The decision to use rFVIIa resulted from a more profound haemorrhage. We did not gain any evidence to extend the use of rFVIIa into less severe cases of PPH. Furthermore, this policy would result in a profound increase in the overall costs of the treatment. Randomized placebo-controlled trials are urgently needed to optimize the use of rFVIIa in obstetric haemorrhage.

A low-dose (4 mg), low-volume (0.8 mL), low-flow (2 min) technique with hyperbaric bupivacaine toward the dependent side oriented injection and maintenance of the lateral decubitus position for 10 min produced selective spinal anesthesia with rapid recession of motor block and early discharge home.

The effects of diazepam and thiopental on voluntary saccades and pursuit eye movements were tested in 9 volunteers, with an interval of at least 2 weeks between tests. One, 4 and 8 h after intravenous injection of diazepam (0.3 mg/kg) or thiopental (6.0 mg/kg), voluntary saccades and pursuit eye movements were tested and blood samples taken for analysis of drug concentration. As compared to results of tests without drugs, a significant reduction both of saccadic peak velocity and gain of pursuit eye movements was found 1 h after injection of either drug, but not after 4 and 8 h. The amplitude of saccades elicited with the 60 degrees stimulus was significantly reduced 1 h after injection of diazepam. Latency of saccades increased significantly up to 4 h after injection of either drug. No significant correlation was found between peak velocity of saccades and blood concentration of either thiopental or diazepam 1 h after administration. The present results confirm that in man saccades and pursuit eye movements are reduced by benzodiazepines and barbiturates, but provide no support for the previously described efficacy of saccades in monitoring the effect of benzodiazepines. It is hypothesized that diazepam and thiopental also induce reduction of voluntary saccades and pursuit eye movements via a general sedation of the central nervous system (CNS), besides having specific effects on CNS structures important to the performance of voluntary eye movements.

Six healthy male subjects were given in a crossover fashion medium molecular weight (HES 125) and low molecular weight (HES 40) hydroxyethyl starch, dextran, and balanced salt solution by intravenous infusion. The plasma volumes were determined using labeled albumin and plasma protein measurements. Three properties of factor VIII protein complex and indices of blood coagulation and hemostasis were measured before and after the infusions. Both the salt solution and HES 40 increased plasma volume, but their effect wore off within 3 hours. Dextran and HES 125 increased plasma volume significantly (P less than 0.001) more than the salt solution did, and the expansion was maintained for 24 hours. Plasma volume increases (dextran and HES 125) were associated with high nonglucose carbohydrate levels in plasma and low levels in urine. No or slight increases in plasma volumes (HES 40), on the other hand, were associated with low and high carbohydrate levels in plasma and urine, respectively. Serum alpha-amylase activity increased significantly after both HES preparations as compared to salt solution. Dextran and HES 125 decreased all the three values of factor VIII, these decreases being maximal 3 to 6 hours after administration and highest (about 25 per cent) for F VIII R:Ag and F VIII R:cof. It is concluded that HES 125 and dextran are equally effective plasma expanders.

No abstract