bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vecuronium and phaeochromocytorna
Authors: DAROWSKI M. J. , COUTINHO W. B. A. , POWER S. J. , JONES R. M. 
Published: February 2007

SummaryTwo patients presenting for removal of phaeochromocytoma are described. Vecuronium was used to provide neurornuscular blockade by two different methods of administration: an infusion and a large bolus dose. Both gave satisfactory results and we suggest that vecuroniurn may be the neuromuscular blocking agent of choice for patients with phaeochromocytoma.
A disposable device for infusion analgesia
Authors: REEKIE R. M. , CARTER K. B. , OWEN H. 
Published: February 2007

SummaryThe performance of the Travenol infusor when used to administer an intravenous infusion of analgesic after surgery has been investigated. Mean flow was very similar to the manufacturer's quoted figure of 2 ml/hour, but there was a large interindividual variation. Results from a laboratory study suggest that this was due to variation in the manufacture of the infusor.
Increased hepatic microsomal activity after halothane anaesthesia in children
Authors: ST. HAXHOLDT OLGA , LOFT S. , CLEMMENSEN ANETTE , HJORTSØ ELSE 
Published: February 2007

SummaryThe effect of anaesthesia and surgery on microsomal enzyme activity was studied in 19 children aged 4–9 years, scheduled for tonsillectomy. The children were randomly allocated to either halothane or ketamine anaesthesia. Antipyrine clearance was measured before and 4 days after surgery by u salivary one–sample technique. Statistically signijcant (p < 0.001) increases in antipyrine clearance was found in children who received halothane anaesthesia. The antipyrine clearance was increased by a mean of 26% 4 days after surgery, compared with a pre–operative control measurement. No significant change in antipyrine clearance was observed in children who received ketamine anaesthesia. There was also a significant difference in antipyrine clearance changes after surgery between the two groups (p < 0.05). Halothane has enzyme–inducing properties after a siigle exposure in children, while a single dose of ketamine does not.
Propofol and alfentanil infusion
Authors: KAY B. 
Published: February 2007

SummaryIn 42 patients undergoing major surgery, anaesthesia was induced by intravenous alfentanil 10 μg/kg together with methohexitone 1.5 mg/kg or propofol 2 mg/kg. An infusion of six times these doses per hour was then started; the rate was varied subsequently as indicated by the monitoring of arterial blood pressure, heart rate, EEG and frontalis electromyogram. The mean duration of infusion was 76.7 minutes for propofol and 74.5 minutes for methohexitone and the infusion was stopped about 10 minutes before the end of surgery in each group. The induction dose differed, but the total dose requirement for the two drugs was similar. In every case, anaesthesia was satisfactory. Methohexitone caused a significant rise in mean pulse rate throughout anaesthesia (p < 0.05, paired t–test). There was no change in mean puke rate during propofol infusion. The dose of alfentanil used provided excellent control of autonomic reflexes, with negligible respiratory depression. Naloxone was not required. Propofol provided better anaesthesia than methohexitone, with fewer side effects (p < 0.05. Chi squared test), easier control of the level of narcosis and faster recovery (p 0.001. t‐test after log transformation).
Anaphylaxis to precurarising doses of gallamine triethiodide
Authors: HARRISON J. F. , BIRD A. G. 
Published: February 2007

SummaryTwo cases are described in which patients developed acute anaphylactic reactions to precurarhing doses of gallamine. Life threatening complications can arise from the use of small doses of drugs as adjuncts to anaesthesia and raises the question whether the benefts of precurarisation outweigh the risks of anaphylaxis.
No moving parts
Authors: CALHAEM M.N. 
Published: February 2007

SummaryInterchange between ventilatory and spontaneously breathing modes using a Bain system and a Penlon Nuffield 200 ventilator may be achieved by the single action of switching the ventilator on or off. No alteration is made to the expiratory valve, reservoir bag, ventilator tubing or scavenging system and there are no levers.
Ventilation and the oculocardiac reflex
Authors: MIRAKHUR R. K. , SHEPHERD W. F. I. , JONES C. J. 
Published: February 2007

SummaryA randomised prospective study was carried out in children undergoing surgery for squint correction, to determine the value of controlled ventilation as a prophylaxis against the occurrence of the oculocardiac reflex. One hundred patients anaesthetised with nitrous oxideloxygen and halothane were randomly assigned to either ventilated or spontaneously breathing groups of 50 each. Half the patients in each group received glycopyrronium 7.5 μg/kg intravenously at the time of induction of anaesthesia. Heart rate, rhythm, blood pressure and end tidal CO2 concentration were monitored throughout. A positive oculocardiac reflex. defined as a fall in heart rate of 20% or more and/or the occurrence of dysrhythmias, was observed in 72% of spontaneously breathing patients and in 100% of ventilated patients not receiving prophylactic intravenous glycopyrronium. The incidence of a positive reflex in patients receiving glycopyrronium was 10% (4 and 16% respectively in spontaneously breathing and ventilated patients). It is concluded that controlled ventilation is of no value as a preventive measure against the occurrence of the oculocardiac reflex in patients undergoing squint surgery and that prophylaxis is safely achieved with the use of intravenous glycopyrronium.
Acquired C1 esterase inhibitor deficiency
Authors: RAZIS P. A. , COULSON I. H. , GOULD T. R. , FINDLEY I. L. 
Published: February 2007

SummaryA case of acquired C1 esterase inhibitor deficiency and its anaesthetic implications is presented. Prophylaxis against angioneurotic oedema using danazol and tranexamic acid is described and the resultant complication of mesenteric venous thrombosis reported.
In vitrobuffering capacity of Alka Seltzer Effervescent
Authors: Murrell G. c. , Rosen M. 
Published: February 2007

SummaryThe variety of antacids used as a prophylaxis for acid aspiration syndrome reflects dissatisfaction with each agent. Alka Seltzer Effervescent is a proprietary product without aspirin. We have shown that it can easily be dissolved in a small volume, readily mixes with hydrous fluids, and has a satisfactory neutralising capacity. Its non‐particulate nature, storage in individual packages and palatability, indicated by commercial acceptance overseas, show that further trials in vivo as a method of raising gastric pH may be useful.
Time course of action of combinations of vecuronium and pancuronium
Authors: Pandit S. K. , Ferres C. J. , Gibson F. M. , Mirakhur R. K. 
Published: February 2007

SummaryVecuronium 0.1 mg/kg, puncuronium 0.1 mg/kg, vecuronium 0.075 mg/kg t pancuronium 0.025 mg/kg, vecuronium + pancuronium 0.05 mg/kg each and vecuronium 0.025 mg/kg + pancuronium 0.075 mg/kg were compared with respect to time tuken to onset oj effect, duration of clinical relaxation and intubation conditions in jive groups of 20 patients each. Thi. time to onset and intubating conditions were similar in all thc groups. indicating that the combinations have no advantage over the individual drugs. The duration of clinicul relaxation was 25 minutes with vecuronium, and increased as the proportion of pancuronium in the niixturc increased, being 56 minutes with pancuronium 0.I mg/kg.
Anaesthesia for surgical occlusion of the basilar artery
Authors: Child C. S. , Heining M. P. D. , Calder I. , Crockard H. A. 
Published: February 2007

SummaryA case is described of a giant fusiform aneurysm of the basilar artery which was treated successfully by proximal surgical occlusion of the artery. The anaesthetic management involved the intra‐operative awakening of the patient in order to assess neurological function immediately after application of the clip. The difficulties involved in this type of surgery are discussed.
A pre‐induction test dose for suxamethonium
Authors: CARNIE J. 
Published: February 2007

SummaryA two‐part experimental and clinical study was conducted to determine the effects of administration of a pre‐induction dose of suxamethonium, and to see whether the symptoms produced could form the basis of a test dose, to determine sensitivity to suxamethonium prior to administration of a full intubation dose. Suxamethonium was shown to produce distinctive clinical features characterised by signs of both extra‐ocular muscle contraction and paresis, manifest by symptoms of eye and eyelid heaviness without generalised paresis. The dose response was determined in individuals with normal plasma cholinesterase, to a test dose of suxamethonium chloride of between 20 and 1 μg/kg. Individuals with abnormal plasma cholinesterase were shown to exhibit sensitivity to these low doses and were easily distinguished from those with normal enzyme.A protocol is suggested which can conveniently establish, prior to induction, those individuals with a reduced ability to hydrolyse suxamethonium.
An investigation of factors affecting postoperative rewarming of adult patients
Authors: CARLI F. , GABRIELCZYK M. , CLARK MARGARET M. , ABER V. R. 
Published: February 2007

SummaryAural canal temperature was measured for one hour after arrival in the recovery room in 200 adult patients who underwent one of the following types of major surgery: abdominal, pelvic, vascular, orthopaedic or prostatic. One group of 100 patients was studied in the recovery room of Hammersmith Hospital which was not equipped with a controlled system for constant ventilation and humidification, while the other 100 patients were studied in the recovery room of Edgware General Hospital. which had a constant ambient temperature and controlled relative humidity with 20 air changes/hour. The rate of rewarming was found to be similar in both groups. Within the range of ambient temperatures and relative humidities measured, patients over 60 years of age rewarmed more slowly than did patients under 60 years (p < 0.05). General anaesthesia was associated with significantly faster rewarming than was local anaesthesia (p < 0.01).
Atracurium infusions in patients with renal failure on an ITU
Authors: GRIFFITHS R. B. , HUNTER JENNIFER M. , JONES R. S. 
Published: February 2007

SummaryAn infusion of atracurium was used (after an initial bolus dose) in five patients with renal and respiratory failure, who were being subjected to intermittent positive pressure ventilation before renal dialysis. Neuro‐muscular function was monitored by the train‐of‐four pattern of stimulation. In three patients, atracurium 0.6–0.7 mg/kg/hour completely abolished the twitch response; in the other two (both of whom were markedly oedematous) this did not occur, even with a dose of 1.0 mg/kg/hour. although satisfactory clinical control was obtained. In all patients. there was rapid spontaneous recovery when the infusion was stopped. One patient convulsed, but plasma laudanosine levels taken at this time were below the toxic range. Atracurium infusions appear to provide easily controllable neuromuscular blockade in the intensive therapy unit, although these preliminary results suggest that larger doses may be required in the oedematous patient.
Changes in skin thermal clearance during anaesthesia
Authors: SAUMET J. L. , DEGOUTE C. S. , DITTMAR A. , BANSSILLON V. 
Published: February 2007

SummaryThermal and vascular side effects occuring during general anaesthesia are related to skin blood flow. A new, noninvasive probe which measures skin thermal clearance, a variable closely related to skin blood flow, was used in nine patients under phenoperidine, droperidol, propanidid anaesthesia. Statistically significant increases in skin thermal clearance clearly preceded the drop in mean arterial blood pressure and the rise in skin temperature. It is concluded that general anaesthesia induced an early increase in skin blood flow and that thermal clearance is a better technique than skin thermometry to monitor skin blood flow.
Morbidity after day case laparoscopy. A comparison of two techniques of tracheal anaesthesia
Authors: Skacel M. , Sengupta P. , Plantevin O.M. 
Published: February 2007

SummaryA comparison was made of postoperative morbidity following two anaesthetic techniques for day case laparoscopies. One group of patients was allowed to breathe spontaneously after intubation under suxamethonium. The second group received atracurium and their lungs were mechanically ventilated. Patients in the controlled ventilation group experienced significantly less severe sore throats and muscle pain in the first 24 hours postoperatively than the patients who breathed spontaneously. Both techniques proved to be safe and are suitable for day case laparoscopy. The safety of patients is discussed in relation to the choice of anaesthetic technique used.
Fire in the operating theatre. Evacuation pre–planning may save lives
Authors: Moxon Mary A. , Ward M.E. 
Published: February 2007

SummaryAn operating theatre fire and the steps taken to deal with it are described: the difficulties encountered in evacuating anaesthetised patients are highlighted. Measures which might be taken to prevent recurrence of these problems, and recommendations on the institution of fire drills for the safety of patients and staff are given.
Beta‐adrenoceptor blockade and suxamethonium‐induced rise in plasma potassium
Authors: Maryniak J. K. , Henderson A. M. , Woodall N. M. , Lim M. , Simpson J. C. 
Published: February 2007

SummaryThe effects of beta‐adrenergic blockade on the suxamethonium‐induced rise in arterial plasma potassium were studied in patients who presented for open heart surgery. No potentiation of the immediate rise in plasma potassium was observed.
Lung water during the puerperium
Authors: MACLENNAN F. M. , MACDONALD A. F. , CAMPBELL D. M. 
Published: February 2007

SummaryAn alteration in pulmonary water balance might be expected during pregnancy and the puerperium, as a result of the physiological adaptations to pregnancy. A preliminary investigation of this hypothesis was conducted using a radiological method of lung water measurement in 20 normal primigravidae during the early puerperium. Evidence of interstitial lung water was found in seven of the 20 mothers. There was a significant correlation with plasma volume (p < 0.05) and fluid turnover (p < 0.05) in the group with excess lung water. The implications of increased interstitial lung water and its possible causes during pregnancy are discussed.
A new percutaneous infraclavicular approach to the axillary vein
Authors: NICKALLS R. W. D. 
Published: February 2007

SummaryA new percutaneous infraclavicular approach for cannulating the axillary vein is described. The technique was devised using surface landmarks established by cadaver dissection. This is a relatively safe procedure with no risk of pneumothorax, provided that the tip of the needle remains inferior to the clavicle.
Vecuronium—A variable dose technique
Authors: Feldman S.A. , Liban J.B. 
Published: February 2007

SummaryVecuronium was administered to patients in doses of 100, 150, 200 and 250 μg/kg and the duration of action recorded by noting the time to recovery of the first twitch in a train‐of‐four to 10% of the control twitch. The recovery times ranged from a mean of 28.4 minutes (100 μg/kg) to 72.4 minutes (250 μg/kg). It is suggested that for operations of medium to long duration the use of a large initial bolus dose of vecuronium is a technique with advantages over the use of an infusion or frequent incremental doses.
Vomiting after ophthalmic surgery
Authors: VAN DEN BERG A. A. , LAMBOURNE A. , YAZJI N. S. , LAGHARI N. A. 
Published: February 2007

SummaryThe usefulness of intra‐operative antiemetics and postoperative oral fluid restriction in the prevention of vomiting following anaesthesia for ophthalmic surgery, was studied in 200 patients. They were allocated into four groups of 50 and given either saline (as control), droperidol, metoclopramide or prochlorperazine. Oral intake was restricted postoperatively in half of the patients of each group. Anaesthesia comprised morphine and atropine premedication and a halothane, nitrous oxide and oxygen spontaneous breathing technique. No significant beneficial effects resulted from intra‐operative antiemetics; vomiting incidences of 26% after saline and droperidol, 28% after metoclopramide and 14% after prochlorperazine were observed. Younger patients and females vomited most frequently. Restriction of oral fluids did not decrease the incidence of vomiting but demonstrated that approximately half of those patients who vomit do so with their first postoperative oral intake. Vomiting was observed more frequently after non intra‐ocular surgery than after intra‐ocular surgery (37% cf. 16%, p < 0.01) and postoperative analgesics were required by more non intra‐ocular patients than by intra‐ocular patients (25% cf. 5%, p < 0.001). Squint patients vomited most frequently (48%) and most frequently required postoperative analgesia (35%).
Economy in the use of muscle relaxants Vecuronium after pancuronium
Authors: KAY B. , CHESTNUT R. J. , SUM PING J. S. T. , HEALY T. E. J. 
Published: February 2007

SummaryVecuronium is an intermediate duration, non‐depolarising muscle relaxant. When used during prolonged procedures, it may be given by intermittent injection, by continuous infusion or by a single very large dose at the start of anaesthesia. It may also be used to maintain relaxation after the initial use of a long‐acting agent, such as pancuronium. This study demonstrates that the effect of a dose of vecuronium used in this fashion is increased when interaction with pancuronium takes place. The clinical and theoretical implications of this observation are discussed.
Respiratory obstruction following vocal cord injection
Authors: BODENHAM A. , LATIMER R. , BETHUNE D. 
Published: February 2007

SummaryTwo patients who each had a paralysed left vocal cord are discussed. Both had poor coughing ability preoperatively. The affected cords had been injected with tetrafluoroethylene (Teflon) paste 3 days before operation and this had given immediate improvement in coughing and speech. During induction of anaesthesia, respiratory obstruction occurred that was related to the injected cord. This cause of obstruction has not been reported previously. The potential benefits of cord injection for voice, cough and laryngeal competence are reviewed.
Drawover anaesthetic systems
Authors: MACKIE A. M. 
Published: February 2007

SummaryThe factors that determine the inspired oxygen concentration delivered by drawover anaesthetic systems were studied in the laboratory and in anaesthetised patients. The inspired oxygen concentration is dependent upon oxygen flow, reservoir volume and total ventilation; respiratory rate and inspiration: expiration ratio have a small influence. A reservoir of at least of 1 m corrugated tube (internal volume 415 ml) makes optimal use of a 4 litres/minute oxygen flow. Delivery of a safe inspired oxygen concentration can be ensured with economical oxygen flows.
Concurrent drug therapy in patients undergoing surgery
Authors: Duthie D.J.R. , Montgomery J.N. , Spence A.A. , Nimmo W.S. 
Published: February 2007

SummaryIn a retrospective study of 57 176 patients and a prospective study of 216 patients undergoing surgery, 24–32% of patients were receiving some concurrent medication. Between 10 and 16% were taking drugs for cardiovascular disease. Of these, only 71% had their normal medication prescribed before surgery and only 41% received their drugs on the day of surgery.
Value of pre‐operative carotid sinus massage
Authors: McCONACHIE I. 
Published: February 2007

SummaryThe usefulness of carotid sinus massage in pre‐operative assessment is discussed with case examples. The technique and risks of carotid sinus massage are described. Carotid sinus massage is of particular value in the demonstration of sino‐atrial and atrioventricular node disease in the absence of definitive abnormalities on the routine resting electrocardiogram, and in the identification of patients who show a hypersensitive response to vagal stimulation. These patients should be identified prior to procedures that involve marked vagal activity, since prolonged sinus arrest may occur.
Abscess following cannulation of the radial artery
Authors: LINDSAY S. L. , KERRIDGE R. , COLLETT B‐J. 
Published: February 2007

SummaryLocal abscess formation, septicaemia and median nerve patsy occurred as complications of radial artery cannulation in a 24‐year‐old man with malaria. The case is described and the nosocomial infection hazard of arterial cannulation is discussed.
Comparison of conventional intermittent positive pressure ventilation with high frequency jet ventilation
Authors: NORMANDALE J. , PATRICK M. , SHERRY K. M. , FENECK R. O. 
Published: February 2007

SummaryThis study was designed to compare the cardiorespiratory effects of high frequency jet ventilation at 150 breaths/minute with and without added positive end expiratory pressure, with conventional intermittent positive pressure ventilation in 20 patients following aortocoronary bypass graft surgery. On comparison with intermittent positive pressure ventilation, there was a decrease in peak airway pressure during high frequency jet ventilation when positive end expiratory pressure of 0 or 0.5 k Pa was applied, but not with 1 k Pa. and an increase in mean airway pressure with positive end expiratory pressures of 0.5 and 1 k Pa. On changing from intermittent positive pressure to high frequency jet ventilation with no added end expiratory pressure, there was an acute decrease in arterial oxygen tension and increases in cardiac output and total tissue oxygen delivery. On changing from intermittent positive pressure ventilation to high frequency jet ventilation with I k Pa of positive end expiratory pressure, there was an acute decrease in arterial oxygen tension, cardiac output and oxygen delivery, and increases in pulmonary arterial, right atrial and pulmonary capillary wedge pressures. The addition of positive end expiratory pressure did not prevent the acute decrease in arterial oxygen tension which occurred on transfer to high frequency jet ventilation.
Intranasal nitroglycerine attenuates pressor response to tracheal intubation in beta‐blocker treated hypertensive patients
Authors: Grover V. K. , Sharma S. , Mahajan R. P. , Singh H. 
Published: February 2007

SummaryThe effect of intranasal nitroglycerine on the pressor response to laryngoscopy and tracheal intubation was studied in 40 adult hypertensive patients treated with beta‐blocking drugs. Nitroglycerine 0.75 mg, administered intranasally 30 seconds before induction of anaesthesia, was compared with a placebo solution of saline. Haemodynamic variables were measured for 10 minutes after laryngoscopy and tracheal intubation. Heart rate did not change significantly in either group. Systolic as well as mean arterial blood pressure increased significantly for the first 5 minutes in the control group, whereas patients in the nitroglycerine group showed a decrease in systolic as well as in mean arterial pressure. No patient in the nitroglycerine group showed a decrease in systolic arterial pressure greater than 20 mmHg. In conclusion, intranasal nitroglycerine ameliorates the pressor response to laryngoscopy and tracheal intubation in beta‐blocked patients.
Closed‐loop administration of atracurium
Authors: WEBSTER N. R. , COHEN A. T. 
Published: February 2007

SummaryThe advent of newer muscle relaxants with predictable rates of metabolism and times of offset of neuromuscular blockade now makes it possible to use intravenous infusion safely as a mode of delivery. This has many advantages over administration by intermittent bolus. Moreover, it is feasible to use a servo system for their delivery. We have developed and evaluated such a system which is portable and requires little computer expertise to set up and use. It is a useful adjunct to routine anaesthesia, as well as a potentially powerful research tool.