[Etiology and management of dysrhythmia during general anaesthesia]

As a result of our study, we came to the conclusion that: the major causes of dysrhythmias are: Irritation of the larynx when anaesthesia is not deep enough, inadequate oxygenation and accumulation of CO2. As preventive measures: premedication, spraying the larynx with local analgesia, adequate oxygenation and elimination CO2 are suggested. Finally monitoring is essential for early detection of dysrhythmias and proper and swift confrontation

[Clinical trials on new non-depolarizing muscle relaxant: pipecuronium bromide]

Fifty patients of both sexes, with ages ranging from / 30 - 70 / years, received an initial single dose of 4 mg pipecuronium bromide, topped up in pxolong operation with [50%] as a repeated dose, following induction with thiopentone -suxamethonium and endotracheal intubation. Anaesthesia was maintained with a mixture of nitrous oxide and oxygen, supplemented with [0.5%] halothan and controlled ventilation. - The onset of action is observed through cessation of respiration, the duration and the depth of relaxation are controlled using the measurement of the isometric single twitch of the adductor policis muscle in response to 0.2 HZ. - The changes in circulation and cardiac rythm are followed through continuous monitoring of EGG using leas II and heart rate, with interrupted recording of FCG, every 2,5, and 10 minutes after injection of pipecuronium, with measurement of systolic and diastolic blood pressure every five minutes using Riva Rocci apparatus. - The results of our study revealed that: the onset of action is round 40 seconds, the average duration 43 minutes, antagonization unevenful with minor and statistically insignificant fluctuation in heart rate and blood pressure with no change at all or in cardiacly normal patients. The reverse occurred in cardiac patients, where dysrythmia occurred or exacerbated during induction, disappeared, and normal rythm is reestablished / 2 - 10 / minutes following injection of pipecuronium. - It is concluded that pipecuronium bromide is another / steroid derivation and competitive muscle relaxant. - We noticed the stabilizing effect on circulation and cardiac rythm, which makes pipecuronium the relaxatnt of choice for patients with ischemic heart disease and the disturbances of circulation