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Blood Volume and Extracellular Fluid
592
BRITISH JOURNAL OF ANAESTHESIA
ALTERATIONS DE LA REACTION A LA DOULEUR SOMATIQUE ASSOCIEE A L'ANESTHESIE XXI: ALTHESIN SOMMAIRE
Des doses sousanesthesiques Althesin, (CT 1341), un nouvel anaesth£sique stjeroide, ont produit une; intensification passagere de 1'appreeciation de la douleur somatique, dont la signification clinique est improbable.
Une antanalgesie de moins courte duree a ete observee durant le retablissement apres doses elevees, qu'apres des doses comparables de thiapentone. ABWANDLUNGEN BEIM ANSPRECHEN AUF KoRPERLICHEN SCHMERZ WAHREND DER ANAESTHESIE XXI: ALTHESIAN ZUSAMMENFASSUNG
Unter der Anaesthesie-Grenze liegende Dosen von (Althesin, (CT 1341), eines neuen Steroid-Anaesthetikums, bewirkten eine voriibergehende verstarkte Empfindung korperlichen Schmerzes, der wahrscheinlich keine grosse klinische Bedeutung zukommt. Wahrend der Erholungsphase nach grossen Dosen wurde eine weniger lange Schmerzfreiheit hsobachtet als nach vergleichbaren Dosen von "Thiopentone". ALTERACIONES EN LA RESPUESTA A DOLOR SOMATICO ASOCIADO CON ANESTESIA XXI: ALTESINA RESUMEN
Dosis subanestesicas de altesina (CT 1341), un nuevo anestesico esteroideo, produjeron un incremento transitorio en la apreciaci6n de dolor somatico, que probablemente no tiene gran importancia clinica. Durante la recuperation despues de dosis elevadas fue observada una antanalgesia de duracion mas breve que despues de dosis comparables de tiopentona.
BOOK REVIEW Blood Volume and Extracellular Fluid Volume (2nd edn.). By Solomon N. Albert. American Lecture Series. Published by Charles C. Thomas, U.S.A. Pp. xxxvii + 295; illustrated. Price $16.75. Why is blood volume estimation a neglected measurement? At first sight it would appear to be simple to measure and easy to interpret. Knowledge of blood volume would appear to be important if not vital in the management of many severe disorders. Yet in spite of the availability of a number of automated machines for its rapid determination, blood volume measurement appears to be a little performed manoeuvre. A major reason for this is that even when performed with the most scrupulous technique blood volume estimations are often subject to large errors. These estimations also require the presence of a steady state, so that in the bleeding or transfused patients, where knowledge of blood volume would be of inestimable value, the methods of measurements are virtually useless. Whilst all the drawbacks of blood volume estimation are stated in this book, Dr Albert, an ardent advocate of this measurement, naturally stresses the advantages of the various techniques, many of which he has done much to introduced. There is therefore some danger of the uninformed reader acquiring too sanguine a view of the problems in blood volume determination. The first section of this book, entitled "Significance of blood volume", opens with chapters on the elementary physiology of blood and the circulation. The major portion of this section consists of an expanded list of the situations in which blood volume may change. These are illustrated with a number of case histories which are poorly laid out and thus add little to the text. There are
useful chapters on the factors regulating blood volume and on the problems of interpreting haematocrit estimations. There is also a small gem written by R. D. Miller, in which the general principles of blood transfusion are cogently dealt with in two pages. Part two, subtitled "Technology", begins with a laborious development of the elementary equations defining indicator dilution theory. Detailed descriptions of procedures for blood volume estimation using different indicator techniques are given with worked examples. There is a good section on the differences in results obtained with different indicators, and another somewhat critical of the use of automated blood volume measuring devices. This book abounds in spelling mistakes. Throughout the work alignment charts are disconcertingly referred to as "normograms". The nomogram on page 229 relating blood volume to height, weight and sex has been reproduced from the literature of a manufacturer who, preferring symmetry to exactitude, has redrawn and thus rendered incorrect the original. The illustrations range from the obvious to the over-elaborate (the reviewer has yet to find someone to explain to him figure 6). The two sections of the book have separate bibliographies with much overlap; these could have usefully been combined. Despite the title, only thirteen pages are devoted to extracellular fluid volume. The prospective purchaser should also know that by the time he has looked through the foreword, preface, introduction, acknowledgements to the second and first editions, an expanded table of contents, and lists of figures, tables, cases and charts, he will have turned over forty pages of expensive paper before reaching the first word of the text C. M. Comaay
Downloaded from http://bja.oxfordjournals.org/ at University of Iowa Libraries/Serials Acquisitions on June 18, 2015
Clarke, R. S. J., Montgomery, S. J., Dundee, J. W., and Bovill, J. G. (1971). Clinical Studies of induction agents. XXXIX: CT1341—a new steroid anaesthetic. Brit. J. Anaesth., 43, 947. Chitton-Brock, J. (1960). Some pain threshold studies with particular reference to thiopentone. Anaesthesia, 15, 71. Dundee, J. W. (1960). Alterations in response to somatic pain. I I : The effect of thiopentone and pentobarbitone. Brit. J. Anaesth., 32, 407. (1964). Alterations in response to somatic pain associated with anaesthesia. XVI: Methohexitone. Brit. J. Anaesth., 36, 798. Clarke, R. S. J. (1965). Alterations in response to somatic pain associated with anaesthesia. XVII: Propanidid (FBA1420). Brit. J. Anaesth., 37, 121. Moore, J. (1960). Alterations in response to somatic pain associated with anaesthesia. I : An evaluation of a method of analgesimetry. Brit. J. Anaesth., 32, 396.
BRITISH JOURNAL OF ANAESTHESIA
ALTERATIONS DE LA REACTION A LA DOULEUR SOMATIQUE ASSOCIEE A L'ANESTHESIE XXI: ALTHESIN SOMMAIRE
Des doses sousanesthesiques Althesin, (CT 1341), un nouvel anaesth£sique stjeroide, ont produit une; intensification passagere de 1'appreeciation de la douleur somatique, dont la signification clinique est improbable.
Une antanalgesie de moins courte duree a ete observee durant le retablissement apres doses elevees, qu'apres des doses comparables de thiapentone. ABWANDLUNGEN BEIM ANSPRECHEN AUF KoRPERLICHEN SCHMERZ WAHREND DER ANAESTHESIE XXI: ALTHESIAN ZUSAMMENFASSUNG
Unter der Anaesthesie-Grenze liegende Dosen von (Althesin, (CT 1341), eines neuen Steroid-Anaesthetikums, bewirkten eine voriibergehende verstarkte Empfindung korperlichen Schmerzes, der wahrscheinlich keine grosse klinische Bedeutung zukommt. Wahrend der Erholungsphase nach grossen Dosen wurde eine weniger lange Schmerzfreiheit hsobachtet als nach vergleichbaren Dosen von "Thiopentone". ALTERACIONES EN LA RESPUESTA A DOLOR SOMATICO ASOCIADO CON ANESTESIA XXI: ALTESINA RESUMEN
Dosis subanestesicas de altesina (CT 1341), un nuevo anestesico esteroideo, produjeron un incremento transitorio en la apreciaci6n de dolor somatico, que probablemente no tiene gran importancia clinica. Durante la recuperation despues de dosis elevadas fue observada una antanalgesia de duracion mas breve que despues de dosis comparables de tiopentona.
BOOK REVIEW Blood Volume and Extracellular Fluid Volume (2nd edn.). By Solomon N. Albert. American Lecture Series. Published by Charles C. Thomas, U.S.A. Pp. xxxvii + 295; illustrated. Price $16.75. Why is blood volume estimation a neglected measurement? At first sight it would appear to be simple to measure and easy to interpret. Knowledge of blood volume would appear to be important if not vital in the management of many severe disorders. Yet in spite of the availability of a number of automated machines for its rapid determination, blood volume measurement appears to be a little performed manoeuvre. A major reason for this is that even when performed with the most scrupulous technique blood volume estimations are often subject to large errors. These estimations also require the presence of a steady state, so that in the bleeding or transfused patients, where knowledge of blood volume would be of inestimable value, the methods of measurements are virtually useless. Whilst all the drawbacks of blood volume estimation are stated in this book, Dr Albert, an ardent advocate of this measurement, naturally stresses the advantages of the various techniques, many of which he has done much to introduced. There is therefore some danger of the uninformed reader acquiring too sanguine a view of the problems in blood volume determination. The first section of this book, entitled "Significance of blood volume", opens with chapters on the elementary physiology of blood and the circulation. The major portion of this section consists of an expanded list of the situations in which blood volume may change. These are illustrated with a number of case histories which are poorly laid out and thus add little to the text. There are
useful chapters on the factors regulating blood volume and on the problems of interpreting haematocrit estimations. There is also a small gem written by R. D. Miller, in which the general principles of blood transfusion are cogently dealt with in two pages. Part two, subtitled "Technology", begins with a laborious development of the elementary equations defining indicator dilution theory. Detailed descriptions of procedures for blood volume estimation using different indicator techniques are given with worked examples. There is a good section on the differences in results obtained with different indicators, and another somewhat critical of the use of automated blood volume measuring devices. This book abounds in spelling mistakes. Throughout the work alignment charts are disconcertingly referred to as "normograms". The nomogram on page 229 relating blood volume to height, weight and sex has been reproduced from the literature of a manufacturer who, preferring symmetry to exactitude, has redrawn and thus rendered incorrect the original. The illustrations range from the obvious to the over-elaborate (the reviewer has yet to find someone to explain to him figure 6). The two sections of the book have separate bibliographies with much overlap; these could have usefully been combined. Despite the title, only thirteen pages are devoted to extracellular fluid volume. The prospective purchaser should also know that by the time he has looked through the foreword, preface, introduction, acknowledgements to the second and first editions, an expanded table of contents, and lists of figures, tables, cases and charts, he will have turned over forty pages of expensive paper before reaching the first word of the text C. M. Comaay
Downloaded from http://bja.oxfordjournals.org/ at University of Iowa Libraries/Serials Acquisitions on June 18, 2015
Clarke, R. S. J., Montgomery, S. J., Dundee, J. W., and Bovill, J. G. (1971). Clinical Studies of induction agents. XXXIX: CT1341—a new steroid anaesthetic. Brit. J. Anaesth., 43, 947. Chitton-Brock, J. (1960). Some pain threshold studies with particular reference to thiopentone. Anaesthesia, 15, 71. Dundee, J. W. (1960). Alterations in response to somatic pain. I I : The effect of thiopentone and pentobarbitone. Brit. J. Anaesth., 32, 407. (1964). Alterations in response to somatic pain associated with anaesthesia. XVI: Methohexitone. Brit. J. Anaesth., 36, 798. Clarke, R. S. J. (1965). Alterations in response to somatic pain associated with anaesthesia. XVII: Propanidid (FBA1420). Brit. J. Anaesth., 37, 121. Moore, J. (1960). Alterations in response to somatic pain associated with anaesthesia. I : An evaluation of a method of analgesimetry. Brit. J. Anaesth., 32, 396.