No abstract

Summary We present a case of delayed haemolytic transfusion reaction and hyperhaemolysis syndrome in a patient with sickle cell disease. A 32‐year‐old woman with a history of sickle cell disease was scheduled for total hip replacement. She was transfused pre‐operatively and suffered a delayed haemolytic transfusion reaction. Postoperatively the patient continued to haemolyse, despite the use of antigen compatible blood, suggesting that she had developed hyperhaemolysis syndrome following her delayed haemolytic transfusion reaction. Although rare, both conditions must be borne in mind when dealing with patients who have undergone multiple transfusions.

The cardiovascular effects of thiopentone 3 mg kg-1 and midazolam 0.3 mg kg-1 were observed during induction of anaesthesia in 16 premedicated patients about to undergo myocardial revascularization. There were no significant changes in either group in cardiac output or central venous pressure. The heart rate in both groups showed an increase at 3 min and thereafter returned to control values. After 3 min, there was a significant decrease in both arterial pressure and peripheral resistance by 12% and 15% (mean values) respectively from control values in the group receiving midazolam, whereas after thiopentone the peripheral resistance increased by approximately 13% and was not affected by a further dose of thiopentone 1 mg kg-1.

Intravenous midazolam and diazepam have been compared as sedatives during surgery pevormed under local anaesthesia. Satisfactory conditions were produced by both drugs. No dwference was detected in the rate of recovery, but a highly significant greater degree of amnesia followed the use of midarolam.