Mortality in Anaesthesia

113 This system of monitoring might be improved further if all cases in this category were investigated jointly by a forensic pathologist and an anaesthesiologist at the very outset of the investigation and during the actual autopsy. Free Papers The Influence of Pancuronium on Primary Conjugated Bile Acids A. Fassoulaki, T. Mihas, A. Mihas and P. Kaniaris Experimental studies have been reported in which a prolonged action of steroid neuro- muscular blocking agents followed bile acids administration(1, 2). A prolonged neuro- muscular action of pancuronium has also been detected in patients with biliary obstruc- tion(3). In the present study serum bile acids and intracellular liver enzymes were estimated after anaesthesia in which pancuronium was used as a muscle relaxant (Fig. 1). An at- tempt is made to investigate the effect of pancuronium on bile acid levels. Material and Methods Twelve female patients aged between 40 and 50 years were studied. All of them were visited in the ward the night before the operation by the anaesthesiologist where their clinical condition was assessed and their consent was obtained to participate in the pre- sent study.

None of them had a history of hepatic disease or was taking drugs. The oper- ation performed in all cases was modified radical mastectomy and intracellular liver en- zymes are routinely determined in these patients preoperatively. The twelve patients were reassured and stated that they did not want to have any tranquillizer for premedi- cation.