bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contamination of internal jugular lines
Authors: OPIE J.C. 
Published: February 2007

Summary From July to December 1977, 217 patients underwent open heart surgery at this institution. From this group, 125 internal jugular venous lines (JVL) were collected, cultured and the organisms identified. Nose, throat, urine and sternotomy wounds were also cultured. Notable findings included a JVL contamination rate of 65%. The commonest infecting organism (90%) was Staphylococcus epidermidis (albus). This organism was also found in the nares in 74% of cases, but was not isolated from other sites. Postoperative pyrexia, but no morbidity or mortality, could be related to the JVL contamination.It was concluded that the source of the JVL contamination was the patients' neck skin, which itself is contaminated by the patients' noses.
Glycopyrrolate in children
Authors: LAVIS D. M. , LUNN J. N. , ROSEN M. 
Published: February 2007

SummaryThe effect of intravenous administration of glycopyrrolate and atropine shortly before induction were compared in a double blind study in children. The study shows that glycopyrrolate, unlike atropine, administered before anaesthesia had little effect on heart rate. The heart rate changes at, and following, tracheal intubation were similar in both groups.
Hypoglycaemic coma following epidural analgesia
Authors: ROMANO E. , GULLO A. 
Published: February 2007

SummaryA diabetic patient who was taking an intermediate‐acting insulin preparation developed sudden hypoglycaemic coma after epidural analgesia between T5 and L1. Several diagnostic possibilities are discussed.It is concluded that prophylactic intravenous infusion of glucose and small doses of local anaesthetic are always advisable in diabetic patients having epidural analgesia.
Anaesthesia for surgical correction of fractured femoral neck A comparison of three techniques
Authors: White I.W.C. , Chappell W.A. 
Published: February 2007

SummarySixty patients with fractured neck of femur and scheduled for surgical correction were randomly allocated to receive one of three anaesthetic techniques: general anaesthesia; spinal analgesia; psoas compartment block. The patients in the local anaesthetic groups also received a light general anaesthetic. There was little difference in the pre‐, intra‐ and postoperative events, and no difference in postoperative mortality.
Corrective cardiac surgery in infants
Authors: MANNERS J.M. , MONRO J.L. , EDWARDS J.C. 
Published: February 2007

SummaryThis is a review of 136 patients who have undergone corrective surgery for congenital heart disease with the aid of profound hypothermia in a 6‐year period. Almost all patients were less than one year old and less than 10 kg. In 1979 the average age was 3·4 months and the average weight was 4·1 kg in 34 infants. The hypothermic technique consisted of surface cooling followed by cardiopulmonary bypass cooling and circulatory arrest during definitive surgery. The hospital mortality was 26% for the whole period, having decreased from 53% in 1974 to 15% in 1979. After operation 70% of patients with uncomplicated ventricular septal defect or the tetralogy of Fallot were extubated within 4 hours, 65% of all patients were extubated within 12 hours of operation.
Maternal opinion about analgesia for labour
Authors: ROBINSON J.O. , ROSEN M. , EVANS J.M. , REVILL SUSAN I. , DAVID H. , REES G.A.D. 
Published: February 2007

SummaryIn a randomised controlled trial epidural analgesia with bupivacaine 0·5% (mean dose 112·8 mg) was compared with pethidine (mean dose 200 mg) and inhalational analgesia in primipara (28 and 30 mothers) and multipara (17 and 18 mothers). Mothers who had an uneventful pregnancy and labour and agreed to have either treatment were studied during labour and followed‐up at interviews for 5 months after delivery. Epidural block was rated significantly superior in respect of pain relief and comfort, there were no differences between the groups in reports of perineal discomfort. Twice as many primipara required forceps delivery after epidural block. Very few mothers, in each group, reported something missing in their experience of childbirth. Two thirds of each group would use the same method again. Epidural block can therefore be recommended to uncommitted mothers as a satisfying and effective method of pain relief for labour.
Windows in the intensive therapy unit
Authors: KEEP PHILIP , JAMES JOSEPHINE , INMAN MICHAEL 
Published: February 2007

SummaryRetrospective surveys were carried out on two groups of patients who had survived a stay of at least 48 h in an Intensive Therapy Unit. One group had been kept in a unit without windows, and the other in a similar unit with translucent but not transparent windows.Survivors from the windowless unit had a less accurate memory of the length of their stay, and were less well orientated in time during their stay. The incidence of hallucinations and delusions was more than twice as high in the windowless unit.The phenomenon of depersonalisation in the face of life‐threatening danger is described and discussed.
Cor pulmonale and the Pierre Robin anomaly
Authors: FREEMAN M.K. , MANNERS J.M. 
Published: February 2007

SummaryAn infant with Pierre Robin anomaly was anaesthetised for cardiac catheterisation. There was cor pulmonale with the pulmonary artery pressure at systemic level, a patent foramen ovale and a persistent ductus arteriosus. The effects of alterations in blood gases on the haemodynamics and intracardiac shunts are considered. Subsequent management of the obstructed airway with a nasopharyngeal tube for 4 weeks is described.
Endotracheal intubation with the fibre‐optic bronchoscope
Authors: Messeter K.H. , Pettersson K.I. 
Published: February 2007

SummaryTracheal intubation with the aid of the fibre‐optic bronchoscope was compared to conventional and alternative methods in 41 consecutive patients suffering from advanced rheumatoid arthritis. All patients were scheduled for anterior and/or posterior cervical fusion. It was shown that the use of the fibre‐optic bronchoscope significantly diminished the number of complicated intubations and reduced the intubation trauma considerably. The occurrence of postoperative upper airway oedema was significantly related to the extent of the intubation trauma. Tracheal intubation with the fibre‐optic bronchoscope is considered useful in adult patients when intubation is expected to be difficult or dangerous and when orthodox intubation is found to be very difficult.
Methylprednisolone prior to cardiopulmonary bypass
Authors: THOMPSON M.A. , BROADBENT M.P. 
Published: February 2007

SummaryPatients undergoing cardiopulmonary bypass were randomly allocated to receive methylprednisolone 30 mg/kg in a single dose prior to bypass, or to a control group receiving saline. The effect of this treatment on 2,3‐DPG and oxygen delivery to the tissues was determined.There was no difference between the groups in 2,3‐DPG levels, P50 or oxygen availability, but the methylprednisolone group showed a highly significant difference in oxygen consumption immediately following cardiopulmonary bypass (p < 0·001) and a significant difference in serum phosphate levels in the immediate postoperative period (p < 0·05). Methylprednisolone levels were measured by radioimmunoassay, and these showed a rapid decline in the 4 hours following administration.
A neurological complication following interscalene brachial plexus block
Authors: BARUTELL C. , VIDAL F. , RAICH M. , MONTERO A. 
Published: February 2007

SummaryA case is reported of the unfortunate development of permanent neurological damage to the motor outflow of at least two of C7, C8 and T1 motor nerve roots; following an attempted block of the brachial plexus using the interscalene approach.
Spinal analgesia for instrumental delivery
Authors: Hutchins C.J. 
Published: February 2007

SummaryOne hundred and eighty‐three patients undergoing instrumental delivery were randomly divided into two groups, one of which received low spinal anaesthesia and the other pudendal nerve block for delivery. Both were administered by the operator. No patient who received spinal anaesthesia experienced pain. 62% of patients who had a rotational delivery under pudendal nerve block experienced severe pain; 15% had pain during direct delivery. Hypotension was not observed. The incidence of postnatal complications was similar in each group. Low spinal anaesthesia in the hands of the operator provided superior anaesthesia with no increase in complications.
Chlormethiazole as sleep cover for the elderly. Intravenous infusion during local analgesia
Authors: Marley John E. , Ward Stephen 
Published: February 2007

SummaryA method of avoiding postoperative confusion when local analgesic techniques are indicated for the elderly is described. Basal sedation using 0·8% chlormethiazole infusion intravenously, was employed. Mental function was not altered when the technique was used and it is suggested that the length of stay in hospital can be reduced.
Automatic ventilation with the Ayre's T‐piece
Authors: NEWTON N.I. , HILLMAN K.M. , VARLEY J.G. 
Published: February 2007

SummaryA simple modification to an existing adult ventilator has been designed to permit mechanical ventilation of neonates and small children with the Ayre's T‐piece circuit.The Nuffeld Anaesthesia Ventilator Series 200 has been modified by replacing the piston in the patient valve with a fixed leak. This arrangement avoids the problems of critical adjustment commonly encountered with other methods of converting adult ventilators to paediatric use, and allows the ventilator controls to be used normally.The ventilator has been assessed according to the proposed International Standards Organization specifications for the evaluation of the performance of lung ventilators, and the results are described in detail.The modified ventilator is shown to perform as a time‐cycled pressure generator capable of delivering tidal volumes between 10 and 300 ml at frequencies from 10 to 85/minute. It is therefore ideally suited to neonatal and paediutric use.
Tourniquet failure and arterial calcification
Authors: JEYASEELAN S. , STEVENSON T.M. , PFITZNER J. 
Published: February 2007

SummaryA patient with Mönckeberg's calcinosis is presented in whom a pneumatic limb tourniquet failed to be effectitie because of calcification of the femoral artery wall. Bleeding from the operation site was noticed to be appreciably greater while the tourniquet was inflated since the cuff, though not occluding the femoral artery, acted as a very effective venous tourniquet.Theoretical risks which might be associated with the use of tourniquets in the presence of arterial calcification are fracture of the calcified vessel wall and systemic overdose of local anaesthetic agent following attempted regional intravenous block.The problem of tourniquet failure in general, and the dangers which might be associated with the use of tourniquets in patients with incompressible arteries, are briefly discussed.
Bleomycin therapy and Anaesthesia
Authors: ALLEN S.C. , RIDDELL G.S. , BUTCHART E.G. 
Published: February 2007

SummaryBleomycin is a cytotoxic drug used in the treatment of teratoma of the testis. This drug appears to sensitise the lungs so that acute lung damage occurs with concentrations of oxygen normally considered free from toxic effects. Two anaesthetics administered to the same patient undergoing thoracotomy are reported. No postoperative lung damage was produced on either occasion.
Forum
Authors: Carrie L.E.S. , O'Sullivan G.M. , Seegobin R. 
Published: February 2007

SummaryThirty‐eight patients with a normal obstetric history who had not received intramuscular sedation and who requested or required analgesia were given 150–200 μg of fentanyl into the epidural space. Excellent pain relief was achieved until late in the first stage of labour but analgesia was inadequate during the latter part of the 1st stage and during the 2nd stage of labour. No serious side‐effects were noted in any of the mothers but one baby required treatment for respiratory depression.
Cryoanalgesia
Authors: EVANS P.J.D. 
Published: February 2007

SummaryThe introduction of cryoanalgesia has reawakened interest in the therapeutic use of cold as a means of producing pain relief. The historical background to both local cooling and nerve freezing is recorded and the advances since the introduction of cryoprobes in 1961 are described. The possible mechanisms of freeze damage, the physical changes occurring in tissues as a result of ice crystal formation and the influence of the probe design on the size of individual cryolesions are all discussed. Gas expansion cryoprobes are described and the application of nerve freezing in the control of both post operative and chronic pain reported.
Spinal narcotics and central nervous system depression
Authors: SIDI AVNER , DAVIDSON JOSEPH T. , BEHAR MORT , OLSHWANG DAVID 
Published: February 2007

SummaryA case of central nervous system depression which developed 7 hours after an intrathecal injection of 4 mg of morphine is described. The patient lapsed into coma with bradypnoea and ‘pin‐point’ pupils and there was no response to naloxone 0·4 mg. Treatment was continued for 3 hours. No postoperative analgesics were required for 126 hours. The problems associated with the use of intrathecal opiates are reviewed, delay in onset being the usual feature. Use of hyperbaric solutions of the narcotic and maintenance of a head‐up posture may protect against respiratory depression.
Anaesthesia under civil war conditions
Authors: CARMICHAEL G.L. MURRAY 
Published: February 2007

SummaryThe work of British Red Cross surgical teams during the Cambodian civil war in 1975 and the Angolan war of 1976 is described. The medical, social and military situations are discussed. The problems caused by the deteriorating conditions in the working environments of these teams during the collapse of the governing regimes within which they were operating are outlined and some of the methods which were used to solve these are considered.
Sydney Ringer (1834–1910) and Alexis Hartmann (1898–1964)
Authors: LEE J. ALFRED 
Published: February 2007

SummaryThis article outlines the careers and the achievements of Sydney Ringer (1834–1910) and Alexis Hartmann (1898–1964), both of whom gave their names to well‐known solutions for intravenous infusions.
Liver enzyme studies with continuous intravenous anaesthesia
Authors: BLUNNIE W.P. , ZACHARIAS M. , DUNDEE J.W. , DOGGART J.R. , MOORE J. , McILROY P.D.A. 
Published: February 2007

SummaryA battery of liver function tests was carried out before operation and on the 3rd–5th and 13th–15th postoperative days in patients anaesthetised with continuous infusion of thiopentone, Althesin or etomidate for an intermediate operation. Some derangement of enzyme activity was found in one quarter to one third of the patients, and was most marked after Althesin. The findings are compared with published data on ketamine, which had an effect on enzyme activities similar to that of Althesin. On pooling data from different studies it became very apparent that large doses of intravenous anaesthetics cause a greater derangement of liver function than that which occurs using a balanced technique for the same operation.
Experiences with epidular morphine in obstetrics
Authors: Crawford J. Selwyn 
Published: February 2007

SummaryMorphine (2–6 mg) injected into the epidural space was ineffective in relieving the pain of labour in eight patients. Morphine (2 mg) injected into the epidular space of 60 patients whilst they were undergoing caesarean section was associated only modestly, if at all, with a diminished incident of postoperative pain and discomfort, when compared with the epidular injection of saline in 60 patients matched for type of operation and type of Anaesthesia. A relatively high incident of postoperative vomiting was noted among the patients who received morphine.
Amitriptyline and perphenazine (Triptafen DA) in chronic pain
Authors: Clarke Ian M.C. 
Published: February 2007

SummaryOne‐hundred and twenty patients with chronic pain, who had all failed to obtain relief with traditional medical treatment, were given a standard psychotropic drug mixture consisting of amitriptyline 25 mg and perphenazine 2 mg. Of those who completed 2 months of treatment, 33·68% were pain free, while 8·3% had unacceptable side‐effects. The best results were obtained in patients with postherpetic neuralgia and postoperative scar pain.
Accidental intrathecal injection of bupivacaine and dextran
Authors: EVANS P.J.D. , LLOYD J.W. , WOOD G.J. 
Published: February 2007

SummaryThe case is reported of a patient who received an accidental intrathecal injection of a mixture containing 0.375% plain bupivacaine in dextran following a paravertebral block. From the duration of anaesthesia produced, it is suggested that the addition of dextran to a solution of bupivacaine does not potentiate the action of subarachnoid bupivacaine.
Obstetric pain relief in a district hospital.
Authors: DAVIES H.F. 
Published: February 2007

SummaryThe effectiveness of the various methods used to provide obstetric pain relief in a District General Hospital was assessed. More than 70% of mothers were generally satisfied with the pain relief they received, but the majority would, in retrospect, have liked some additional analgesia at some stage. Seventeen per cent would have liked an epidural. Neither the social group of the mothers nor their duration of residence in the area of the hospital affected the demand for additional pain relief. The demand for epidurals was greater in social groups I and II.The effect of the obstetric pain relief service on the workload of available trained staff was assessed: most of the demands were made between the hours of 0900 and 2100 hours.
Reduction of pain on injection of etomidate
Authors: Brown P.M. , Moss E. 
Published: February 2007

SummaryThe effect of the addition of lignocaine or saline to etomidate was studied in a randomised, double‐blind trial involving 98 patients attending for day case surgery under general anaesthesia. The incidence of pain on injection of etomidate was significantly reduced by the addition oflignocaine in a strength of 1 mg/ml.
Ketamine‐diazepam anaesthesia in a patient with carcinoid syndrome
Authors: EISENKRAFT JAMES B. , DIMICH IVAN , MILLER RAYMOND 
Published: February 2007

SummaryThe use of ketamine in patients with carcinoid syndrome is controversial because of the catecholamine response to this agent. Prior administration of diazepam modifies the catecholamine response to ketamine and may make its use in such patients safe. The successful use of a diazepam–ketamine technique for anaesthesia of a patient with malignant carcinoid syndrome and associated tricuspid valve disease who underwent laparotomy and hepatic artery ligation is described. The theoretical advantages of safe ketamine anaesthesia in carcinoid patients are discussed and the relevant literature reviewed. To the authors' knowledge the successful use of ketamine anaesthesia in carcinoid syndrome has not previously been reported.
Calibration of a Floscope peak flow meter and a Vitalograph pulmonary monitor
Authors: FISHER J. , SHAW A. 
Published: February 2007

SummaryThe performance of a Floscope peak flow meter and the Vitalograph pulmonary monitor are assessed using an absolute calibration method. Both instruments have good repeatability. For peak flows greater than 150 litres/minute, the Floscope showed errors of between −12.4% and +7.1%. For flows below 150 litres/minute the percentage errors were greater.The pulmonary monitor showed errors of between −20% and −5.5%. Its high resistance makes it an inappropriate instrument to use for absolute measurement of peak flows. It is useful for assessing trends.
A pharyngeal pack fixed on to the tracheal tube
Authors: SCHECK PAUL A.E. 
Published: February 2007

SummaryIn 205 patients undergoing surgery of the nose, throat or dental surgery, a gauze pack was used fixed onto the tracheal tube, remaining during surgery above the vocal cords. Advantages in adults as well as children are discussed: laryngoscopy has to be performed only once, a free operating field is secured for the surgeon in the throat, the tube cannot be inserted too far into the trachea and the pack cannot be forgotten in the pharynx.The only disadvantage noticed so far was that in about 10% of the patients intubation was somewhat more difficult for the less experienced anaesthetist.
Nitrous oxide concentrations in the dental surgery
Authors: HILLMAN K.M. , SALOOJEE Y. , BRETT I.I. , COLE P.V. 
Published: February 2007

SummaryPollution in the dental outpatient surgery was assessed by measuring atmospheric nitrous oxide levels and comparing these with the venous blood concentrations in the operator‐anaesthetist and his assistant.The effects of scavenging on both measurements have also been determined. Without scavenging the nitrous oxide level in the blood of the dentist was over four times that of the average anaesthetist working in an operating theatre. Some of the factors contributing to these high levels, and the effectiveness of scavenging are discussed.
Teaching anaesthetics to medical students
Authors: NEWELL J.P. , OGG T.W. , WAKEFORD R.E. 
Published: February 2007

SummaryThe paper describes the rationale and implementation of anaesthetics teaching in the new 2½1/2‐year clinical medical course at Cambridge University. A programme designed to monitor and evaluate the teaching was established, and the results are reported.Significant improvements in students' knowledge of anaesthetics and their experiences of practical procedures were noted, as compared to a control group. It is concluded that the course achieves the dual aims of providing an introduction to the scope and vocabulary of modern anaesthesia and giving students the opportunity to practise a variety of specified practical skills.
Myocardial depression by ketamine
Authors: CHAMBERLAIN J.H. , SEED R.G.F.L. , UNDRE N. 
Published: February 2007

SummaryThis study investigated the effect of ketamine on myocardial function. In dogs the drug was infused directly into the left main coronary artery. The concentration chosen was similar to the peak concentration found following a bolus intravenous injection. A mild depression of inotropic state was found which recovered completely after stopping the infusion. Myocardial depression was confirmed in a guinea pig Langendorff preparation. No changes in high energy phosphates were found in these hearts after 45–60 minutes of perfusion with ketamine in the perfusion medium. This study confirms that myocardial depression occurs with ketamine but suggests that it is unlikely to be of clinical significance. Depletion of high energy phosphates did not seem to be the cause of the depression.
Survival from DIC following amniotic fluid embolism
Authors: TAENAKA N. , SHIMADA Y. , KAWAI M. , YOSHIYA I. , KOSAKI G. 
Published: February 2007

SummaryA 30‐year‐old multigravida of 38 weeks gestation bled profusely at delivery. Coagulation studies revealed disseminated intravascular coagulation and a diagnosis of amniotic fluid embolism was made. Treatment consisted of transfusion of whole blood and administration of a synthetic serine proteinase inhibitor, FOY. Approximately two hours after administration of the latter, bleeding began to cease and vital signs became stable. The patient survived without sequelae.
Pressures on endotracheal tube cuffs
Authors: BLACK A.M.S. , SEEGOBIN R.D. 
Published: February 2007

SummaryThe general relationships between the pressure inside an endotracheal tube cuff, the pressure exerted by that cuff on the tracheal wall and the airway pressure have been re‐examined in a model system. In relatively recent literature, the tracheal wall pressure at a given cuff volume has been calculated as the difference between intracuff pressures at that volume when the cuff is infated inside the trachea and when it is inflated whilst suspended freely in air. This has been used as a general relationship, as an alternative to direct measurement in real and model tracheas. In this study, the directly measured pressure was not generally equal to the pressure as calculated above.