Interscalene brachial plexus block: area of analgesia, complications and blood concentrations of local anesthetics

In a prospective clinical study including 100 patients, the consequences of using the interscalene approach to block the brachial plexus were investigated according to the area of analgesia, complications, and blood concentrations of local anesthetics. Sufficient analgesia of the shoulder and the upper part of the arm was obtained in 98-99% of the cases, whilst the area of analgesia in the forearm and the hand was more variable. In two groups, with 10 patients in each group, the blood concentration was measured during the first 50 min after injection in the neurovascular sheath by either the interscalene or the axillary approach. The peak values were at the same level in the two groups, but there was a much more rapid rise in concentration in the interscalene group. No toxic reactions were seen. The complications were in accordance with those reported in other publications.

The effect of tranexamic acid on secondary haemorrhage after traumatic hyphaema

During the period from March 1978 to November 1979, 232 consecutive patients with traumatic hyphaema were allocated by admission-date to conservative treatment and to treatment with the antifibrinolytic drug tranexamic acid. Secondary haemorrhage occurred in only two of 102 tranexamic acid treated patients, while secondary haemorrhage occurred in 12 out of 130 conservatively treated patients. This difference was statistically significant. Some clinical aspects of the rebleeding cases are presented and briefly discussed.

Astigmatism and surface phenomena in pterygium

Examination of 39 eyes with pterygium and 17 contralateral eyes revealed increased astigmatism with the rule (greater than 0.5 D in 46%, greater than or equal to 4 D in 13%) without associated impairment of vision. Intensified vital staining was seen to be provoked over the pterygium by tetrazolium and rose bengal, whereas this was not the case with fluorescein or alcian blue. There were no signs of desiccation (Break up time normal). Stocker's line in front of the pterygium was observed in 46%. In 13% this was continuous with Hudson Stahli's line. A quantitative cytologic study disclosed keratinisation in 5%. Increased desquamation was seen in 10%. The central thickness of the cornea was the same as in normal eyes.

A case report of an autistic girl with an extra bisatellited marker chromosome

Cytogenetic examination of a 14-year-old severely retarded girl revealed a karyotype of 47 chromosomes with an extra bisatellited chromosome, a translocation between No. 22 and a chromosome in the D group. The girl had presented an early autistic syndrome beginning about 6 months of age during plastering for a congenital luxation of the hips and receding from the age of 5. In addition, she was hyperkinetic with various aggressive and auto-aggressive traits and had atypical minor epileptic fits. Data from child psychiatric examinations at 5 and 14 years are presented. The importance of giving parents information as early as possible about biological causes of mental retardation and mental illness is stressed.

Vocalisation via a cuffed tracheostomy tube. A new prinicple

A thin catheter mounted on the upper surface of a tracheostomy tube enables a flow of air to reach the vocal cords and makes vocalisation possible during artificial ventilation.