By A N Kingsnorth; Aljafri A Majid
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Many anaesthetists prefer it for induction of anaesthesia in cardiovascularly compromised patients and severe asthmatics. Even one dose produces inhibition of the 11b and 17a hydroxylase enzymes involved in cortisol synthesis. It often produces excitatory type movements on induction. Etomidate has been associated with epileptiform EEG activity. It may be painful on injection and has a relatively high incidence of thrombophlebitis. Opioids Some of the more important locations of opioid receptors are the periaqueductal matter of the brainstem, hypothalamus, and substantia gelatinosa of the spinal cord.
Deﬁciencies in this enzyme cause suxamethonium apnoea. 28 Fundamentals of surgical practice Suxamethonium reliably provides the fastest and best conditions for intubation. 5 mg/kg after loss of consciousness. It is the drug of choice for emergency intubations. Some anaesthetists use it for difﬁcult intubations in which ventilating the lungs is not likely to present a risk, as its rapid elimination facilitates the prompt return of breathing if intubation fails. Suxamethonium has many side-effects.
Clinical Indicators of increased perioperative clinical cardiovascular risk (myocardial infarction, heart failure, death). g. g. unable to climb a ﬂight of stairs with a bag of vegetables) History of stroke Uncontrolled systemic hypertension AHA guidelines . 7. Risk of reinfarction following anaesthesia; relationship to previous myocardial infarction. Interval between previous myocardial infarction and surgery (months) 0–3 3–6 7–12 No previous myocardial infarction From , with permission.