SummaryInspiratory and expiratory tidal volume, peak and plateau airway pressure, compliance of the respiratory system, pressurevolume and jow-volume loops were monitored continuously and recorded in seven women undergoing laparoscopy with carbon dioxide insujflation to an intra-abdominal pressure of 1.6 k Pa. AN patients were anaesthetised using a total intravenous technique and a constant minute ventilation was maintained. Peak airway and plateau airway pressures increased by 50% and 81% respectively, whilst the compliance of the respiratory system decreased by 47% during the period of increased intra-abdominal pressure. Following release of the pneumoperitoneum, peak and plateau pressures remained elevated by 37% and 27% respectively, and the compliance was 86% of the pre-insuflation value. On-line monitoring of respiratory volumes, pressures and compliance may be helpful during general anaesthesia for laparoscopic procedures to avoid the potential harmful effects of increased airway pressures occurring with increased intra-abdominal pressure.

No abstract

SummaryThe efficacy and safety of ondansetron in preventing postoperative nausea and vomiting.fol1owing Postoperative nausea and vomiting are complications in 20% to 40% of general anaesthesia cases [I]. Women undergoing gynaecological surgery are particularly at risk of experiencing these problems. In the absence of any antiemetic treatment, the incidence of nausea and vomiting after gynaecological surgery can range from 58% to 80% [2, 31. Ondansetron is a selective antagonist of 5-hydroxytryptamine type 3 (5HTJ receptors, with little or no clinically relevant effects on dopamine or other receptors. Initial studies in the guinea-pig [4] showed that a dose of 0.001 mg.kg-l given by intraperitoneal injection had a positive effect on gastric kinetics equivalent to that of 5 mg.kg-' metoclopramide. Furthermore, ondansetron is an effective antiemetic in patients receiving cancer chemotherapy [5, 61 or radiotherapy [7].Recent studies have evaluated the efficacy of intravenously administered ondansetron 8 mg in the prevention and treatment of postoperative nausea [8-1 I], and also orally administered ondansetron 16 mg in the prevention of postoperative nausea and vomiting [12].In this present study, the antiemetic effect of ondansetron in the prevention of postoperative nausea and vomiting was investigated in patients undergoing major gynaecological surgery.

In our group of young ASA I/II patients, in the absence of any noxious stimulus, no implicit or explicit memory was found when the calculated concentration of propofol using a Diprifusor was maintained at the level associated with LOC.

Flow-volume and pressure-volume loops were measured with continuous spirometry in 49 patients in whom the trachea was intubated "blindly" with a double-lumen endobronchial tube for thoracic surgery. Nineteen endobronchial tubes were malpositioned by fibreoptic bronchoscopic criteria; 63% of these were suspected because of the configuration of the spirometric loops. During positioning of the patient and during operation, 34.7% of the endobronchial tubes migrated from the initially correct or corrected position. The secondary displacements were identified by abnormal loop configurations and confirmed with fibreoptic bronchoscopy. Continuous spirometric monitoring is helpful in detecting endobronchial tube displacement during intubation and surgery.