bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anaesthesia equipment malfunction
Authors: HOLLEY H. S. , CARROLL J. S. 
Published: February 2007

SummaryAnaesthetic equipment was studied to determine whether the accuracy was improved and failure rate decreased by routine maintenance and calibration by a biomedical technician. Each piece was evaluated, and then repaired and rechecked at intervals by the same technician. Equipment failures were divided into three types: first, equipment that was completely nonfunctional; second, equipment that was functional but inaccurate; and third, equipment that was functional and accurate but needed minor repairs. The percentage of equipment failures in each group was compared on initial evaluation and after 6 months. Of the 311 pieces of equipment, 40% needed repair at the time of the initial survey; 8% was nonfunctional, and 18% was functional but inaccurate. After six months on a maintenance schedule, only 15% of the equipment needed repair, 3% was nonfunctional, and 6% was functional but inaccurate. The difference between the total percentage of equipment failure initially and after six months was statistically significant. After a regular maintenance, calibration, and checkout schedule by a biomedical technician was instituted, there was a significant improvement in the accuracy of the equipment and a reduction in the percentage of equipment needing repair.
Moisture‐conserving efficiency of condenser humidifiers*
Authors: OGINO M. , KOPOTIC R. , MANNINO F. L. 
Published: February 2007

SummaryThe moisture‐conserving efficiency of commercially available condenser humidifiers (small, disposable, airway humidifiers) was studied. A comprehensive comparison of all currently available condenser humidifiers utilising a laboratory system which simulated a breathing, intubated patient in temperature, humidity, dead space, and respiratory pattern characteristics was undertaken. The percentage of moisture conserved, or efficiency, of the humidifiers was calculated gravimetrically from the water loss of the testing system with and without the condenser humidifiers. The Portex Humid‐Vent® and Trach‐Vent®, Siemens Servo 150® and the Terumo Brethaia® were evaluated.The data revealed an inverse correlation between efficiency and tidal volume. The most efficient were the Portex Humid‐ Vent® at low tidal volumes and Siemens Servo 150® at the mid and high tidal volumes. To achieve a minimum inspired water content of 33 mg H2O/litre gas. a 79% condenser humidifier efficiency is necessary. None of these units met this requirement; however, they may be appropriate for limited clinical application.
Epidural sufentanil for postoperative pain relief
Authors: DONADONI R. , ROLLY G. , NOORDUIN H. , BUSSCHE G. VANDEN 
Published: February 2007

SummaryAn open pilot study was undertaken to evaluate the analgesic properties of epidurally administered sufentanil in the early postoperative period. After orthopaedic surgery of the lower extremity, four different groups of five adult patients each received either 15 μg (group 1), 30 μg (group 2), 50 μg (group 3) or 75 μg (group 4) sufentanil via an epidural catheter prviously used for the surgical procedure. Results were satisfactory in groups 3 and 4 with very good relief of pain and a mean duration of action of 372 and 307 minutes respectively. Dosage above 50 μg did not seem to improve the quality or duration of pain relief although the onset of action was faster with 75 μ;g. Sedation was always present in patients with effective analgesia. In the present study respiratory depression was not evident, but three patients complained of itching and two of urinary retention.
Suprofen compared to dextropropoxyphene hydrochloride and paracetamol (Cosalgesic) after extraction of wisdom teeth under general anaesthesia
Authors: ROSEN M. , WEBSTER J. A. 
Published: February 2007

SummaryIn a randomised double‐blind trial in postoperative ambulant day case dental patients suprofen 200 mg (29 patients) was compared with dextropropoxyphene hydrochloride 65 mg and paracetamol 650 mg (Cosalgesic, 28 patients) both available four times daily for 3 days. Suprofen was better than cosalgesic in the patients' opinion of initial (p = 0.01) and overall pain relief (p = 0.08) compared to Cosalgesic and the second night's sleep was better (p = 0.01). Side effects were reported in six suprofen patients and 10 cosalgesic patients (two suffering from vomiting withdrew). Suprofen, a non‐steroidal anti‐inflammatory drug is as good as, or better than, a widely used opioiparacetamol mixture for ambulant patients with postoperative dental pain.
Use of vecuronium in the management of tetanus
Authors: POWLES A. B. , GANTA R. 
Published: February 2007

SummaryA case of tetanus sufficiently severe to require treatment with neuromuscular blocking drugs and controlled ventilation is described. The use of an infusion of vecuronium helped to minimise the cardiovascular disturbances which accompanied the disease and permitted rapid spontaneous reversal of neuromuscular blockade when the infusion was stopped.
Resistance of tracheal tubes 3.0 and 3.5 mm internal diameter
Authors: BLOM H. , RYTLANDER M. , WISBORG T. 
Published: February 2007

SummaryThe resistance of RAE, Rüsch, Mallinckrodt paediatric and Portex plain nasal and oral tracheal tubes with internal diameters 3.0 mm and 3.5 mm was calculated at air flows of 1 to 10 litres per minute. The flow resistance profiles of RAE and Rusch tracheal tubes was generally higher than those of Mallinckrodt paediatric and Portex plain tubes. All RAE and Rüsch nasotracheal tubes of size 3.0 mm internal diameter and orotracheal tubes 3.0 mm internal diameter had a flow resistance exceeding 3.0 kPa litres/second at an airflow of 4 litres/minute. It is concluded that these tracheal tubes ought only to be used with assisted or controlled ventilation.
Thiopentone levels during cardiopulmonary bypass
Authors: MORGAN D. J. , CRANKSHAW D. P. , PRIDEAUX P. R. , CHAN H. N. J. , BOYD M. D. 
Published: February 2007

SummaryPlasma total and unbound concentrations of thiopentone were investigated during exponentially decreasing infusions in seven patients undergoing cardiopulmonary bypass. Total plasma thiopentone concentrations reached a plateau (10.2, SD 2.1 μg|ml) soon after the initial bolus dose and commencement of the infusion. Concentrations were maintained until the onset of cardiopulmonary bypass, whereupon total plasma thiopentone concentration fell abruptly to 50.0 (SD 5.8) percent of the prebypass level. The unbound fraction of thiopentone increased from 16.6 (SD 1.9) percent before bypass to a maximum to 29.3 (SD 5.6) percent during bypass (p < 0.01), decreased to 22.9 (SD 3.3) percent at the end of bypass (p < 0.01), hut was still elevated 5–7 hours later (20.5, SD 2.5 percent). The result of the changes in binding was a smaller decline in unbound thiopentone concentration at the onset of bypass to 76.4 (SD 15.7) percent of the prebypass level. Also, unbound levels returned to the prebypass level by the end of bypass, whereas total levels remained low.
Computerised tomography guided lumbar sympathectomy
Authors: REDMAN D. R. O. , ROBINSON P. N. , AL‐KUTOUBI M. A. 
Published: February 2007

SummaryFifteen patients had lumbar sympathetic block using needle localisation by computerised tomography. The technique has the advantage that the needle route to the sympathetic plexus can be accurately planned, avoiding damage to other organs. In this study, 13 patients out of 15 had significant benefit, from the procedure.
Comparison of induction characteristics of four intravenous anaesthetic agents
Authors: Mccollum J. S. C. , Dundee J. W. 
Published: February 2007

SummaryThe induction characteristics of thiopentone, etomidate and methohexitone have been compared to those of propofol (2,6 di‐isopropyl phenol) in unpremedicated patients. Propofo1 2.5 mg/kg caused significantly more hypotension, excitatory side effects and pain on injection at the dorsum of hand than thiopentone 5 mg/kg. However, with regard to the latter two sequelae. etomidate 0.3 mg/kg and methohexitone 1.5 mg/kg caused similar or more frequent upset. Propofol 2.0 mg/kg was equipotent with thiopentone 4.0 mg/kg in terms of successful induction of anaesthesia. Hypotension may contraindicate the use of propofol in the hypovolaemic or unfit patient.
Compound sodium lactate (Hartmann's) solution. Caution: risk of clotting
Authors: Edwards M.P. , Clark D.J. , Mark J.S. , Wyld P.J. 
Published: February 2007

SummaryWe have observed blood clothing in blood administration sets were Hartmann's solution (Travenol) has preceded blood transfusion. This is due 10 calcium ions (Ca++) contained in the Hartmann's solution and is more likely to occur at 37°C. We suggest that this potential hazard be more widely realised and that the practice cease.
Influence of induction of anaesthesia with midazolam on the neuro‐endocrine response to surgery
Authors: DAWSON D. , SEAR J. W. 
Published: February 2007

SummaryThe effect of midazolam, for induction of anaesthesia, on the glycaemic and adrenocortical responses to lower pelvic surgery in female patients has been studied and compared with a comparable group of patients receiving thiopentone. Although midazolam has been shown to obtundadrenaline andnoradrenaline release to electrical or surgical stress in the rat and dog, there was no blunting of the glycaemic response to surgery in man. Plasma cortisol levels in response to surgery and anaesthesia were comparable in the two groups of patients.
Pressure changes in tracheal tube cuffs
Authors: CHANDLER M. 
Published: February 2007

SummaryThe pressure changes in tracheal tube cuffs can be explained by classical permeation theory. The transport of all gases contributes to pressure changes which may be negative or positive, depending upon the conditions. In vitro experiments were carried out to determine the applicability of this approach and the efjcacy of the methods for minimising the rise in cuff pressure.
Triazolam premedication
Authors: THOMAS D. , TIPPING T. , HALIFAX R. , BLOGG C. E. , HOLLANDS M. A. 
Published: February 2007

SummaryA randomised, double blind study, of 58 female patients undergoing laparoscopic investigation was carried out to compare triazolam 0.25 mg, lorazepam 2 mg, or placebo as oral premedication. Each patient was assessed by only one of the authors both pre‐ and postoperatively with regard to anxiolysis, sedation and rapidity of recovery. Triazolam and lorazepam were each associated with a significant reduction in anxiety compared to the initial assessment, whereas placebo had no anxiolytic effect. Sixty minutes after premedication, patients who had received triazolam were significantly more sleepy than patients given placebo or lorazepam. Two hours after the operation, the patients who had had triazolam or lorazepam were significantly more sleepy than those who received placebo. However, at 6 hours postoperatively there was no difference between triazolam and placebo, whilst those who had been given lorazepam were still significantly more sleepy than those given placebo. Triazolam appears to offer advantages over either lorazepam or placebo in patients who require rapid recovery, sedation and reduction in pre‐operative anxiety.
The current status of pulse oximetry
Authors: Taylor M. B. , Whitwam J. G. 
Published: February 2007

SummaryThe history of the development of pulse oximetry is outlined and the principle of how the apparatus works is described. The instrument detects hypoxic hypoxia and the shape of the oxygen dissociation curve means that the minimum saturation alarm should be set at 94% in anaesthetic usage. It is accurate to within 2% and is usually unaffected by racial pigmentation, but accuracy can be aflected in low perfusion states, hypotherrnia and in the presence of abnormal forms of haemoglobin and pigments in the blood. Its clinical evaluation in the operating theatre and intensive care unit is reported. It was found to be useful and reliable and would appear to have logistical and other advantages over current methods of detecting hypoxia. Pulse oximetry may make a signijcant contribution to the safety of anaesthetic practice.
Topical nitroglycerin
Authors: Kamra S. , WIG J. , Sapru R. P. 
Published: February 2007

SummaryIn order to attenuate the pressor response to intubation of the trachea we have studied the effects of 2% nitroglycerin ointment rubbed on the forehead approximately 12 minutes prior to intubation. A double blind, randomized design was used in 56 consecutive patients. Of these, 30 patients received the ointment while 26 patients formed the control group. The maximum rise in the systolic arterial pressure was significantly lower (p < 0.001) in the group (7.66 mmHg. 6.2%) as compared to the control group (25.7 mmHg. 20.2%). The rise in arterial pressure persisted for up to 4 minutes in the control group, but lasted for only one minute in the nitroglycerine group. The pulse rate, however, increased in both groups to an equal extent. We have found the application of 2% nitroglycerine ointment to be a safe, inexpensive, comfortable and effective means of attenuating the pressor response to intubation of the trachea.
A double‐blind comparison of intramuscular pethidine and nalbuphine in labour
Authors: WILSON C. M. , McCLEAN E. , MOORE J. , DUNDEE J. W. 
Published: February 2007

SummaryA double‐blind, between‐patient comparison of intramuscular pethidine 100 mg and nalbuphine 20 mg for the relief of pain during labour in 80 patients is described. Severity of pain was assessed before and after treatment by subjective pain scores and visual analogue scales. Neither of these methods showed a significant difference between the treatments. Nalbuphine was associated with less maternal nausea and vomiting than pethidine, but this possible advantage was somewhat offset by a tendency of the drug to produce more maternal sedation and dizziness. The mean umbilical vein/maternal vein ratio was significantly higher for nalbuphine (0.78. SEM 0.03) than for pethidine (0.61, SEM 0.02). which suggests easier placental transfer of the former. This finding was reflected in significantly lower 2–4 hour neurobehavioural scores for the infants of mothers given nalbuphine, but there was no significant difference between these scores at 24 hours. On the basis of this study, nalbuphine does not offer a substantial improvement over pethidine for pain relief in labour.
Halothane hepatitis in an 11–month‐old child
Authors: WHITBURN R. H. , SUMNER E. 
Published: February 2007

SummaryHalothane hepatitis is extremely rare in childhood. However, this occurred in an 11‐month‐old infant, following multiple exposure to halothane. The diagnosis was confirmed by detection of specific antibodies to halothane‐sensitised rabbit hepatocytes. The anaesthetic technique for a subsequent procedure with a halothane‐free breathing system is also outlined.
Psychomotor testing of oncall anaesthetists
Authors: Narang V. , Laycock J.R.D. 
Published: February 2007

SummaryThe critical flicker fusion frequency and choice reaction times of 16 on‐call anaesthetists were measured between 1400 and 1600, at 2300 and at 0200 hours. Critical picker fusion decreased between the afternoon and 2300; there was no further change between 2300 and 0200. No signgcant dijjferences in choice reaction times were found on any of these different occasions.
Oral lormetazepam in premedication. A comparison with diazepam
Authors: Jakobsen C.‐J. , Jensen J.‐J. , Hansen W. , Grabe N. 
Published: February 2007

SummryLormetazepam, a relatively new benzodiazepine was compared in a randomised, double blind trial with diazepamfor its effectiveness as an oral premedicant drug. A scoring system was used to assess sedntion. relief of anxiety. nausea, dizziness and cardiovascular effects in two groups of patients having orthopaedic operations. Some statistical indication that lormetazepam has a greater anxiolytic effect than diazepam was found, but in assessing total eflect using a known scoring system, no difference was demonstrated between the two drugs.
The haemodynamic effects of bronchoscopy
Authors: Wark Katheryn J. , Lyons J. , Feneck R. O. 
Published: February 2007

SummaryThe cardiovascular responses to bronchoscopy under general anaesthesia were investigated in 36 premedicated patients. Twelve patients acting as controls received a standard intravenous anaesthetic of intermittent thiopentone and suxamethonium. A further 24 patients were given either fentanyl6 pgglkg or aventanil 18 pgglkg intravenously, one minute prior to induction. There were signijcant rises in systolic arterial bloodpressure (p < 0.05) and in rate pressure product (p < 0.05) in the patients in the controlgroup, but these changes were not seen in those patients receiving either fentanyl or awentanil. However, dysrhythmias and ST segment changes indicative of myocardial ischaemia were present in some patients in all three groups.
Raynaud's phenomenon precipitated by blood transfusion
Authors: MOORE JULIA K. , PROCTOR D. W. 
Published: February 2007

SummaryA patient undergoing surgery with spinal anaesthesia received a transfusion of concentrated red cells. Whenever the rate of blood transfusion reached a certain critical value, the symptoms and signs of Raynaud's phenomenon appeared in the hand distal to the site of the intravenous cannula. Possible causes of this transfusion‐induced vasospasm are discussed.
Caudal analgesia for perianal surgery
Authors: BAILEY P. M. , SANGWAN S. 
Published: February 2007

SummarySeventy‐three patients undergoing elective perianal surgery were randomly divided into a control group, a group who received a caudal injection of 20 ml bupivacaine 0.5% plain and a group who received diamorphine 2.5 mg in 10 ml normal saline by caudal injection; a comparison was then made of postoperative analgesia requirements. The bupivacaine group had better analgesia than the control group for the first 8 hours, after which there was no difference. The diamorphine group had better analgesia than the control group for the first 24 hours postoperatively. Side effects were less in the diamorphine group than the control, or the bupivacaine group. In particular, 41% of the bupivacaine group complained of some degree of urinary retention and one patient required temporary catheterisation. It is concluded that caudal diamorphine gives good postoperative analgesia for perianal operations, particularly when motor blockade is not wanted by the surgeon.
The prevalence of serological markers for hepatitis B virus infection amongst anaesthetists in the Oxford region
Authors: SINCLAIR M. E. , ASHBY M. W. , KURTZ J. B. 
Published: February 2007

SummaryA total of 125 anaesthetists from nine hospitals within the Oxford region were surveyed to study the prevalence of serological markers for hepatitis B virus (HBV) infection. No anaesthetists were positive for Hepatitis B Surface Antigen (HBsAg) and only four (3.2%) were positive for HBsAg antibody (anti‐HBsAg). This result is in marked contrast to other studies and suggests that anaesthetists in the United Kingdom do not constitute a high risk population. The reasons for this are discussed.
Severe acute anaemia in a Jehovah's Witness
Authors: HOWELL P. J. , BAMBER P. A. 
Published: February 2007

SummaryA case is described in which a Jehovah's Witness underwent emergency surgery following which her haemoglobin fell to 1.8 g/dlitre. She was successfully treated in an intensive care unit with intermittent positive pressure ventilation of the lungs, high inspired oxygen concentrations and transfusions of large volumes of gelatin solution.
The neuroleptic malignant syndrome
Authors: ALLSOP P. , TWIGLEY A. J. 
Published: February 2007

SummaryFollowing the administration of fluphenthixol (a depot phenothiazine) for a psychotic illness, a 44‐year‐old woman developed weakness, rhabdomyolysis and renal failure, together with hyperthermia (42°C) and signs of both autonomic and central nervous System dysfunction. She died following massive intestinal haemorrhage, intra‐abdominal sepsis and probable disseminated intravascular coagulation. A diagnosis of neuroleptic malignant syndrome had been made, but treatment with dantrolene sodium was probably instituted too late to prevent the progress of the complications she had developed. This syndrome, which follows the use of phenothiazines or butyrophenones, is rare, potentially fatal and probably underdiagnosed. It has been likened lo malignant hyperthermia, but a review of the literature points to many differences. Both dantrolene sodium and dopaminergic drugs (bromocriptine, amantidine and L‐dopa) have been shown to be efficacious and their continued use, despite a failure in this case, is advocated until more is known about this syndrome.
The severance of epidural catheters
Authors: HUTCHISON G. L. 
Published: February 2007

SummaryFour groups of Portex Minipack epidural sets were tested to measure the force required to sever the catheter on the needle bevel. The 18‐gauge radio‐opaque catheter was found to sever at a significantly lower applied force and to stretch significantly less before breaking than the 18‐gauge clear catheter or either of the 16‐gauge catheters. The other catheters tested had breaking strains of between 10–20 Newtons (1–2 kg force) and stretched by more than 30% of their lengths before breaking, ft is suggested that these other catheters may therefore be a preferable alternative to the 18‐gauge radio‐opaque.
Bradycardia associated with the use of vecuronium. A comparative study with pancuronium with and without glycopyrronium
Authors: Cozanitis D.A. , Pouttu J. , Rosenberg P.H. 
Published: February 2007

SummaryOne hundred and twenty patients undergoing anaesthesia for elective surgery received either pancuronium or vecuronium for muscle relaxation. Within each of these two groups, half were given glycopyrronium and the remainder an inert placebo. The incidence of bradycardia or bradydysrhythmias was higher in the group having vecuronium compared with those given pancuronium. Glycopyrronium afforded protection against undesirable vagal activity.
Magill versus Mallinckrodt tracheal tubes. A comparative study of postoperative sore throat
Authors: Sprague N.B. , Archer P.L. 
Published: February 2007

SummaryAn attempt to assess the relative merits of Magill and Mallinckrodt tracheal tubes is described. One hundred patients scheduled for routine gynaecological operations were randomly allocated to one of two groups of 50; in one, Magill red rubber tubes were used and in the other, Mallinckrodt lubes. The incidence and severity of postoperative sore throat were assessed on the day after operation. Fifty percent of those intubated with Magill lubes suffered sore throats, compared with 28% with Mallinckrodt (p < 0.05). In both groups, sore throat was more frequent in younger patients undergoing short operations: smokers intubated with Magill tubes had significantly more sore throat than smokers in whom Mallinckrodt tubes were used.
Should air‐oxygen replace nitrous oxide‐oxygen in general anaesthesia?
Authors: MOSELEY H. , KUMAR A. Y. , SHANKAR K. BHAVANI , RAO P. S. , HOMI J. 
Published: February 2007

SummaryThe use of compressed air‐oxygen mixtures to replace nitrous oxide‐oxygen in general anaesthesia was investigated in 378 patients. There were neither prolongations of recovery time nor instances of awareness under anaesthesia. The cost of general anaesthesia using compressed air‐oxygen was about half that for nitrous oxide‐oxygen mixtures.
Paroxysmal nocturnal haemoglobinuria
Authors: TAYLOR M. B. , WHITWAM J. G. , WORSLEY A. 
Published: February 2007

SummaryThe peri‐operative management of a patient with paroxysmal nocturnal haemoglobinuria and associated hypoplastic anaemia, who underwent successful elective surgery for the complication of Budd‐Chiari syndrome, is described. Anaesthesia in patients with paroxysmal nocturnal haemoglobinuria should be based on drugs and materials least likely to cause complement activation. The reasons for use of a technique based on benzodiazepines, opioids, isoflurane and the avoidance of nitrous oxide are discussed.