No abstract

MvsctrzA~ HYPEr~,CrlWTY during recovery from general anaesthesia variously termed "spasticity, .... shivering," and "shakes," has been described by several authors and has been particularly related to halothane. 1~ Several mechanisms have been suggested in explanation including heat loss, t respiratory alkalosis, a early recovery of spinal reflex activity) at~d sympathetic overactivity. 7 The reported incidence varies from 5 per cent to 70 per cent a.s and this suggests that perhaps different phenomena are being described. Having noticed that some patients seemed to show true shivering whilst others showed intense muscular spasticity during emergence from general anaesthesia, this study was designed to try to elucidate whether there were, indeed, two distinct phenomena, what was their incidence, and whether they were specifically i~lated to halothane anaesthesia. Spasticity was defined as sustained muscular hypertonieity most easily observed in jaw, neck and pectoral muscles, flexors of the upper limbs, and extensors and adductors of the lower limbs. Shivering, on the other hand, was a rhythmic contraction of muscle groups with irregular intermittent periods of relaxation.

No abstract

We have presented three patients with epiglottitis who developed pulmonary oedema during the course of treatment with nasotracheal intubation and antibiotics. The exact mechanism for the development of pulmonary oedema in these patients is not known. Possible mechnisms are changed in the physical factors controlling the movement of fluids across the capillary-alveolar membrane, transitory bacteraemia and endotoxinaemia, or myocardial depression by the antibiotics and the anaesthetic agent. The pulmonary oedema had a benign course and responded to mechanical ventilation and increased airway pressure.