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British Journal of Anaesthesia 2007 98(6):701-704; doi:10.1093/bja/aem106
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

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The first 150 words of the full text of this article appear below.

Since the earliest days of i.v. anaesthesia, clinicians have recognized the need to administer the agents judiciously and to allow time for physiological responses to develop. In 1955, John Dundee wrote

‘While rapid injection produces a short period of good relaxation, the high concentration of the drug has a profound effect on the blood pressure and cardiovascular system in general. The safety of thiopentone is decreased enormously by a rapid rate of injection’.1

The separation of administration and effect is most striking with competitive neuromuscular blockers where up to 3 min is required for full paralysis to develop. A similar but briefer dislocation of arterial concentration and drug effect is seen with i.v. anaesthetics. That is, after a single dose, both compartments (arterial and effect) are in disequilibrium. Arterial drug concentration increases before measurable increased drug effect occurs and, subsequently, the drug effect persists while blood concentration decreases. In 1978, . . . [Full Text of this Article]

J. R. Sneyd* and A.E. Rigby-Jones

Peninsula Medical School, Plymouth, UK

* E-mail: robert.sneyd@pms.ac.uk


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E-letters:

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A similar BIS value does not mean a similar depth of anaesthesia
Ian F Russell
British Journal of Anaesthesia, 7 Jun 2007 [Full text]
Should we abandon the term "depth of anaesthesia" ?
Jo Mourisse, et al.
British Journal of Anaesthesia, 29 Jun 2007 [Full text]