bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous metoprolol and cardiac dysrhythmias
Authors: ROLLASON W.N. , RUSSELL J.G. 
Published: February 2007

SummaryThe use of intravenous metoprolol in a dose of 0·06–0·17 mg/kg body weight proved effective in the treatment of sinus tachycardia in excess of 150 beats/min and/or ventricular dysrhythmias associated with light halothane anaesthesia for outpatient dental surgery. There were no side‐effects related to this cardioselective beta‐blocker in the dosage used.The prophylactic use of oral metoprolol should be considered for patients who find the prospect of dental treatment a fearsome experience.
Transcutaneous electrical nerve stimulation for chronic pain
Authors: Bates J.A.V. , Nathan P.W. 
Published: February 2007

SummaryThe results of 7 years experience in treating pain with transcutaneous electrical stimulation are reported. It was used on a group of 74 patients with postherpetic neuralgia and on a mixed group of 161 patients with chronic pain due to other conditions for which other forms of treatment had been unsatisfactory.The patients were lent stimulators and electrodes of various kinds. A half of the patients returned their stimulators after one month, but a quarter of the patients were still using transcutaneous stimulation after 2 years.No particular disease responded better or less well than any other; no particular kind of pain responded particularly well or badly.One third of the patients with postherpetic neuralgia started improving from the commencement of stimulation.
Clinical pharmacokinetics of fazadinium
Authors: BEVAN D.R. , D'SOUZA J. , ROUSE JANE M. , CALDWELL J. , SMITH R.L. 
Published: February 2007

SummaryFazadinium was administered as an intravenous bolus of 0·5 or 1 mg/kg to nine patients during neuroleptanaesthesia. Continuous recording of neuromuscular activity and serial collection of blood samples for drug assay allowed the relationship between neuromuscular blockade and plasma fazadinium concentration to be studied. Pharmacokinetic analysis demonstrated high plasma clearances (221 and 185 ml/min), and short terminal half‐lives, (30 and 50 min), for the two doses of the drug. Mean plasma concentrations at 10 and 50% recovery were 1·42 and 0·88 μg/ml respectively, demonstrating that the potency of fazadinium is approximately half that of tubocurarine and one eighth that of pancuronium. In addition, the relationship between plasma concentration and depression of neuromuscular activity during spontaneous recovery from the relaxant is described.
Applications of respiratory mass spectrometry to intensive care
Authors: GOTHARD J.W.W. , BUSST C.M. , BRANTHWAITE M.A. , DAVIES N.J.H. , DENISON D.M. 
Published: February 2007

SummaryA monitoring and research system based on a respiratory mass spectrometer controlled by a microprocessor has been installed in a paediatric intensive care unit. It provides an opportunity to study up to twelve patients simultaneously at distances up to 30 m from the instrument, can operate for prolonged periods without intervention, and includes a routine for regular calibration checks. There is an automatic sensitivity control which compensates for minor variations in probe patency or in water vapour pressure.Information derived from the system can be displayed centrally or at the bedside and data can be conserved for up to 24 hours; past events can be recalled and displayed for either the previous hour or previous 24 hours. The system can be used to measure respired gas tensions, metabolic gas exchange, lung volume, pulmonary blood flow and pulmonary tissue volume. The clinical value and limitations of the system are discussed.
Administration of drugs during cardiopulmonary bypass
Authors: Kamath B.S.K. , Thomson D.M. , Johnston B. 
Published: February 2007

SummaryThis study was conducted to determine the efficiency of delivery of drugs injected as boluses by the common routes available during cardiopulmonary bypass.Radioactive technetium (99m Tc) was injected in a 50 μci bolus into the central venous line or into the arterial or venous lines of the oxygenator and its passage monitored downstream by suitable radiation detectors. When injected into the central venous line, delivery was unpredictable and at times 50‰ or more of the dose may not appear for 5 min. When injected into the venous line of the oxygenator an average 5‰ of the total dose had not reached the detector during first passage, and had completely cleared at 2 min.No significant difference was found between the different oxygenators and it is concluded that the venous line of the oxygenator is the most efficient site for the achievement of rapid action of drugs.
Haemodynamic changes following buprenorphine and morphine
Authors: SCOTT DAVID H. T. , ARTHUR G. RICHARD , SCOTT D. BRUCE 
Published: February 2007

SummaryTwenty‐five women were investigated on the day after lower abdominal surgery in a single‐blind non‐crossover trial to assess and compare the haemodynamic effects of intravenous injections of buprenorphine 0·3 mg and morphine 7·5 mg. Arterial blood pressure was measured by sphygmomanometry and cardiac output by thoracic impedance cardiograph. Arterial blood pressure was significantly reduced following both drugs (p < 0·05), although the mean decrease in systolic arterial pressure was less than 8 mmHg. However, in one patient in each group the decrease was more than 20 mmHg. Cardiac output decreased but the mean reduction was less than 5%. The greatest individual decreases were 21% after buprenorphine and30% after morphine. Myocardial contractility, assessed by systolic time indices, did not appear to change. There were no consistent differences in the haemodynamic effects of the two drugs.
Computer‐assisted self‐assessment in anaesthesia: a preliminary study
Authors: Campbell Donald , Kenny Gavin N.C. , Schmulian Carol , Davis Paul D. 
Published: February 2007

SummaryFifty‐six anaesthetists participated in a trial of the use of microcomputers for self‐assessment. Ninety‐three per cent of the anaesthetists found the concept of computer‐assisted self‐assessment acceptable. The only significant difference in the scores achieved by different groups was found with a specialised intensive care program in which senior registrars had a higher average score than older consultants.
Pulmonary blood flow and tissue volume
Authors: SALT J.C. , GOTHARD J.W.W. , BRANTHWAITE M.A. 
Published: February 2007

SummaryPulmonary blood flow and tissue volume have been measured by a rebreathing technique in which the disappearance of soluble and insoluble gases from an inhaled mixture is followed continuously using a respiratory mass spectrometer. Although measurements made with diethyl ether are more reproducible than those made with freon‐22, they are inaccurate because ether (the more soluble gas) is taken up by the tissues surrounding the respiratory dead space. Experiments carried out on four normal subjects demonstrate that measurements of both pulmonary blood flow and tissue volume are influenced by the volume of gas in the lungs during the manoeuvre. Possible reasons for this are discussed and an exponential relationship between the two variables and lung volume is suggested.
Anaesthetic staffing in England and Wales
Authors: REES L.T. 
Published: February 2007

SummaryThe numbers of anaesthetists and of surgeons in the English Health Regions and in Wales as at September 1978, are given in whole‐time equivalents per 100,000 of population.All Regional figures are presented as percentages of the national average so that comparisons between Regions can be made. Marked inter‐Regional differences are shown, both in the nunbers of anaesthetists per unit of population and in the ratios of surgeons to anaesthetists.The pattern argues for a modification in central policy and for a greater involvement of anaesthetists in future manpower planning than appears to have been the case in the past.
Low frequency ventilation
Authors: SPOEREL WOLFGANG E. 
Published: February 2007

SummaryTwo miniature ventilators, the ‘Automatic‐Vent’ and the ‘Minivent’, were used for controlled ventilation by intermittent occlusion of the outflow from the Bain breathing system. They were attached in a reverse position to that of their original use, so that the fresh gas inflow inflated the lungs up to the critical pressure of the magnetic valve. This resulted in low frequency ventilation with a long gradual inflation, a much shorter deflation, and no rebreathing.The combination of the Bain system and the miniature ventilators was examined in a simple lung model. The minute ventilation had an upper limit of about 5·5 litres/minute which could no longer be increased with fresh gas flows above 8·0 litres/minute due to the design of the ventilators. Changes in compliance or inflation pressure altered the frequency or the I:E ratio, but not the minute ventilation.Twenty‐eight patients were ventilated from 30 to 90 minutes with this system during routine anaesthesia, using fresh gas volumes usually recommended for the Bain system and inflation pressures between 15 and 20 cmH2O. A mean (± SD) fresh gas volume of 74 ± 4 ml/kg/minute resulted in a frequency of 6 ± litres/minute at an I:E ratio between 3:1 and 4:1. The mean PaCO2 was 4·92·0·67 kPa. The PaO2 ranged between 14·7 and 17·9 kPa with an inspired O2 of about 28%. No adverse cardiovascular effects were observed. Low frequency ventilation with an I: E ratio of up to 4:1 can provide adequate CO2 elimination and oxygenation. The combination of Bain circuit and magnetic vents could be used with caution as an economical ventilating system during anaesthesia.
Errors in oxygen concentration analysis: sensitivity of the IMI analyser to nitrous oxide
Authors: ORCHARD C.H. , SYKES M.K. 
Published: February 2007

SummaryThe sensitivity to nitrous oxide of the IMI oxygen analyser (Model 3300) has been tested. Even if the manufacturer's checks are performed and the analyser appears to be functioning correctly, the reading given by the IMI oxygen analyser may be seriously affected by the presence of nitrous oxide.There is a wide variation in the sensitivity to N2O between different instruments, and this variation is partly a function of the electrode.The influence of nitrous oxide on a particular meter may be assessed by placing the probe in 100% nitrous oxide and noting the shift of the meter from zero.
ICI 35868 (Diprivan): a new intravenous anaesthetic
Authors: KAY B. , STEPHENSON D.K. 
Published: February 2007

SummaryICI 35868 (Diprivan), 1–2 mg/kg was used to induce anaesthesia in 20 patients, and the results compared with induction of anaesthesia by Althesin 0·5 ml/kg given to a similar group of 20 patients. ICI 35868 was effective in inducing anaesthesia, but produced more respiratory depression, and cardiovascular effects which were significantly different from those produced by Althesin. ICI 35868 gave a smoother induction. It is concluded that ICI 35868 is a promising new induction agent which may also find application for the maintenance of anaesthesia.
Recovery from pancuronium
Authors: MARSH R.H.K. , CHMIELEWSKI A.T. , GOAT VALERIE A. 
Published: February 2007

SummaryThe rate at which paralysis from pancuronium could be reversed by neostigmine was monitored in two groups of patients, one elderly and the other young adults.Some patients were found to have prolonged recovery times, and this slow reversal occurred more frequently in the older group of patients. Possible reasons for this are discussed.
Barbiturate therapy in cerebral ischaemia
Authors: BELOPAVLOVIC M. , BUCHTHAL A. 
Published: February 2007

Summary Experimental and clinical studies of the protective effect of barbiturates in cerebral ischaemia are reviewed. Their action in protecting the brain from the effects of ischaemia is related to their action as anaesthetic agents and probably to the depression of neuronal function and metabolism but is incompletely understood. Their effect is dose related. Early administration is likely to be crucial to the success of barbiturate therapy as secondary events following an episode of cerebral ischaemia can lead to irreversible brain damage within 2–3 h. A potential collateral circulation appears to be essential for the protective effect of barbiturates. There may be a possibility of partly overcoming time delays in administration by giving larger doses of barbiturates.
Barbiturate therapy in the management of cerebral ischaemia
Authors: BELOPAVLOVIC M. , BUCHTHAL A. 
Published: February 2007

SummaryTwo patients who underwent surgery for cerebral aneurysms are presented. In the first case 31 g thiopentone were given postoperatively over 20 h after the patient had already been comatose for many hours. Such high doses raise considerable problems in patient management. In the second case a loading dose of 50 mg/kg thiopentone was given prophylactically to a patient undergoing cerebral aneurysm surgery beginning at the induction of anaesthesia and before surface cooling was begun. Cerebral activity was monitored continuously with a cerebral function monitor (CFM). There was no significant cardiovascular depression, little delay in postoperative recovery and no permanent neurological sequelae.In cerebral aneurysm surgery, cerebral oedema following cerebral ischaemia, either associated with vasospasm or resulting from surgical occlusion of vessels, remains a major problem postoperatively and may be an indication for preventive treatment with barbiturates. The authors contend that this technique merits further evaluation in cerebro‐vascular surgery, especially in high risk cases.
Intra‐operative awakening during scoliosis surgery
Authors: Abott T.R. , Bentley G. 
Published: February 2007

SummaryA method of intra‐operative awakening which allows assessment of spinal cord function during Harrington rod spinal fusion for scoliosis is described. The anaesthetic technique is based on a standard muscle relaxant, N2O anaesthetic sequence supplemented with intravenous morphine 0·1 mg/kg at the commencement of surgery and 0·2 mg/kg intramuscular premedication. This relatively large total dose of morphine may reduce intra‐operative awareness, and may also provide substantial pain relief during the initial 24 h postoperative period. It has been used successfully in 20 patients aged between 6 and 16 yr. Five patients remembered being woken, but did not regard it as unpleasant. In one patient, this technique allowed intra‐operative detection and correction of impaired motor function of the legs
Occupational exposure to anaesthetics in 20 hospitals
Authors: DAVENPORT H.T. , HALSEY M.J. , WARDLEY‐SMITH BRIDGET , BATEMAN P.E. 
Published: February 2007

SummaryThe nitrous oxide and halothane contamination in the inspired air of anaesthetists and in the atmospheres of operating theatres, anaesthetic induction and recovery rooms, were measured during normal unmodified working sessions in 20 hospitals using integrated personal samplers. The nitrous oxide (and halothane) levels ranged from < 10 to 3000 ppm (<0·1 to 60 ppm) in the different areas with an average of 388·5 ppm (2·8 ppm) for the inspired air of the anaesthetists during 2 hour sampling periods. There was no correlation between the levels of the anaesthetists' exposures and those in the static air samples and this appeared to be due primarily to a wide variation in work practices and techniques. Thus it is potentially misleading to assess anaesthetists' occupational exposure by collecting ambient air samples in the operating rooms. Comparisons with more prolonged measurements in one hospital indicated that the installation of relatively simple active scavenging devices will be effective in most hospitals.
Laryngeal oedema and pre‐eclampsia
Authors: SEAGER S. JEANNE , MACDONALD ROSEMARY 
Published: February 2007

SummaryA case of laryngeal obstruction secondary to laryngeal oedema and a superimposed upper respiratory tract infection in a pre‐eclamptic patient is reported. The management of the case is described and the possible effects of drug therapy on the uterus are discussed. Other reports of asymptomatic laryngeal oedema in pregnancy are reviewed.
Paraplegia after epidural analgesia associated with an extradural spinal tumour
Authors: HIRLEKAR GIRISH 
Published: February 2007

SummaryA patient is described who developed paraplegia after epidural analgesia. Myelography showed obstruction at the level of T7. Laminectomy revealed an extradural metastasis involving the vertebral column and causing compression of the spinal cord. The primary was an adenocarcinoma of the prostate.
Obstetric pain relief using epidural morphine
Authors: Booker P.D. , Wilkes R.G. , Bryson T.H.L. , Beddard J. 
Published: February 2007

SummaryEpidural injections of morphine (2·5 or 4 mg) were given to 25 patients in labour. Forty‐eight per cent had good relief of pain lasting from 3¼ to 11 hours (average 5¼ hours). Sixteen per cent of patients had transient or partial relief, and in 36% there was no discernible effect at all. No serious side effects were observed in either mother or baby. It is felt that this technique merits further investigation in view of its potential advantages over more traditional methods of pain relief in labour.
Buprenorphine in postoperative pain: results in 7500 patients
Authors: Harcus A.H. , Ward A.E. , Smith D.W. 
Published: February 2007

SummaryBuprenorphine, a partial opiate‐receptor agonist with potent analgesic properties, was given to 7548 patients in the immediate postoperative period. Ninety per cent of patients had good or adequate pain relief for at least 4 hours; there were few adverse effects and the incidence of drug‐associated respiratory depression was estimated at less than 1%. There were no other side‐effects of clinical note.
Nitrous oxide elimination by the newborn
Authors: MANKOWITZ E. , BROCK‐UTNE J.G. , DOWNING J.W. 
Published: February 2007

SummaryThe elimination of nitrous oxide by ten infants whose mothers had received 50% nitrous oxide in oxygen and enflurane 0·6–1% during general anaesthesia for Caesarean section was studied. The concentration of nitrous oxide detected in end‐expired gas ranged from 1 to 4 vol% (mean 1·9 vol%). These levels are too low to produce significant diffusion hypoxia in vigorous neonates. However, a minority of infants may be adversely affected and it is recommended that oxygen‐enriched air be administered to infants whose mothers have received nitrous oxide.
Forum
Authors: Welch D.B. , Hrynaszkiewicz A. 
Published: February 2007

SummaryThe effectiveness of methadone given postoperatively by the lumbar epidural route to patients following upper abdominal or thoracic surgery was assessed. Intermittent injections of methadone diluted in large volumes of normal saline were given during the first 48 hours after surgery. Pain relief was assessed by both the patient and an observer using a visual linear analogue scoring system. Methadone 4–5 mg in 18–20 ml normal saline provided good postoperative pain relief for 6–8 hours.
The Triservice anaesthetic apparatus
Authors: HOUGHTON I.T. 
Published: February 2007

SummaryThe Triservice anaesthetic apparatus is a draw‐over system using ambient air as the primary carrier gas. Its modules are a self‐inflating bag, a vaporiser, a supplementary oxygen regulator and a ventilator; each is described. The outputs of halothane and trichloroethylene were measured with changes of temperature, continuous and intermittent gas flows and with alteration in barometric pressure. The output of oxygen from the Houtonox regulator was measured and the effect of the oxygen supplementation on the inspired oxygen concentration determined. The resistance to airflow of the apparatus was also measured and the effect of extreme cold observed.The merits, limitations and the way in which the equipment may be used are discussed. A carrying case with equipment for 10 anaesthetics is illustrated.
Cimetidine in elective Caesarean section
Authors: Mccaughey W. , HOWE J.P. , MOORE J. , DUNDEE J.W. 
Published: February 2007

SummaryAspiration pneumonitis, Mendelson's syndrome, continues to be an important cause of maternal morbidity and mortality in obstetric Anaesthesia, despite widespread adoption of the practice of routine administration of alkalis. Histamine H2 receptor blocking drugs have been shown to reduce gastric secretion in non‐obstetric patients. Cimetidine was given intravenously to fasting patients before elective Caesarean section. In all 10 patients who received cimetidine 200 mg intravenously at 60–80 minutes before Anaesthesia, the pH of gastric contents at the time of induction was above 2·5. When the interval between administration of the drug and induction of Anaesthesia was only 30–40 minutes (six patients) or was over 90 minutes (20 patients) then the pH was raised to above this value in only two‐thirds of patients. By contrast eight of 10 untreated patients were found to have a gastric pH of less than 2·5. No adverse effects of cimetidine were seen in mothers or infants.
An Addisonian crisis complicating anaesthesia
Authors: SMITH M.G. , BYRNE A.J. 
Published: February 2007

SummaryA patient with Addison's disease required surgery having attempted suicide, by cutting his throat and wrist. He was also in an acute adrenal crisis, as a result of deliberately omitting his replacement steroid therapy. Urgent surgery was indicated and therefore anaesthesia was undertaken before the patient's adrenal crisis was fully controlled. The anaesthetic management is described.
A case of status epilepticus.
Authors: FENECK R.O. 
Published: February 2007

SummaryA case of status epilepticus which was refractory to conventional anticonvulsants is described. The total dosage of thiopentone necessary to control the convulsions is greater than that previously recorded. The use of regular plasma estimation of thiopentone levels, and of cortical monitoring with the Cerebral Function Monitor (Ormed Engineering) is described, and is recommended where anticonvulsants are used for prolonged control of status epilepticus and in dosages greater than is common practice.
Endotracheal compared with intravenous injection of 3 mg/kg of lignocaine
Authors: PATEL R.I. , PETERSON R.G. , ALDRETE J.A. 
Published: February 2007

SummaryThe arterial and venous concentrations differ quantitatively and temporally after the administration of lignocaine via any route. Hence, arterial and venous levels were studied simultaneously following intravenous and tracheal injection in dogs, at 5, 15, 30, 60 seconds and at 5, 15, 30, 60, 120 minutes. Following intravenous injection, concentrations in the carotid artery were consistently higher for 60 seconds, the jugular vein levels were higher at 5 minutes and they were parallel thereafter.Following tracheal administration the highest arterial concentration was reached in 15 minutes and the highest venous levels at 5 minutes.
Cardiovascular and hormonal responses to electroconvulsive therapy.
Authors: JONES RONALD M. , KNIGHT PAUL R. 
Published: February 2007

SummaryA patient suffering from severe psychiatric depression underwent a course of electroconvulsive therapy. A marked rise in systemic arterial pressure, heart rate and plasma catecholamines in response to electroconvulsive therapy was attenuated by β‐receptor blockade using propranolol. The significance and mechanism of this attenuation are discussed.