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We found that preoperative beta-blockade during combined general anaesthesia and high thoracic epidural blockade stabilised perioperative HR and CI and decreased total oxygen consumption.

Plasma glyceryl trinitrate (GTN) concentration was studied in 12 volunteers producing gun powder. Serial blood samples were obtained from the cubital vein before and during work at two sites of production; high concentrations of GTN were detected in the plasma. Control specimens from a femoral vein contained much less GTN, indicating that blood in the cubital vein was enriched by dermally absorbed GTN. In the roll mill area concentrations of GTN in the cubital vein were higher than in the press area, but individual factors were also important since some workers consistently had higher concentration of GTN than others. Differences in absorption were more important than differences in the metabolism of GTN since only a small variation in disappearance rate was found after a sublingual test dose of GTN. Moderate changes in pulse rate and blood pressure were noted during the day. The major discomfort experienced was a headache that increased during working hours, but this was not significantly related to GTN concentrations in the air or in the blood from the cubital vein. The observations imply that major efforts should be made to reduce dermal contact with GTN during production work.

Ninety-five patients with 122 legs with a systolic blood pressure on the big toe below 30 mmHg were the subject of arterial reconstructive surgery. Investigating the limb survival rate we found the systolic blood pressure on the big toe to be the most important predictor, whereas there was found no predictive value of the ankle pressure/index. Preoperative clinical symptoms, which are closely related to the digital blood pressure, were significant predictors of the limb survival rate: the low-pressure limb with no symptoms or intermittent claudication had a significantly higher survival rate than the limb with rest pain and/or gangrene. Following arterial reconstructive surgery the social fate of patients with threatened legs was fairly good as 83% became fully independent.

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