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Anesthesia for Infants and Children (3rd edition)
BRITISH JOURNAL OF ANAESTHESIA
964
E F F E T D E STIMULATION RESPIRATOIRE D E LA MORPHINE CHEZ L'HOMME SOMMAIRE
Une dose intra-veineuse de 10 mg de sulfate de morphine par 70 kg a provoque une stimulation
immediate de la respiration chez 2 homines sur 8 sujets norrnaux. Chez l'un des deux la depression respiratoire suivit en moins de 15 minutes; chez Pautre un certain degr£ d'hyperventilation existait encore apres 2 heures malgre une irregularity respiratoire analogue a celle qui accompagna l'hypoventilation chez les autres sujets.
MORPHIN ALS RESPIRATORISCH STIMULIERENDES AGENS BEIM MENSCHEN ZUSAMMENFASSUNG
Eine intravenos verabreichte Dosis von 10 mg Morphinsulfat/70 kg Korpergewicht verursachte bei zwei der acht normalen Versuchspersonen eine sofort einsetzende Stimulierung der Atmung, der bei einer der beiden Personen innerhalb von 15 Minuten eine Atemdepression folgte, bei der anderen bestand noch nach zwei Stunden ein gewisser Grad von Hyperventilation, obwohl es zu Unregelmafiigkeiten der Atmung kam, die den die Hypoventilation bei den anderen Versuchspersonen begleitenden Storungen des Atemrhythmus ahnlich waren.
BOOK REVIEW Anesthesia for Infants and Children (3rd edition). By Robert M. Smith. Published by C. V. Mosby Co., St. Louis. Pp. 530; 240 illus.; indexed Price 1 5 7 J . 6d. This is the third edition of this important textbook of paediatric anaesthesia within ten years and reflects the changes that have taken place since the second edition was published five years ago. The presentation of this edition differs only slightly from the previous edition and maintains the excellent standard of production. The total number of pages has risen by over one-sixth and now numbers 530, so that this book must still be regarded as the most comprehensive work of this specialty. Only three chapters have been retitled and, not unexpectedly, greater space has been allocated to the diagnosis and treatment in respiratory emergencies and oxygen and respiratory therapy. The chapters that have increased most significantly are those dealing with "Respiratory physiology in infants and children" by Drs. Cook and Motoyama, "Use of muscle relaxants", "Anesthesia for infants under one year of age" and "Anesthesia for thoracic surgery". Significant trends in paediatric anaesthesia have been described. The introduction of halothane has had a most influential effect in replacing other inhalational anaesthetics, though the possibility of hepatotoxic and now hypirthermic actions threaten the popularity of this agent. Partly as a result of this change in use of inhalational agents the T-piece system is deservedly b:ing more widely used than valvular apparatus both in non-breathing and absorption systems. It is encouraging to note that techniques of anaesthesia employing
muscle relaxants are being gradually more understood and appreciated, particularly in the poor-risk child undergoing cardiac surgery. The large incremental dose of tubocurarine recommended may perhaps account for some of the difficulties still encountered when using this drug. As stated in the first edition this work was intended to be a basic text that would be useful to anyone who might be called upon to give anaesthesia to an infant or child. Since that time considerable advances have been made in this field of paediatric anaesthesia and a large number of anaesthetists have been specially trained in this branch. It is perhaps, therefore, a little surprising to find that the choice of anaesthetic for the premature baby is largely limited by weight and that the three-pound infant, especially if weak and listless, is scheduled for local analgesia whilst the healthy fourpound baby is given a general anaesthetic. One might well argue that the ill premature, in particular, requires all the care the anaesthetist can give, esp«aally controlled ventilation. Indeed respiratory support with a mechanical ventilator is advised for weak infants postope ratively. Obviously any text that emanates from a department of anaesthesia in which there have been only 11 death* in 69,977 cases that might be attributed to anaesthesia entirely, or might have been precipitated by anaes-thesia (and many of these are not proven), deserves tremendous respect. The price of the book has risen by over 50 per cent, no doubt largely due to the economic difficulties under which this country is labouring. Gordon H. Bush
Downloaded from http://bja.oxfordjournals.org/ at The University of British Colombia Library on July 1, 2015
Dripps, R. D., and Comroe, J. H. (1945). Clinical studies on morphine. 1: The immediate effect of morphine administered intravenously and intramuscularly upon respiration of normal man. Anesthesiology, 6, 462. Jennett, S., Barker, J. G., and Forrest, J. B. (1968). A double-blind controlled study of the effects on respiration of pentazocine, phenoperidine and morphine in normal man. Brit. J. Anaesth., 40, 864. Reynolds, A. K., and Randall, L. O. (1957). Morphine and Allied Drugs, p. 19. University of Toronto Press. Wikler, A. (1944). Studies on the action of morphine on the central nervous system of the cat J. Pharmacol, 80, 176.
964
E F F E T D E STIMULATION RESPIRATOIRE D E LA MORPHINE CHEZ L'HOMME SOMMAIRE
Une dose intra-veineuse de 10 mg de sulfate de morphine par 70 kg a provoque une stimulation
immediate de la respiration chez 2 homines sur 8 sujets norrnaux. Chez l'un des deux la depression respiratoire suivit en moins de 15 minutes; chez Pautre un certain degr£ d'hyperventilation existait encore apres 2 heures malgre une irregularity respiratoire analogue a celle qui accompagna l'hypoventilation chez les autres sujets.
MORPHIN ALS RESPIRATORISCH STIMULIERENDES AGENS BEIM MENSCHEN ZUSAMMENFASSUNG
Eine intravenos verabreichte Dosis von 10 mg Morphinsulfat/70 kg Korpergewicht verursachte bei zwei der acht normalen Versuchspersonen eine sofort einsetzende Stimulierung der Atmung, der bei einer der beiden Personen innerhalb von 15 Minuten eine Atemdepression folgte, bei der anderen bestand noch nach zwei Stunden ein gewisser Grad von Hyperventilation, obwohl es zu Unregelmafiigkeiten der Atmung kam, die den die Hypoventilation bei den anderen Versuchspersonen begleitenden Storungen des Atemrhythmus ahnlich waren.
BOOK REVIEW Anesthesia for Infants and Children (3rd edition). By Robert M. Smith. Published by C. V. Mosby Co., St. Louis. Pp. 530; 240 illus.; indexed Price 1 5 7 J . 6d. This is the third edition of this important textbook of paediatric anaesthesia within ten years and reflects the changes that have taken place since the second edition was published five years ago. The presentation of this edition differs only slightly from the previous edition and maintains the excellent standard of production. The total number of pages has risen by over one-sixth and now numbers 530, so that this book must still be regarded as the most comprehensive work of this specialty. Only three chapters have been retitled and, not unexpectedly, greater space has been allocated to the diagnosis and treatment in respiratory emergencies and oxygen and respiratory therapy. The chapters that have increased most significantly are those dealing with "Respiratory physiology in infants and children" by Drs. Cook and Motoyama, "Use of muscle relaxants", "Anesthesia for infants under one year of age" and "Anesthesia for thoracic surgery". Significant trends in paediatric anaesthesia have been described. The introduction of halothane has had a most influential effect in replacing other inhalational anaesthetics, though the possibility of hepatotoxic and now hypirthermic actions threaten the popularity of this agent. Partly as a result of this change in use of inhalational agents the T-piece system is deservedly b:ing more widely used than valvular apparatus both in non-breathing and absorption systems. It is encouraging to note that techniques of anaesthesia employing
muscle relaxants are being gradually more understood and appreciated, particularly in the poor-risk child undergoing cardiac surgery. The large incremental dose of tubocurarine recommended may perhaps account for some of the difficulties still encountered when using this drug. As stated in the first edition this work was intended to be a basic text that would be useful to anyone who might be called upon to give anaesthesia to an infant or child. Since that time considerable advances have been made in this field of paediatric anaesthesia and a large number of anaesthetists have been specially trained in this branch. It is perhaps, therefore, a little surprising to find that the choice of anaesthetic for the premature baby is largely limited by weight and that the three-pound infant, especially if weak and listless, is scheduled for local analgesia whilst the healthy fourpound baby is given a general anaesthetic. One might well argue that the ill premature, in particular, requires all the care the anaesthetist can give, esp«aally controlled ventilation. Indeed respiratory support with a mechanical ventilator is advised for weak infants postope ratively. Obviously any text that emanates from a department of anaesthesia in which there have been only 11 death* in 69,977 cases that might be attributed to anaesthesia entirely, or might have been precipitated by anaes-thesia (and many of these are not proven), deserves tremendous respect. The price of the book has risen by over 50 per cent, no doubt largely due to the economic difficulties under which this country is labouring. Gordon H. Bush
Downloaded from http://bja.oxfordjournals.org/ at The University of British Colombia Library on July 1, 2015
Dripps, R. D., and Comroe, J. H. (1945). Clinical studies on morphine. 1: The immediate effect of morphine administered intravenously and intramuscularly upon respiration of normal man. Anesthesiology, 6, 462. Jennett, S., Barker, J. G., and Forrest, J. B. (1968). A double-blind controlled study of the effects on respiration of pentazocine, phenoperidine and morphine in normal man. Brit. J. Anaesth., 40, 864. Reynolds, A. K., and Randall, L. O. (1957). Morphine and Allied Drugs, p. 19. University of Toronto Press. Wikler, A. (1944). Studies on the action of morphine on the central nervous system of the cat J. Pharmacol, 80, 176.