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Eighty-one patients admitted for minor surgery were followed with questionnaires and self-rating scales in the pre- and post-anesthetic period to evaluate the effect of giving either routine or detailed information. The patients were randomly allocated to two groups and received either routinely given information by the anesthetist for about 5 min or more detailed information for at least 20 min. The patients' experience of the effect of the preanesthetic visit was tranquillizing and adequate in both groups. The most significant difference with detailed information was a smaller number of side-effects like slow cerebration, nausea and a general feeling of discomfort compared to the routinely informed patients. Repetitive ratings on Spielberger's State of Anxiety Scale showed that the patients who had had previous anesthetic experience were less influenced by the degree of information given. In view of the considerable numbers of parameters investigated, there were relatively few significant differences between the groups, and it was concluded that there was no convincing benefit from expanding routine to detailed information.

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Eighty healthy adult patients randomly allocated to four groups received pancuronium 0.01, 0.015, 0.02 mg kg-1 or gallamine 0.3 mg kg-1 i.v. 3 min before induction. Just before induction of anaesthesia, the patients were examined for signs and symptoms of neuromuscular blockade. After induction of anaesthesia with thiopentone, suxamethonium 1.5 mg kg-1 was administered i.v. Five minutes later the second dose was injected. No serious arrhythmia was seen in any of the four groups following the repeated dose of suxamethonium. However, the highest dose of pancuronium (0.02 mg kg-1) caused an unacceptably high frequency of partial neuromuscular blockade.

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The effect of a single dose of suxamethonium on cardiac rate and rhythm during halothane anesthesia with babiturate induction was studied in a prospective, triple-blind trial with 28 patients. No atropine was given and patients were not intubated. A slight but significant preponderance of sinus-bradycardia without hemodynamic consequences was found in the group given suxamethonium. Suxamethonium did not provoke ventricular ectopies or conduction disturbances. It is concluded that in anesthesia with barbiturate induction, but without atropine or intubation, the use of a single dose of suxamethonium is a safe procedure with regard to cardiac rate and rhythm.

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The effect of barbiturates on cardiac rate and rhythm during halothane anesthesia without intubation was studied in a triple-blind, randomized trial with 28 patients. The test group was premedicated with pentobarbital and induced with thiopental, while the control group was anesthetized with halothane and nitrous oxide only. There was a significant preponderance of sinus-bradycardia and supraventricular disturbances in the control group. It is concluded that the use of barbiturates is advantageous because of their ability to suppress enhanced vagal tone.

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The effect of i.v. atropine premedication on cardiac rhythm was studied in healthy adult patients during thiopental-N2O/O2-halothane anesthesia without intubation. A higher incidnece of arrhythmias was seen in younger patients in close relation to administration of atropine, but the overall incidence during anesthesia was identical in atropine groups and the control groups. The most common arrhythmias were supraventricular ectopies. None of the ECG irregularities led to serious arrhythmias. No consistent changes in blood pressure were observed as the result of arrhythmias or changes in heart rate. It is concluded that atropine should be reserved for situations where severe bradycardia and hypotension occur, or can be expected to occur, and not given automatically, since cardioacceleration which is inherent in its action may be injurious to patients with limited cardiac reserve.

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The changes in cardiac rhythm which occurred during induction of halothane-N2O/O2 anesthesia with thiopenthal and one single dose of suxamethonium for intubation were studied in two groups of patients, one (at random) of which was given atropine intravenously 0.1 mg/10 kg 2 min before induction.

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Hypercarbia was induced in 12 patients anesthetized with either halothane or fluroxene in an inspired concentration of approximately 1.3 MAC (1% halothane and 4-5% fluroxene). The six patients receiving halothane anesthesia responded to hypercarbia with a pronounced tachycardia, an increased arterial pressure and an electrocardiographically monitored threshold level for ventricular arrhythmias at a Paco2 level averaging 98 mmHg. The six patients receiving fluroxene anesthesia responded to hypercarbia with both tachycardia and hypertension, but in spite of an average Paco2 level of 109 mmHg, no ventricular arrhythmias could be provoked. It is therefore suggested that within the non-narcotic level of hypercarbia a threshold level for cardiac arrhythmias does not exist under fluroxene anesthesia.

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