ABSTRACT
Measurements of complement conversion and white cell variations were made on sequential blood samples obtained from a single volunteer following repeated administration of Althesin. The results suggest a mechanism by which a clinically significant hypersensitivity reaction to the drug might be mediated. Studies of patients receiving routine anaesthesia revealed a very high incidence of subclinical "hypersensitivity" reaction, some of which appear to be immune-mediated. These reactions occurred irrespective of whether the patients were induced with Althesin, methohexitone or propanidid.
Subject(s)
Alfaxalone Alfadolone Mixture/adverse effects , Drug Hypersensitivity/etiology , Pregnanediones/adverse effects , Adult , Clinical Trials as Topic , Complement C3/analysis , Complement C4/analysis , Humans , Leukocyte Count , Lymphocyte Activation , MaleABSTRACT
It is not possible to distinguish between direct pharmacological effects and immune-mediated hypersensitivity reactions by clinical observation alone and errors may occur in the absence of laboratory tests. A convenient and simple test is the measurement of plasma complement C3 consumption and conversion in sequential blood samples taken at intervals over the 24 h following an adverse response.
Subject(s)
Anesthesia, Intravenous/adverse effects , Drug Hypersensitivity/etiology , Alfaxalone Alfadolone Mixture/adverse effects , Complement C3/analysis , Drug Hypersensitivity/immunology , Humans , Immunoglobulin G/analysisABSTRACT
The relatives of a patient who died from malignant hyperpyrexia were examined clinically and biochemically. One fo the deceased's children, an identical twin, undergoing an anesthetic, was found to develop malignant hyperpyrexia on exposure to nitrous oxide. The creatine phosphokinase concentrations in this family were unhelpful as a method of identifying susceptible individuals.
Subject(s)
Malignant Hyperthermia/genetics , Adolescent , Adult , Aged , Anesthesia/adverse effects , Child , Child, Preschool , Creatine Kinase/analysis , Female , Humans , Infant , Male , Malignant Hyperthermia/chemically induced , Malignant Hyperthermia/metabolism , Middle Aged , Nitrous Oxide/adverse effects , PedigreeSubject(s)
Malignant Hyperthermia/chemically induced , Nitrous Oxide/adverse effects , Biopsy , Child , Dexamethasone/therapeutic use , Female , Humans , Malignant Hyperthermia/diagnosis , Malignant Hyperthermia/drug therapy , Malignant Hyperthermia/genetics , Malignant Hyperthermia/pathology , Muscles/pathologyABSTRACT
Carbonated bupivacaine, plain bupivacaine hydrochloride, and bupivacaine hydrochloride with adrenaline were used to provide epidural analgesia for patients undergoing vaginal hysterectomy. Following injection to the blood concentrations of bupivacaine were measured at intervals over a period of 30 minutes. All three preparations produced satisfactory analgesia at a bupivacaine dose of 1.5 mg/kg body weight. The highest group mean blood concentrations were just outside the toxic dose range. Carbonated bupivacaine was absorbed most rapidly producing significantly higher blood concentrations up to 12 minutes after injection.
