bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recovery times and side effects after propofol infusion and after isoflurane during ear surgery with additional infiltration anaesthesia
Authors: Ledderose H. , Rester P. , Carlsson P. , Peter K. 
Published: February 2007

SummaryTwo anaesthetic procedures that did not include nitrous oxide were compared in a randomised study of 50 patients for tympanoplasty and tympanoscopy: propofol given for induction and maintenance, and thiopentone‐isoflurane given for induction and maintenance, respectively. Induction in the first group was with a bolus injection of propofol and the same agent was given for the duration of anaesthesia by continuous intravenous administration. Thiopentone was given until loss of the eyelash reflex and anaesthesia maintained with isoflurane 0.4–2.0%. Analgesia was achieved in both groups by fentanyl given intravenously and by local injection of mepivacaine with ornipressin. The two patient groups were analysed for age, sex and weight as well as for side effects during the induction, maintenance and recovery periods, such as coughing, vomiting, venous pain, spontaneous movements, singultus, headaches, dysrhythmias and psychic disorders possibly due to anaesthesia. Side effects were moderate in both groups. Recovery time was statistically significantly shorter in the propofol group and the patients in this group appeared to be much more aware after recovery than those in the thiopentone‐isoflurane group.
Gastro‐oesophageal reflux in pregnancy at term and after delivery
Authors: VANNER R. G. , GOODMAN N. W. 
Published: February 2007

SummaryGastro‐oesophageal reflux during a 40‐minute reflux provocation test was assessed by lower oesophageal pH monitoring in 25 pregnant women at term, and again on about the second day after delivery. At term 17 women refluxed a total of 29 times; after delivery five women refluxed once each. There was a significant decrease in gastro‐oesophageal reflux by the second day after delivery (p< 0.05). Gastro‐oesophageal reflux is, however, only one of the factors that predisposes to acid aspiration pneumonitis.
Multidimensionality of psychological recovery from anaesthesia
Authors: ZUURMOND W. W. A. , BALK V. A. , van DTS H. , van LEEUWEN L. , PAUL E. A. A. 
Published: February 2007

SummarySix recovery tests, choice reaction time (CRT), CRT double task, jinger tapping test (FTT), critical flicker fusion frequency (CFF), Maddox wing, and p‐deletion test, which cover basic cognitive, motor and perceptive functions as well as concentration, were analysed and compared with each other. Correlation between these tests after recovery from standardised general anaesthesia was calculated in 22 patients. Moderate to high correlation was found between CRT and CRT doubletask (r = 0.62 to r = 0.73), when parameters of six different tests were compared. Finger tapping correlated moderately with the movement time of both the CRT and the CRT doubletask (r = 0.46 andr = 0.47 respectively). We concluded that the CRT test, which measures initiation and movement time, might replace the CRT doubletask and the FTT. The CFF correlated moderately with the initiation time of the CRT doubletask, but because a srightly different function seems to be involved, further research is needed. Maddox wing and the p‐deletion test correlated with no other test. Results indicated that recovery is differentiated in at least four distinct psychomotor functions, which should be tested by CRT (to measure initiation and movement time), Maddox wing and p‐deletion.
Continuous versus intermittent epidural analgesia
Authors: LAMONT R. F. , PINNEY D. , RODGERS P. , BRYANT T. N. 
Published: February 2007

SummaryA randomised study of 381 women was carried out to compare the obstetric outcome after epidural analgesia maintained by an intermittent fop‐up regimen or with a continuous infusion. The two groups were well matched with respect to age, parity, mode of onset of labour and indication for epidural. Maintenance of epidural analgesia by continuous infusion resulted in a significantly decreased need for top‐up doses. A reduction in the incidence of hypotension, cardiotocographic evidence of intrapartum fetal hypoxia and Caesarean section was associated with this. It is concluded that the maintenance of epidural analgesia by continuous infusion is a safe and reliable method and may be more advantageous and less labour intensive than the traditional intermittent regimen.
Intravenous regional analgesia with prilocaine for foot surgery
Authors: DAVIES J. A. H. 
Published: February 2007

SummaryIntravenous regional analgesia for foot surgery with an ankle tourniquet was used for 48 cases. Prilocaine 0.5% 3 mg/kg body weight was injected either quickly over about 2 minutes or slowly over about 5 minutes. The tourniquet was intiated either to occlusion pressure plus 100 mmHg or to occlusion pressure plus 200 mmHg. Plasma prilocaine levels were measured while the tourniquet remained inflated and after release of the tourniquet. All four techniques resulted in a low incidence and magnitude of prilocaine leak and low prilocaine plasma levels after tourniquet release. The data suggest that a slow injection with the high tourniquet infation pressure is better, although the diferences in leakage with an intact tourniquet were not statistically significant. Excellent analgesia was achieved in over 90% of patients and there were no complete failures. No dangerously high prilocaine plasma levels were produced and no serious side eflects observed.
A disposable device for patient‐controlled analgesia with fentanyl
Authors: ROWBOTHAM D. J. , WYLD R. , NIMMO W. S. 
Published: February 2007

SummaryA disposable nonelectronic patient‐controlled analgesia device was used to deliver fentanyl after upper abdominal surgery. Pain relief was satisfactory and plasma fentanyl concentrations were similar to those obtained by other workers who used electronic patient‐controlled analgesia devices.
Dose‐response studies of atracurium, vecuronium and pancuronium in the elderly
Authors: Bell P. F. , Mirakhur R. K. , Clarke R. S. J. 
Published: February 2007

SummaryDose‐response curves were constructed for atracurium. vecuronium and pancuronium in elderly subjects in order to assess potency of these relaxants. The results were compared to data previously obtained for adult subjects using the same method. A single‐dose method of potency determination was used in both studies. The results indicate no significant difference in the potency of these relaxants between elderly and adult subjects; the ED95s were 249 and 226 μg/kg for atracurium, 43.1 and 39.6 μg/kg, for vecuronium and 65.9 and 60 μg/kg for pancuronium respectively in the elderly and the adults.
Ventilator disconnexion alarm failures
Authors: PRYN S. J. , CROSSE M. M. 
Published: February 2007

SummaryPressure‐sensitive ventilator disconnexion alarms do not always alarm during disconnexion of a discharging compliance ventilator such as Manley Blease, unless accurately adjusted. High flows during disconnexion result in significant pressure generation caused by outflow resistance of catheter mounts, heat and moisture exchangers, capnometer cuvettes, and angled connectors; this may lead to alarm failure because of incorrectly adjusted pressure alarm limits. The exact position of the disconnexion is critical and if the alarm's pressure sensor is placed in either the inspiratory or expiratory limb of the ventilator it makes no difference to its correct function. Nine different heat and moisture exchangers were compared in the same breathing system. Those with 15‐mm male connectors generate the highest pressures on disconnexion (1.1 kPa). It is suggested that the low pressure alarm limit is set only marginally below the peak inspiratory pressure, and that it is readjusted for every patient and after every change in ventilation. Most importantly, the alarm should be shown to be functional by a trial disconnexion at the tracheal tube.
Alfentanil used to supplement propofol infusions for oesophagoscopy and bronchoscopy
Authors: Kestin I. G. , Chapman J. M. , Coates M. B. 
Published: February 2007

SummaryThis randomised double‐blinded study compared the cardiovascular stability and rate of recovery when propofol infusions with or without alfentanil were used to provide anaesthesia for rigid oesophagoscopy and (or) bronchoscopy. Forty‐six patients were allocated randomly to receive either alfentanil 10 μg/kg or saline just before a rapid sequence induction with propofol. Suxamethonium I mg/kg was given and infusions of suxamethonium 10 mg/minute and propofol (10 mg/kg/hour for 10 minutes, 8 mg/kg/hour for 10 minutes and then 6 mg/kg/hour thereafter) were started. There were 23 patients in each group with no significant demographic differences between the groups. A significantly mean lower induction dose of propofol was needed in the alfentanil group (1.7 mg/kg compared to 2.2 mg/kg). Cardiovascular measurements were made on the ward pre‐operatively, just before induction, just after induction, just after intubation, and at 3‐minute intervals thereafter. Arterial pressure was significantly lower during the procedure in the patients who received alfentanil and there was a significant incidence of hypotension. There was no significant difference between the groups in respect of heart rate, with a significant increase in both groups just after intubation compared to the baseline values. Recovery from anaesthesia was assessed using the critical flicker fusion threshold. No differences were found between the groups and patients in both groups had returned to baseline values by 60 minutes. No patient had any recall of intra‐operative events, and there were no other adverse effects of any significance.
Gastric aspirates after trauma in children
Authors: BRICKER S. R. W. , McLUCKIE A. , NIGHTINGALE D. A. 
Published: February 2007

SummaryThe volumes and pH of gastric aspirates obtained from 110 children (aged 1–14 years) who underwent surgery for trauma were related to the duration of pre‐operative starvation and to the interval between food and injury. Aspirates were larger in children fasted for 4–6 hours than in those fasted for up to 10 hours, and were larger in children injured within 2 hours of eating than in those in whom this interval was longer (p < 0.05). However, 19 of 39 children (49%) starved for over 8 hours had an aspirate of more than 0.4 ml/kg. as did five of 16 children (31%) injured 3 or more hours after eating. Thus, a ‘safe’ interval between oral intake and induction cannot be predicted. We conclude that securing the airway by prompt tracheal intubation is the safest way to manage any child who presents for emergency anaesthesia after trauma.
Regional anaesthesia for surgery of the forearm and hand
Authors: SMITH B. E. , CHALLANDS J. F. , SUCHAK M. , SIGGINS D. 
Published: February 2007

SummaryEighty patients who presented for surgery of the forearm or hand were allocated randomly to one of two groups. In Group A, surgery was performed under supraclavicular brachial plexus block only; a mixture of equal parts of prilocaine 1% and bupivacaine 0.5% without adrenaline was used. In Group B, supraclavicular brachial plexus block was performed using prilocaine 1% alone, but in addition discrete nerve blocks were performed at elbow level using 0.5% bupivacaine without adrenaline. Patients in Group B had a significantly shorter duration of unwanted postoperative motor blockade and a significantly longer duration of postoperative analgesia (p < 0.005).
A comparison between propofol and thiopentone as induction agents in obstetric anaesthesia
Authors: MOORE J. , BILL K. M. , FLYNN R. J. , McKEATING K. T. , HOWARD P. J. 
Published: February 2007

SummaryTwo comparable series of 21 patients who had elective Caesarean section had general anaesthesia induced by thiopentone sodium 4.53 (SD 0.65) mg/kg or propofol 2.15 (SD 0.26) mg/kg. Maintenance was similar for both groups. Blood pressure was lower in the propofol group during the induction‐delivery interval. Umbilicallmaternal vein ratios for thiopentone and propofol were 8.5 and 7.2 respectively. Infant wellbeing as judged by Apgar score and cord blood analysis showed little difference between the two induction agents. Factors associated with uterine relaxation and bleeding were similar in the two groups.
Isoflurane inhibits enflurane metabolism in man
Authors: OIKKONEN M. P. 
Published: February 2007

SummaryHalogenated inhalation anaesthetics interfere with each other's hepatic microsomal metabolism. The increase in plasma inorganic fluoride concentration, caused by the metabolism of a standardised dose of enflurane, was attenuated by isoflurane given either before or after the enflurane exposure. It is conluded that isoflurane inhibits the metabolism of enflurane in man, a fact that might be advantageous in certain clinical situations.
Anaphylactoid reaction to chymopapain
Authors: SMITH M. B. , HOFMANN V. C. 
Published: February 2007

SummaryChymopapain is a proteolytic enzyme used in the chemonucleolysis of the herniated nucleus pulposus of lumbar intervertebral discs. It causes rapid hydrolysis of the noncollagenous polypeptides that maintain the tertiary structure of the chondromucoprotein of the nucleus pulposus. We report here an anaphylactoid reaction after the intervertebral injection of chymopapain.
Variables of patient‐controlled analgesia 2. concurrent infusion
Authors: OWEN H. , SZEKELY S. M. , PLUMMER J. L. , CUSHNIE J. M. , MATHER L. E. 
Published: February 2007

SummaryThe effectiveness of morphine after surgery by patient‐controlled analgesia alone or with a concurrent infusion was studied. The infusion did not reduce the dose of self‐administered analgesic and patients treated in this way received twice as much drug as those who used patient‐controlled analgesia alone. Pain control was similar in both groups. The practice of patient‐controlled analgesia plus infusion requires critical review.
Open‐heart surgery in a patient with a high oxygen affinity haemoglobin variant
Authors: FRANCINA A. , CHASSARD D. , BAKLOUTI F. , GEORGE M. , ESTANOVE S. 
Published: February 2007

SummaryA man in heart failure with a high oxygen affinity haemoglobin variant (Hb Rainier) underwent a mitral comrnissurotomy with the aid of cardiopulmonary bypass. Pre‐operatively, a total blood exchange transfusion was carried out to prevent potential hypoxic and thrombo‐embolic complications. No complications occurred in the postoperative period.
Impairment of the antagonism of vecuronium‐induced paralysis and intra‐operative disopyramide administration
Authors: BAURAIN M. , BARVAIS L. , D'HOLLANDER A. , HENNART D. 
Published: February 2007

SummaryA 63‐year‐old male was admitted to hospital for a cholecystectomy, vagotomy and gastro‐enterostomy. Muscle paralysis was induced with 70 μg/kg vecuronium, followed by increments of 20 μg/kg when the initial twitch height returned to 2.5% of control. The patient received 3 doses of 10 mg disopyramide intravenously, on account of supraventricular ectopic beats, followed by an infusion of 2.5 mg/hour. Paralysis was reversed using 0.75 mg atropine and 2.5 mg neostigmine once the twitch height had returned spontaneously to 2.5% of its initial value. Fifteen minutes later, twitch height had returned to control value and the train‐of‐four was above 85%, but the responses to tetanic stimulation at 100 Hz and 50 Hz remained severely depressed (10% and 45%, respectively). The patient's trachea was extubated after 20 minutes, but residual fade was still observed. This impairment of neuromuscular transmission, detected only with high frequency stimulation, was present with a measured concomitant plasma level of disopyramide of 5.1 μg/ml.
Anaesthetic management of the patient with a permanent pacemaker
Authors: BLOOMFIELD P. , BOWLER G. M. R. 
Published: February 2007

SummaryOver 25 000 people in Britain now have pacemakers, and the number is increasing steadily. Anaesthetists encounter patients with pacemakers regularly. Knowledge about the increasingly wide range of pacemakers available is necessary to ensure safe management of these patients, many of whom are frail and elderly. This review outlines the indications for permanent pacing, the types of pacemaker used and the assessment and management of pacemaker patients for anaesthesia.
A new method of analgesia for relief of circumcision pain
Authors: ANDERSEN K.H. 
Published: February 2007

SummaryA prospective, randomised, double‐blind study was designed to determine whether topical application of 2% lignocaine is effective in decreasing analgesic drug requirements during and after circumcision surgery. General anaesthesia with halo thane and nitrous oxide 60‐70% in oxygen was administered via a facemask and a Bain system. Administration of halothane was stopped after removal of the foreskin; lignocaine (2%) or placebo was applied topically as drops to the surface of the penis to two groups of patients. Halothane was restarted if the anaesthesia was ineffective. The intra‐operative consumption of halothane was significantly less (p < 0.05) in the treated group as compared with the placebo group (0 and 17, SEM 3,%× minute). The treated group required significantly less (p < 0.002) pethidine after operation (5 and 10 patients), and the pain‐free period was significantly longer (p < 0.01) (41, SEM 6 and 6, SEM 2 minutes) as compared with the placebo group.
The use of flumazenil (Anexate, Ro 15‐1788) in the management of drug overdose
Authors: POLLARD B. J. , MASTERS A. P. , Bunting P. 
Published: February 2007

SummaryThis is a report of a large selfadministered overdose of temazepam and meprobamate. The administration of Jumazenil (Ro 15‐1788) led to the partial antagonism of the depressant action of the drugs which was sufficient to avoid the need for invasive respiratory and cardiovascular support.
Second report from an anaesthetic reactions advisory service
Authors: Watkins J. 
Published: February 2007

SummaryThe continued work of the advisory service is reported; this now amounts to at least 300 enquiries about clinically severe adverse reactions each year. Thiopentone is still the most commonly associated intravenous induction agent with adverse reactions (76%), particularly when it is used with suxamethonium. Local anaesthetics account for between 5 and 10% reports.
Laryngeal anaesthesia with aspiration following intubation
Authors: AUCOTT W. , PRINSLEY P. , MADDEN G. 
Published: February 2007

SummaryTwo patients who had undergone emergency tracheal intubation developed signs of aspiration of ingested food. Nasendoscopy demonstrated supraglottic anaesthesia which recovered from the laryngeal margins in towards the vocal cords. It is assumed that this was caused by a neuropraxia of the internal branch of the superior laryngeal nerve, presumably as a result of trauma related to intubation.
Rebreathing during spontaneous and controlled ventilation with T‐piece breathing systems: a general solution
Authors: DORRINGTON K. L. , LEHANE J.R. 
Published: February 2007

SummaryA general solution is presented to the problem of finding the degree of rebreathing generated by T‐piece breathing systems. The solution is applicable to any ventilatory waveform, dead space volume and tidal volume and is identical for spontaneous and controlled ventilation for any given ventilatory waveform. The method is graphical and its use and understanding require no mathematical skills. However, if an analytical form of the ventilatory waveform is known, the method is easily extended by use of calculus to obtain a precise analytical solution.
Pulse oximetry in methaemoglobinaemia
Authors: RIEDER H.U. , FREI F.J. , ZBINDEN A. M. , THOMSON D. A. 
Published: February 2007

SummaryThe results of pulse oximetry saturation in a patient with a high level of methaemoglobinaemia, who subsequently underwent intravenous methylene blue treatment, are presented. The reasons for the erroneously low values after treatment are explained. Pulse oximeters currently available are not helpful in patients treated with methylene blue and should be used with caution in patients who present with cyonosis of unknown origin.
Epidural diamorphine and bupivacaine in labour
Authors: McGRADY E.M. , BROWNHILL D.K. , DAVIS A.G. 
Published: February 2007

SummaryA double‐blind randomised study was performed to assess the analgesic effect of epidural diamorphine, administered with bupivacaine, on primigravid women in labour. Fifty patients received 0.25% bupivacaine 10 ml via the epidural catheter as their initial dose; patients in Group I received diamorphine 5 mg with the bupivacaine. A 0.1% bupivacaine infusion was started at 10 minutes and bolus doses of bupivacaine were given if required. There was a significant reduction in rate of bupivacaine administration, pain scores at 20 and 30 minutes, number of supplements required, and degree of motor blockade in the diamorphine group.
The pneuPAC ventilator with new patient valve and air compressors
Authors: PARK G. R. , MANARA A. R. , BODENHAM A.R. , MOSS C. J. 
Published: February 2007

SummaryThe pneuPAC Model 2‐R pneumatic logic ventilator with a new air entrainment valve that offers the option of an Fio2 of l.0 or 0.45 is described. Its robustness, portability, variable Fio2, choice of positive end expiratory pressure and pressure relief valves make it versatile and suitable for transporting critically ill patients, as well as for resuscitation use when adverse conditions may be encountered. Two new medical air compressors, one mains driven and the other battery powered, designed for use with the ventilator, are also described. The function of the ventilator with the new valve was assessed using a piped gas supply and then reassessed when powered by the compressors.
Paraplegia after coeliac plexus block
Authors: WOODHAM M. J. , HANNA M. H. 
Published: February 2007

SummaryA case is described in which paraplegia followed a coeliac plexus block performed using 90% alcohol under X ray screening. The likely cause was an ischaemic injury to the cord secondary to damage to the artery of rldamkiewicz. This rare complication seems difficult to avoid.
The pressor response and laryngeal mask insertion
Authors: BRAUDE N. , CLEMENTS E. A. F. , HODGES U. M. , ANDREWS B. P. 
Published: February 2007

SummaryThe pressor response associated with laryngoscopy and tracheal intubation may be harmful to certain patients. The laryngeal mask airway avoids the need for laryngoscopy and allows positive pressure ventilation of the lungs in appropriate patients. This study compared the pressor response of tracheal intubation with that of mask insertion in two groups of 24 and 23 healthy patients respectively. All patients were anaesthetised with thiopentone, nitrous oxide, enflurane and paralysed with atracurium. We have shown a similar, but attenuated patlern of response associated with mask insertion in comparison with laryngoscopy and intubation; signijicant differences between the groups were evident in arterial diastolic blood pressure immediately after insertion and again 2 minutes later. Use of the laryngeal mask may therefore offer some limited advantages over tracheal intubation in the anaesthetic management of patients where the avoidance of the pressor response is of particular concern.
The requirement for intensive care support for the pregnant population
Authors: GRAHAM S. G. , LUXTON M. C. 
Published: February 2007

SummaryPregnancy‐associated admissions to the Intensive Care Unit during the first 5 years of a newly established teaching hospital obstetric unit are reviewed. There were 23 such admissions; in the same period, 21 983 deliveries occurred. The most frequent cause for Intensive Care admission was hypertensive disease of pregnancy. Most patients required admission for less than 48 hours. Two patients died during the period of study.