, 1975; Feldman, 1976; Hughes, 1976). The establishment of a Danish Cholinesterase Research Unit in 1973, to which all cases of prolonged apnoea in Denmark are reported, has given me the opportunity to anaesthetize eight patients heterozygous for the normal and atypical enzyme (group 1), four patients homozygous for the atypical enzyme (group 2) and one patient heterozygous for the atypical and fluoride-resistant enzyme (group 3). All the patients were anaesthetized with halothane, nitrous oxide and oxygen. Four patients in group 1, two patients in group 2 and the one patient in group 3 showed
Herlev, Denmark REFERENCES
Baraka, A. (1975). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 47,419. Feldman, S. (1976). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 48, 503. Hughes, R. (1976). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 48, 504. Hunter, J. M. (1975). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 47, 1340.
Downloaded from http://bja.oxfordjournals.org/ at Indiana University Library on July 23, 2015
FIG. 1. Catheter inflation equipment attached to fibreoptic bronchoscope.
When rapid, reliable, sedative cover is needed.
The gentle persuaderIntravenous Valium Roche For minor surgery and unpleasant diagnostic and therapeutic procedures an intravenous injection of Valium Roche gives rapid sedation and relief of anxiety with useful muscle relaxation.
Dosage can be adjusted to individual needs by observing the development of ptosis. Keep intravenous Valiwn Roche in mind— and at hand. Valium is the trade mark for Roche pharmaceutical preparation!, containing diazepam. Full prescribing information is available. Roche Products Limited, IX) Box 2LE, 15 Manchester Square, London VC'tA 2LE.
Canad.Anaesth.Soc.J.,l97i,;tf,i66 Bnt.J.Anaesth.,1973,45,1150 Pract1t10neM973.iU.805 Dundee, J. W., and Vfyant. G M , "Intravenous Anaesthesia," Churchill Livingstone, Edinburgh and I-oncUm. 1974
Downloaded from http://bja.oxfordjournals.org/ at Indiana University Library on July 23, 2015
Whilst pleasantly relaxed the patient remains arousable and co-operative. Amnesia for the event is a further advantage.
LIVERPOOL SOCIETY OF ANAESTHETISTS
CANADIAN ANAESTHETISTS' SOCIETY JOURNAL
Editor R. A. GORDON Assistant Editor: GORDON WYANT
Editorial Board MARCEL BOULANGER A. W. CONN RAYNALD DERY KENNETH M. LEIGHTON BERNARD PAIEMENT
The Journal is issued bi-monthly for members of the Society and Subscribers. It contains original articles and reviews on clinical and basic science subjects related to Anaesthesia. Annual Subscription $20.00 post paid (effective July 1, 1975) The Secretary Canadian Anaesthetists' Society 178 St. George Street, Toronto M5R 2M7, Ontario, Canada
Downloaded from http://bja.oxfordjournals.org/ at Indiana University Library on July 23, 2015
Programme for Session 1976-77 Friday, 22nd October 1976, at 7.30 p.m. Postgraduate Centre, Walton Hospital. "An Evening with Dr William McConnell". Thursday, 25th November 1976, at 8 p.m. Joint Meeting with Liverpool Medical Institution at the Liverpool Medical Institution. Symposium on "Disaster Planning", Mr P. A. Freeman, Dr D. G. Nancekievill and Professor Andrew Semple. Friday, 14th January 1977, at 8 p.m. Liverpool Medical Institution. "The Risks to the Surgical Patient with Hypertension and Ischaemic Heart Disease". Professor Cedric Prys Roberts. Friday, 18th February 1977, at 8 p.m. Liverpool Medical Institution. Papers for the Society's Registrar Prize. Friday, 25th March 1977, at 8 p.m. Liverpool Medical Institution. Combined Meeting with the Anaesthetic Section of the Manchester Medical Society. Friday, 29th April 1977, at 8 p.m. Liverpool Medical Institution. 45th Annual General Meeting. Presidential Address: Dr Sampson Lipton. Hon. Secretary: Dr T. H. L. BRYSON Liverpool Maternity Hospital, Oxford Street, LIVERPOOL 7 Tel.: 051-709 5533
1030
Pierson, D. J., Iseman, M. D., Sutton, F. D., and Zwillich, C. W. (1974). Arterial blood-gas changes in fiberoptic bronchoscopy during mechanical ventilation. Chest, 66, 495.
typical fasciculations following the administration of suxamethonium 1 mg/kg body weight i.v. Thus it appears that (concerning the presence of atypical cholinesterase) the statement "the appearance of fasciculations excludes the presence of this abnormality" (Baraka, 1975) is not valid. J. VlBY MOGENSEN
PRESENCE OF SUXAMETHONIUM FASCICULATTONS I N PATIENTS WITH ATYPICAL PLASMA CHOLINESTERASE
Sir,—I should like to comment on the question of muscle fasciculations following suxamethonium in patients with atypical plasma cholinesterase (Baraka, 1975; Hunter, 1975; Feldman, 1976; Hughes, 1976). The establishment of a Danish Cholinesterase Research Unit in 1973, to which all cases of prolonged apnoea in Denmark are reported, has given me the opportunity to anaesthetize eight patients heterozygous for the normal and atypical enzyme (group 1), four patients homozygous for the atypical enzyme (group 2) and one patient heterozygous for the atypical and fluoride-resistant enzyme (group 3). All the patients were anaesthetized with halothane, nitrous oxide and oxygen. Four patients in group 1, two patients in group 2 and the one patient in group 3 showed
Herlev, Denmark REFERENCES
Baraka, A. (1975). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 47,419. Feldman, S. (1976). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 48, 503. Hughes, R. (1976). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 48, 504. Hunter, J. M. (1975). Absence of suxamethonium fasciculations in patients with atypical plasma cholinesterase. Br.J. Anaesth., 47, 1340.
Downloaded from http://bja.oxfordjournals.org/ at Indiana University Library on July 23, 2015
FIG. 1. Catheter inflation equipment attached to fibreoptic bronchoscope.
When rapid, reliable, sedative cover is needed.
The gentle persuaderIntravenous Valium Roche For minor surgery and unpleasant diagnostic and therapeutic procedures an intravenous injection of Valium Roche gives rapid sedation and relief of anxiety with useful muscle relaxation.
Dosage can be adjusted to individual needs by observing the development of ptosis. Keep intravenous Valiwn Roche in mind— and at hand. Valium is the trade mark for Roche pharmaceutical preparation!, containing diazepam. Full prescribing information is available. Roche Products Limited, IX) Box 2LE, 15 Manchester Square, London VC'tA 2LE.
Canad.Anaesth.Soc.J.,l97i,;tf,i66 Bnt.J.Anaesth.,1973,45,1150 Pract1t10neM973.iU.805 Dundee, J. W., and Vfyant. G M , "Intravenous Anaesthesia," Churchill Livingstone, Edinburgh and I-oncUm. 1974
Downloaded from http://bja.oxfordjournals.org/ at Indiana University Library on July 23, 2015
Whilst pleasantly relaxed the patient remains arousable and co-operative. Amnesia for the event is a further advantage.
LIVERPOOL SOCIETY OF ANAESTHETISTS
CANADIAN ANAESTHETISTS' SOCIETY JOURNAL
Editor R. A. GORDON Assistant Editor: GORDON WYANT
Editorial Board MARCEL BOULANGER A. W. CONN RAYNALD DERY KENNETH M. LEIGHTON BERNARD PAIEMENT
The Journal is issued bi-monthly for members of the Society and Subscribers. It contains original articles and reviews on clinical and basic science subjects related to Anaesthesia. Annual Subscription $20.00 post paid (effective July 1, 1975) The Secretary Canadian Anaesthetists' Society 178 St. George Street, Toronto M5R 2M7, Ontario, Canada
Downloaded from http://bja.oxfordjournals.org/ at Indiana University Library on July 23, 2015
Programme for Session 1976-77 Friday, 22nd October 1976, at 7.30 p.m. Postgraduate Centre, Walton Hospital. "An Evening with Dr William McConnell". Thursday, 25th November 1976, at 8 p.m. Joint Meeting with Liverpool Medical Institution at the Liverpool Medical Institution. Symposium on "Disaster Planning", Mr P. A. Freeman, Dr D. G. Nancekievill and Professor Andrew Semple. Friday, 14th January 1977, at 8 p.m. Liverpool Medical Institution. "The Risks to the Surgical Patient with Hypertension and Ischaemic Heart Disease". Professor Cedric Prys Roberts. Friday, 18th February 1977, at 8 p.m. Liverpool Medical Institution. Papers for the Society's Registrar Prize. Friday, 25th March 1977, at 8 p.m. Liverpool Medical Institution. Combined Meeting with the Anaesthetic Section of the Manchester Medical Society. Friday, 29th April 1977, at 8 p.m. Liverpool Medical Institution. 45th Annual General Meeting. Presidential Address: Dr Sampson Lipton. Hon. Secretary: Dr T. H. L. BRYSON Liverpool Maternity Hospital, Oxford Street, LIVERPOOL 7 Tel.: 051-709 5533
