A comparison of eltanolone and propofol anaesthesia for minor gynaecological surgery.

We have used eltanolone and propofol to induce anaesthesia and by intermittent injection to supplement nitrous oxide during maintenance in 67 patients undergoing minor gynaecological surgery. This study was a controlled randomized phase III with two parallel groups and a blinded assessment of post-operative recovery. Complications during induction and maintenance were few. Urticaria occurred in two patients given eltanolone and in none of those given propofol. Time to orientation and time to eye opening were significantly shorter in the propofol group (P < 0.001). Systolic and diastolic blood pressure decreased in both groups but the decrease was significantly greater in the propofol group (P < 0.005 systolic blood pressure; P < 0.001 diastolic blood pressure). Heart rate decreased significantly in the propofol group (P < 0.002). We conclude that eltanolone anaesthesia is associated with a greater haemodynamic stability than propofol anaesthesia but that early recovery occurs more slowly.

Two cases of severe postpartum anaemia in Jehovah's witnesses.

Two cases of severe postpartum anaemia are presented in Jehovah's witnesses who refused blood transfusion. Despite haemoglobin concentrations of less than 3 g/dl both women survived. General management was directed to maximizing oxygen delivery and minimizing oxygen consumption. The use of an emulsified perfluorocarbon was organized for one of the cases, but was not administered because a snow storm prevented its delivery to the hospital. In the other case, recombinant human erythropoietin was used to encourage red cell production. The recovery of haemoglobin concentration in the two cases is compared.