bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recovery and morbidity after daycase anaesthesia
Authors: MILLAR J. M. , JEWKES C. F. 
Published: February 2007

SummaryThe anaesthetic conditions, recovery and side effects for 48 hours postoperatively were compared after anaesthesia for day surgery using propofol or thiopentone‐enflurane with and without alfentanil. Propofol provided good conditions for surgery with faster immediate recovery (p < 0.001): patients who received it were fit for discharge significantly sooner (p < 0.001). Visual analogue scores of postoperative wellbeing showed an improvement in both propofol groups (p < 0.01]; after thiopentone and enflurane the scores were reduced and took 2 days to return to the pre‐operative values. There was a significant (p < 0.001) reduction in postoperative morbidity in both the groups that received propofol up to 24 hours after discharge. The addition of alfentanil improved anaesthetic conditions and reduced postoperative morbidity with both propofol and thiopentone–enflurane.
A comparison of the response of hand and facial muscles to non‐depolarising relaxants
Authors: PATHAK D. , SOKOLL M. D. , BARCELLOS W. , KUMAR V. 
Published: February 2007

SummaryThis study compares the response of the muscles of the hand to those of the face during non‐depolarising neuromuscular blockade. It was found that observation of the facial muscles was misleading both in terms of degree of neuromuscular blockade and adequacy of reversal.
Argyria or cyanosis
Authors: TIMMINSand A. C. , MORGAN G. A. R. 
Published: February 2007

SummaryA case of argyria secondary to the prolonged use of nasal drops that contained mild silver protein is presented. The patient was thought to be cyanosed immediately after a total knee replacement. Argyria, its differentiation from cyanosis and its prevention are discussed. The need for a careful drug history is noted.
Phenytoin‐induced resistance to pancuronium
Authors: HICKEY D. R. , SANGWAN S. , BEVAN J. C. 
Published: February 2007

SummaryA case report is presented of a patient receiving chronic phenytoin therapy who demonstrated resistance to pancuronium by increased hourly requirements. Stable neuromuscular blockade was achieved by atracurium infusion at normal rates. Possible explanations for the differences in response to the two non‐depolarizing muscle relaxants are discussed.
An evaluation of the incentive spirometer to improve lung function after cholecystectomy
Authors: O'Connor M. , Tattersall M. P. , Carter J. A. 
Published: February 2007

SummaryForty patients who underwent elective cholecystectomy were allocated randomly to one of two groups. Patients in one group used an incentive spirometer as part of their postoperative chest physiotherapy; those in the other received routine postoperative physiotherapy as dictated by their needs. Each group contained equal numbers of smokers and nonsmokers, and the data from each group were analysed separately. The use of the incentive spirometer did not confer any benefits as judged by clinical evidence of pulmonary complications, pulmonary function tests or length of hospital stay.
Recovery of neuromuscular function and postoperative morbidity following blockade by atracurium, alcuronium and vecuronium
Authors: KONG K. L. , COOPER G. M. 
Published: February 2007

SummaryRecovery of neuromuscular function and postoperative morbidity were studied in 51 fit female patients who had nonemergency gynaecological laparoscopy as inpatients. They were allocated randomly to one of three groups to receive either atracurium 0.31 mg/kg, alcuronium 0.25 mg/kg, or vecuronium 0.06 mg/kg as part of an otherwise standard anaesthetic technique. There were neither differences in intubation conditions nor in the occurrence of postoperative diplopia whichever muscle relaxant was used. Deficits in grip strength and expiratory force were seen at one hour after reversal with atropine 1.2 mg and neostigmine 2.5 mg in all patients, deficits which persisted for 3 hours in those who received alcuronium. The recovery of inspiratory force, was slower and less complete at up to 3 hours in those who received alcuronium and there was a high incidence of minor postoperative morbidity at up to 24 hours in each of the three groups. The only statistical difference in symptomatic morbidity was an increase in muscle weakness in those who received alcuronium compared with atracurium at 3 hours after laparoscopy. Only 25Va, 20% and 31% of the patients who received atracurium, alcuronium and vecuronium respectively said that they would have liked to be day stay patients.
Comparison of propofol and methohexitone as anaesthetic agents for electroconvulsive therapy
Authors: DWYER R. , McCAUGHEY W. , LAVERY J. , McCARTHY G. , DUNDEE J. W. 
Published: February 2007

SummaryPropofol was compared to methohexitone for induction of anaesthesia for electroconvulsive therapy. Seizures were significantly shorter after the use of propofol, in respect of both visible seizures and duration of cerebral electrical seizure activity. This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent. Propofol was more effective than methohexitone at obtunding the hypertensive response to electroconvulsive therapy without causing significant hypotension.
Plasma catecholamine concentrations—changes after infiltration with local anaesthetic solutions and adrenaline during bat‐ear surgery
Authors: Lew J. K. L. , Mobley K. A. , Achola K. J. , Smith G. 
Published: February 2007

SummaryPlasma catecholamine concentrations were measured in 12 patients who had bilateral bat‐ear surgery following infiltration of each ear with 2 ml 2% lignocaine with adrenaline 1: 100 000. Venous blood samples were withdrawn before and at set intervals after infiltration. Plasma adrenaline concentration increased from 0.8 pmol/ml to a peak of 2.2 pmol/ml at 2 minutes after infiltration: this is cm increase of 175%. There was no significant change in plasma noradrenaline concentration.
Propofol for induction of anaesthesia in children
Authors: MORTON N. S. , WEE M. , CHRISTIE G. , GRAY I. G. , GRANT I. S. 
Published: February 2007

SummaryThe induction characteristics, dosage requirements, cardiovascular and respiratory effects of propofol with added lignocaine were compared with those of thiopentone and halothane inhalational induction in two groups of children aged 1–5 years and 5–10 years. Propofol induction produced significantly greater decreases in blood pressure, particularly in the 1–5‐year age group. Heart rate was maintained well with all three induction techniques. Pain on injection into a vein on the dorsum of the hand was significantly more common with propofol despite the addition of lignocaine. However, this was mild in the majority of children and did not interfere with the induction of anaesthesia. The incidence of respiratory depression and other adverse effects was low with all three induction methods. The mean induction doses of both intravenous agents were greater in the 1–5‐year age group. The ratio of thiopentone to propofol dose was approximately 2.5:1 in both age groups. The high incidence of pain on injection with propofol may prove to be a significant drawback to its otherwise satisfactory use in children.
Reversal of sedation by prolonged infusion of flumazenil (Anexate, Ro 15–1788)
Authors: BODENHAM A. , BROWNLIE G. , DIXON J. S. , PARK G. R. 
Published: February 2007

SummaryA 22‐year‐old male was involved in a road traffic accident and sustained multiple injuries. He received an infusion of midazolam to sedate him during a period of artificial ventilation. His conscious level remained depressed 36 hours after the infusion was discontinued but the sedation was completely reversed with flumazenil. An infusion was started because of the short duration of action of flumazenil, and continued for 8 days. The infusion was slopped seven times during this period and on each occasion except the last, his conscious level deteriorated but returned to normal when flumazenil was administered again. Plasma concentrations of midazolam and α‐hydroxymidazolam were measured and found to be low during this period. Possible explanations for this finding are discussed.
Cuff failure in polyvinyl chloride tracheal tubes sprayed with lignocaine
Authors: WALMSLEY A. J. , BURVILLE L. M. , DAVIS T. P. 
Published: February 2007

SummaryThe incidence of tracheal tube cuff rupture was noted in 30 polyvinyl chloride tracheal tubes lubricated with three different solutions. All cuffs moistened with water were intact after 2 hours of cuff inflation whereas two of 10 lubricated with 4% lignocaine solution had burst. Both of these had leaked at the site of cuff attachment to the tube. Fifty percent of tubes lubricated with Astra lignocaine spray burst during the study. Four of the five had developed pinholes in the cuffs themselves. The remaining 50% of this group showed marked distortion and thinning of their intact cuff walls. The implications of these findings are discussed in view of the widespread use of PVC tracheal tubes.
Intra‐ocular pressure changes during induction of anaesthesia and tracheal intubation
Authors: MIRAKHUR R. K. , ELLIOTT P. , SHEPHERD W. F. I. , ARCHER D. B. 
Published: February 2007

SummaryIntra‐ocular pressure was measured during induction of anaesthesia with propofol (n = 40) or thiopentone (n = 40) followed by vecuronium to facilitate tracheal intubation which was carried out 3 minutes after the administration of relaxant. The average induction doses were 2.15 and 4.83 mg/kg for propofol and thiopentone, respectively. Half the patients in each group received a supplementary dose of the same induction agent (propofol 1.0 mg/kg or thiopentone 20 mg/kg) prior to intubation. Both propofol and thiopentone produced a significant reduction in intra‐ocular pressure which decreased further after administration of vecuronium as well as the second smaller dose of the induction agents. Intra‐ocular pressure prior to intubation was lower in the two propofol groups in comparison to the corresponding thiopentone groups. Intubation was associated with an increase in intra‐ocular pressure but it still remained significantly below the baseline values except in the group given one dose of thiopentone. Supplementary doses of inducation agents before intubation attenuated the increase in intra‐ocular pressure. Propofol was significantly more effective this respect and this group showed the lowest intra‐ocular pressure throughout the study period. However administration of propofol resulted in a 30% incidence of pain on injection and a decrease in systolic arterial pressure of more than 30% in about half the patients.
Mood evaluation and outpatient anaesthesia
Authors: McDONALD N. J. , MANNION D. , LEE P. , O'TOOLE D. P. , O'BOYLE C. , KEANE P. K. 
Published: February 2007

SummaryMood state was evaluated in 40 unpremeditated patients who underwent minor gynaecological surgery, before and up to 4 hours after, anaesthesia induced with either propofol 2.5 mg/kg or thiopentone 5 mg/kg. Assessments were made by a self‐report technique, the profile of mood states method. The results indicate that mood state was less affected postoperatively in patients induced with propofol than with thiopentone. The overall impression of the investigators was that propofol patients had a definite sense of well‐being after anaesthesia.
Propofol for inpatient dental anaesthesia. A comparison of propofol as sole anaesthetic agent with thiopentone and halothane for inpatient dental anaesthesia
Authors: Hunter S. J. , McLaren C. A. B. 
Published: February 2007

SummaryThe induction, maintenance and recovery characteristics of propofol anaesthesia were compared with thiopentone induction and halothane maintenance in 51 spontaneously breathing, intubated patients who underwent dental surgery. Induction with thiopentone produced fewer side effects than propofol, notably pain on injection. Control of the depth of anaesthesia was better in patients who breathed halothane than in those who received intermittent bolus doses of propofol. Recovery characteristics of the two groups were similar.
A comparison of propofol and midazolam by infusion to provide sedation in patients who receive spinal anaesthesia
Authors: Wilson E. , Mackenzie N. , Grant I. S. 
Published: February 2007

SummaryTwenty patients scheduled for orthopaedic surgery under spinal anaesthesia received by intravenous infusion either 1% propofol or 0.1% midazolam at a rate adjusted to maintain adequate sedation as judged on a five‐point scale. No other anaesthetic or analgesic drugs were given. The mean time to reach the required level of sedation was similar in both groups and the quality and ease of control of sedation were good in all patients. Mean infusion rates were 3.73 mg/kg/hour for propofol and 0.27 mg/hg/hour for midazolam. Airway maintenance was excellent and there were no side effects other than restlessness of the arms in one patient in each group. Recovery, judged by ability to open the eyes and recall date of birth, was significantly more rapid after propofol than after midazolam (2 and 10 minutes respectively after the end of infusion) and two patients in the latter group were unduly drowsy in the initial postoperative period. Pre‐ and postoperative amnesia were greater in the midazolam group but no patient had recall of peri‐operative events. Psychometric tests showed significantly better recovery of higher mental function after propofol for up to 2 hours after surgery.
‘Cured’ myasthenia gravis and neuromuscular blockade
Authors: LUMB A. B. , CALDER I. 
Published: February 2007

SummaryA symptomless myasthenic patient who played representative squash received 0.1 mg/kg of vecuronium and enflurane as part of a general anaesthetic for elective gynaecological surgery. Neuromuscular block was prolonged. The effect of neuromuscular blocking agents and volatile anaesthetics in symptomless myasthenics is discussed. We conclude that these patients should be assumed to be sensitive to such agents.
Pupillary signs during cardiac surgery
Authors: WOODALL N. M. , MARYNIAK J. K. , GILSTON A. 
Published: February 2007

SummaryPupil sizes and reactions to light were studied in 100 patients who had cardiopulmonary bypass. Behaviour of the pupils was observed at six stages during the operation. Most patients (71) had pupils of equal size and similar reaction to light at all times. Twenty‐three patients developed unequal pupils at some stage, while six had equal pupils throughout but exhibited differing reaction to light. Major cerebral deficit was significantly more common after operation in patients who developed inequality in pupil size than those who did not (p < 0.05). No relationship was seen between dissimilar pupil reaction to light and the development of neurological complications. The clinical estimation of pupil size may help to identify those patients who may exhibit postoperative major neurological dysfunction.
Hyperosmolality due to antacid treatment
Authors: FARAJ J. H. 
Published: February 2007

SummaryMagnesium trisilicate mixture is an antacid used commonly in our Intensive Care Unit in the prevention and treatment of stress ulcers. In this case the administration of large doses over a period of time led to the development of massive hyperosmolality, cerebral dehydration and coma. Management with hypotonic fluid resulted in complete recovery.
Effect of limb tourniquet on cerebral perfusion pressure in a head‐injured patient
Authors: ELDRIDGE P. R. , WILLIAMS S. 
Published: February 2007

SummaryThirty percent of patients with severe head injury also have significant extracranial injuries. Treatment for these injuries should not be allowed to jeopardise the brain which is more susceptible to damage in these circumstances. A case is presented in which significant decrease in cerebral perfusion pressure occurred consequent upon use of a lower limb tourniquet.
Pain relief after tonsillectomy Effect of benzydamine hydrochloride spray on postoperative pain relief after tonsillectomy
Authors: Valijan A. 
Published: February 2007

SummaryThe efficacy of benzydamine hydrochloride (Difflam) spray to relieve pain from postoperative tonsillectomy was assessed, but it was found that it did not relieve the symptoms after operation when compared to matching placebo.
Peripartum cardiomyopathy
Authors: LAVIES N. G. , TURNER D. A. B. 
Published: February 2007

SummaryA case of peripartum cardiomyopathy that occurred together with pre‐eclampsia is described. This gave rise to pulmonary oedema at 36 weeks’ gestation. Intensive care management and the need for invasive monitoring, especially pulmonary artery wedge pressure, of patients who develop pulmonary oedema in the peripartum period is discussed.
Isoflurane and cerebrospinal fluid pressure—a study in neurosurgical patients undergoing intracranial shunt procedures
Authors: Campkin T. V. , Flinn R. M. 
Published: February 2007

SummaryThe effect of isoflurane 1.0% and 1.5% with nitrous oxide on ventricular cerebrospinal fluid pressure was studied in 17 patients who underwent intracranial shunt procedures. Isoflurane at both concentrations caused significant increases in cerebrospinal fluid pressure during normocapnic ventilation, but these could be prevented by simultaneous hyperventilation or by the prior induction of hypocapnia. Decreases in mean arterial pressure occurred also, and resulted in a significant reduction in cerebral perfusion pressure in normocapnic patients.
Intra‐operative collapse or death related to the use of acrylic cement in hip surgery
Authors: Duncan J. A. T. 
Published: February 2007

SummarySix intra‐operative deaths and two episodes of near‐fatal hypotension occurred in 52 consecutive Hastings procedures (insertion of metal prosthesis grouted in acrylic cement) for subcapital fracture of the femoral neck. This high complication rate was identified by a system of clinical audit undertaken by members of the anaesthetic department.
Propofol—fentanyl anaesthesia for coronary artery surgery and cardiopulmonary bypass
Authors: RUSSELL G. N. , WRIGHT E. L. , FOX M. A. , DOUGLAS E. J. , COCKSHOTT I. D. 
Published: February 2007

SummaryA two‐stage propofol infusion combined with fentanyl was wed to maintain anaesthesia during coronary artery surgery in patients with good ventricular function. Whole blood propofol concentrations were measured at frequent intervals; plasma protein binding was measured before, during and after cardiopulmonary bypass. An initial infusion rate of 10 mg/kg/hour provided good protection from the pressor response to sternotomy. A predictable steady state concentration was achieved in the prebypass period with a maintenance infusion rate of 3 mg/kg/hour. The onset of bypass resulted in a small decrease in propofol concentration as a result of haemodilution. Induced hypothermia resulted in an increase in propofol concentration which returned rapidly to the prebypass steady state value during rewarming. The free propofol fraction increased during cardiopulmonary bypass. No patient had any recall of operative events or required inotropic support during weaning from bypass.
Respiratory arrest after a caudal injection of bupivacaine
Authors: LUMB A. B. , CARLI F. 
Published: February 2007

SummaryA 3.5‐year‐old child with Cornelia de Lange syndrome presenting for orchidopexy and herniotomy received general anaesthesia which was supplemented by a caudal injection of bupivacaine. Shortly after this he had a respiratory arrest with fixed dilated pupils. No cardiovascular system instability was observed. Approximately one hour later the child made a rapid and complete recovery. The possible causes of these events are discussed with particular reference to the potential effects of caudal injections on intracranial pressure.
The Cyclops 33 radiation thermometer
Authors: RAMACHANDRA V. , ALLAN L. G. , CARLI F. 
Published: February 2007

SummaryThe Cyclops 33 is a portable infrared radiation thermometer. It has many potential advantages over existing thermometers in anaesthetic practice. The technical details are described and the benejits over other instruments discussed. This apparatus offers considerable scope for advance in the field of thermometry in anaesthesia.
Epidural fentanyl and perineal pain in labour
Authors: Reynolds F. , O'Sullivan G. 
Published: February 2007

SummaryPerineal pain during the course of routine epidural analgesia with bupivacaine was treated with a 10‐ml top‐up of either bupivacaine 25 mg, fentanyl 100 μg or fentanyl 100 μg plus bupivacaine 10 mg, in 46 women in the first stage of labour. Only fentanyl plus bupivacaine produced consistently reliable analgesia which was quicker in onset and longer in duration (140, SD 26 minutes) than either fentanyl (114, SD 26 minutes) or bupivacaine (99, SD 44 minutes) alone. Side effects, itching and drowsiness, which were not troublesome, were more frequent in the groups given fentanyl.
Spinal anaesthesia in infants born prematurely
Authors: Gallagher T. M. , Crean P. M. 
Published: February 2007

SummarySpinal anaesthesia was used for 25 infants who were born prematurely and who subsequently required inguinal herniotomy. Hyperbaric bupivacaine 0.5% was administered in a dose of 0.3 mg/kg. Satisfactory surgical anaesthesia was achieved in 22 patients and there were no episodes of haemodynamic instability. The technique was not associated with postoperative apnoea. Spinal anaesthesia is a safe and effective alternative to general anaesthesia in these high‐risk infants. However, postoperative apnoea monitoring is still essential for all infants born prematurely.
‘Locked‐in’ syndrome
Authors: KENNY D. J. , LUKE D. A. 
Published: February 2007

SummaryThe ‘locked‐in’ syndrome has not previously been described in the immediate period after open‐heart surgery. We describe the case of a patient who remained tetraplegic and mute, but alert, after graft surgery. A brief review of the aetiological factors in the development of this type of stroke after coronary artery bypass is presented.
Atracurium overdose in a small infant
Authors: CHARLTON A. J. , HARPER N. J. N. , EDWARDS D. , WILSON A. C. 
Published: February 2007

SummaryAn error in setting a syringe driver caused a 2.75 kg infant to receive 37 mg atracurium over 75 minutes. Clinically full recovery of muscle power had returned spontaneously 135 minutes after the infusion was stopped. The child suffered no ill effects. Assay of blood and urine for atracurium and laudanosine conjirmed rapid clearance of the drug.
Hypoxaemia during outpatient dental anaesthesia
Authors: Allen N. A. , Rowbotham D. J. , Nimmo W. S. 
Published: February 2007

SummaryEighty children, ASA grade I, who had outpatient general anaesthesia for tooth extraction were studied. An inhalational induction was performed, with patients receiving halothane, niirous oxide and either 33% or 50% oxygen. Oxygen saturation was measured throughout the procedure using the Ohmeda Biox 3700 pulse oximeter. No Significant difference in the incidence of hypoxaemia was found between the two groups. There was no association between the grade of surgeon or anaesthetist and the incidence of hypoxaemia.
Anaphylaxis to latex during surgery
Authors: LEYNADIER F. , PECQUET C. , DRY J. 
Published: February 2007

SummaryFive young women, all of whom had anaphylactic responses in operating units, are described. Three of them worked in a hospital, three showed immediate hyper sensitivity to fruit and all had known urticaria to latex. Anaphylaxis appeared progressively 15 to 30 minutes after injection of anaesthetic drugs. Skin tests with these drugs were negative. Skin prick tests through gloves and with four different allergen preparations (saline which had been incubated with gloves and three kinds of latex) were positive. Human basophil degranulation tests with all four allergens were positive and radio allergo sorbent tests to latex were also positive. IgE‐dependent allergy to latex may be investigated by questionnaire and if necessary by prick tests before each operation to prevent anaphylaxis due to surgical gloves.