A total of 120 patients who were all anaesthetized for more than 90 minutes were given eye protection with paraffin-based oculentum simplex, Ph. Nord. 63, in one eye, and water-based four per cent methylcellulose in the other. Anaesthesia was conducted with halothane, or thiopentone an meperidine, or by a neurolept technique. Peri-ocular oedema and reaction in the conjunctiva resembling conjunctivitis was less pronounced after methylcellulose. When both paraffin-based ointment and halothane anaesthesia were used, there were signs of drug interaction, as the patients' conjunctivae were now distinctly red. In all three types of anaesthesia, methylcellulose produces a firm gluing of the eyelids with the result that the eye is not dried out and the eye is protected mechanically so that foreign bodies and corneal abrasions are avoided. There were no untoward effects of methylcellulose. It is concluded that methylcellulose four per cent provides better eye protection than paraffin during general anaesthesia.
In a double blind trial 47 anaesthetized patients were given eye protection with the paraffin-based neutral eye ointment Ph. Nord. 63 in one eye and the water-based Methyl cellulose (MC) 4% in the other. Twenty-four hours later the eyes were vital-stained with rose bengal/fluorescein. No unintended effects of the ointments were found and no injury to the eyes were seen. Compared with the paraffin-based ointment the MC ointment produced a more firm adhesion of the eyelids. A water-based 4% MC ointment is therefore as alternative to the fat-based neutral eye ointment.
The volume and pH of gastric contents aspirated prior to anaesthesia were measured in 101 children admitted for emergency surgery. The children were aged between 3 months and 15 years. If we define potential patients at risk by means of the volume and pH of the gastric contents, then 50.0% of the children were at risk of aspiration into the lungs. The number of patients at risk was higher in children aged between 6 and 10 years. There was almost the same risk in the groups with abdominal-, urogenital-, and orthopaedic diseases, while the number of patients at risk was less in the group with superficial lesions. The length of fasting time in the child considerably influenced the volume of gastric contents in emergency surgical cases. It is concluded that in children admitted for emergency surgery there is a risk of aspiration of gastric contents into the lungs. The risk is reduced by preanaesthetic fasting. All children admitted for emergency surgery must be carefully evaluated prior to anaesthesia with special reference to gastric aspiration.
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