bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of halothane and trichloroethylene with isoflurane. A study of drawover air anaesthesia with the Triservice anaesthetic apparatus
Authors: Tighe S. Q. M. , Pethybridge R. J. 
Published: February 2007

SummaryInduction and recovery times were not significantly different between two groups that received halothane with trichloroethylene and isoflurane, respectively. Maintenance of anaesthesia and analgesia was also satisfactory. Isoflurane resulted in a higher heart rate (p < 0.01), a lower respiratory rate (p < 0.01) and a higher inspired oxygen concentration (p < 0.05). Respiration may be more efficient. Other potential advantages of isoflurane for anaesthesia in the field are discussed. Despite the fact that it is 15 times more expensive, the use of isoflurane as sole agent is recommended.
Analgesia from morphine and ketamine
Authors: OWEN H. , REEKIE R. M. , CLEMENTS J. A. , WATSON R. , NIMMO W.S. 
Published: February 2007

SummaryKetamine 4 μg/kg/minute produced pain relief similar to that from morphine 33 μg/minute in a doubleblind study that compared analgesia from constant‐rate intravenous infusions of the two drugs in 60 patients. The analgesic efficacy of the infusions, as assessed by pain scores and the requirement for supplementary self‐administered morphine, was poor. Ventilatory depression, the most significant side effect, occurred only in patients who received morphine infusion. The low dose ketamine infusion did not provide clinically useful analgesia even though adequate plasma concentrations were achieved.
Intravenous sedation for cataract surgery
Authors: GILBERT J. , HOLT J. E. , JOHNSTON J. , SABO B. A. , WEAVER J. S. 
Published: February 2007

SummaryFifty‐five unpremedicated outpatients scheduled for cataract surgery were randomly allocated to receive either a fixed dose of nalbuphine and methohexitone or fentanyl and diazepam administered in a dose adjusted to produce the required sedative effect. Statistical analysis revealed no difference between groups with regard to immediate side effects, intra‐ocular pressure or postoperative nausea or vomiting. Recovery time from administration of the sedative until compliance with simple commands was significantly longer in the nalbuphine/morphine group (89 vs 196 seconds) but this was not felt to be of clinical importance. This combination was better in terms of sedation at the time of insertion of the nerve blocks, lack of recall of insertion of the nerve block, incidence of intra‐operative complications, surgeon's assessment of operating conditions and patient acceptability. This fixed dose by weight drug combination for intravenous sedation should be applied widely.
Epidural sufentanil versus intramuscular buprenorphine for postoperative analgesia
Authors: DONADONI R. , ROLLY G. 
Published: February 2007

SummaryEpidural sufentanil 50 μg was compared with intramuscular buprenorphine 0.3 mg for postoperative pain relief. Patients were assigned randomly to one of two treatment groups and received both an intramuscular and epidural injection, one of which was a placebo. Onset of pain relief was faster and quality of analgesia superior during the first 2 hours in the patients who received epidural sufentanil but the duration of analgesia was longer in the buprenorphine group. Cardiovascular variables remained stable in all patients and no respiratory depression was observed. Side effects were more frequent following buprenorphine.
Respiratory depression in children at different end tidal halothane concentrations
Authors: LINDAHL S. G. E. , YATES A. P. , HATCH D. J. 
Published: February 2007

SummaryRespiratory motor function and timing were investigated at end tidal halothane concentrations of 1.5%, 1.0% and 0.5% before and during 4% carbon dioxide stimulation in 10 spontaneously breathing children who weighed between 10.2 and 25.2 kg, during hypospadias repair under halothane anaesthesia. Their tracheas were intubated and all received a caudal block to eliminate surgical stimulation. Pneumotachography and capnography were used and in three cases movements of ribcage and abdomen were also studied by magnetometers. Respiratory drive was evaluated by occlusion tests. Ventilation was depressed at an end tidal halothane concentration of 1.5%, with smaller tidal volumes, higher respiratory rates, higher end tidal carbon dioxide tensions and a weaker respiratory drive compared with 1.0% and 0.5% halothane. Paradoxical breathing was noted at 1.5% as well as at 1.0% but not at 0.5% halothane anaesthesia; the ribcage moved inwards during inspiration. Respiratory compensation during periods of 4% carbon dioxide stimulation was inadequate at 1.5% halothane, as indicated by higher end tidal carbon dioxide tensions, less negative occlusion pressures and movements of ribcage and abdomen that were unresponsive to 4% carbon dioxide, when compared with 1.0% and 0.5% halothane. Respiratory rates were higher and duration of inspiration longer at 1.5% than at 1.0% and 0.5% halothane. Respiratory timing was unaltered by carbon dioxide stimulation. It is concluded that the ventilatory motor response to carbon dioxide is dose dependent and improves at more superficial anaesthetic levels, while respiratory timing is unresponsive to carbon dioxide stimulation irrespective of the halothane concentration used. Paradoxical breathing existed at end tidal halothane concentrations higher than 1%.
Comparison of the haemodynamic effects of intermittent positive pressure ventilation with high frequency jet ventilation
Authors: SHERRY K. M. , WINDSOR J. P. W. , FENECK R. O. 
Published: February 2007

SummaryThe cardiorespiratory effects of intermittent positive pressure ventilation and high frequency jet ventilation with and without positive end expiratory pressure were compared in patients following valvular heart surgery (mitral and/or aortic). Twenty patients received intermittent positive pressure ventilation and high frequency jet ventilation with 0. 0.5 and 1.0 kPa positive end expiratory pressure. High frequency jet ventilation was well tolerated. The addition of 1.0 kPa positive end expiratory pressure was associated with preservation of the arterial oxygen tension without any increase in shunt or significant adverse haemodynamic effect. The results are discussed and compared with a previous study of high frequency jet ventilation following aortocoronary bypass graft surgery.
Prolonged bradycardia and hypotension after neostigmine administration in a patient receiving atenolol
Authors: ELDOR J. , HOFFMAN B. , DAVIDSON J. T. 
Published: February 2007

SummaryA 78‐year‐old woman admitted for an elective hip operation was maintained on atenolol for control of her hypertension. She received neostigmine and atropine for reversal of muscle relaxation at the end of general anaesthesia. She then developed prolonged bradycardia and hypotension which necessitated the use of adrenaline and isoprenaline. Such an adverse reaction with atenolol has not been described previously.
Protocols in obstetric units: their use in Wales in 1983 *
Authors: Owen B. 
Published: February 2007

SummaryThe Welsh Perinatal Mortality Initiative carried out an extensive enquiry into perinatal deaths in Wales between 1984 and 1986 and their report was published by the Secretary of State for Wales in December 1986. One aspect examined was the obstetric anaesthetic service and a comprehensive questionnaire was sent to all obstetric units where Caesarean sections are carried out. One of the questions was on the use of protocols in obstetrics and the results presented are disappointing.
Minimum fresh gas flow requirements of anaesthetic breathing systems during spontaneous ventilation: a graphical approach
Authors: DORRINGTON K. L. , LEHANE J. R. 
Published: February 2007

SummaryA general solution is presented to the problem of finding the minimum fresh gas flow requirements, during spontaneous ventilation, of anaesthetic breathing systems in the Mapleson classification. The solution is applicable to any pattern of breathing, dead space volume and tidal volume. The method is graphical and its use and understanding require no mathematical skills. However, if an analytical form of the respiratory waveform is known, the method is easily extended by use of calculus to obtain a precise analytical solution.
A laryngoscope adaptor for difficult intubation
Authors: YENTIS S. M. 
Published: February 2007

SummaryTracheal intubation may be hindered by difficulty in insertion of the laryngoscope blade into the patient's mouth because the handle impinges on the patient's chest or on the hand of an assistant applying cricoid pressure. An adaptor is described which modifies the standard Penlon laryngoscope to enable lateral swivelling of the handle, thus avoiding the obstruction.
Removal of a giant ovarian cyst
Authors: MORRISON P. , MORGAN G. 
Published: February 2007

SummaryExcision of a giant ovarian cyst may be associated with considerable mortality. Problems stem from the size of the cyst and the emaciated state of the patient. We describe a case in which the patient's preoperative nutritional and psychological state required attention. Gradual pre‐operative drainage of a cyst weighing 113 kg was carried out successfully. The main problems intra‐operatively stemmed from copious blood loss and the duration of surgery. Postoperatively, ventilatory inadequacy occurred and was probably caused by altered mechanies of ventilation, postoperative pain and pulmonary oedema. We suggest ways in which the management of such cases might be improved.
The morphine sparing effects of diclofenac sodium following abdominal surgery
Authors: Hodsman N. B. A. , Burns J. , Blyth A. , Kenny G. N. C. , McArdle C. S. , Rotman H. 
Published: February 2007

SummaryA randomised, double‐blind placebo controlled study was undertaken to assess the analgesic efficacy of diclofenac. Following major abdominal surgery and 12 hours later, patients received either placebo or diclofenac 75 mg intramuscularly and their cumulative morphine requirements administered by a patient‐controlled system over 24 hours were compared. Pain scores were also measured. Arterial blood gases and coagulation studies were assessed pre‐ and postoperatively. Morphine consumption was significantly greater in the placebo group (59.5 compared to 38.5 mg, p < 0.01). Pain scores were significantly lower in the diclofenac group at 4 hours, but not thereafter. Arterial carbon dioxide was significantly increased in the control groups. There was no significant change in platelet count within each group, but a significant difference between the groups (p < 0.05).
Anatomical re‐evaluation of lumbar dura mater with regard to postspinal headache
Authors: DITTMANN M. , SCHÄFER H.‐G. , ULRICH J. , BOND‐TAYLOR W. 
Published: February 2007

SummaryThe effects of puncture of fresh cadaver dura with 20‐, 22‐, 26‐ and 29‐gauge needles were observed. A ‘tin‐lid’ phenomenon, manifested with all needle sizes, was capable of sealing the resultant hole. The larger the needle, the larger the hole, while rotation of the needle bevel 90° to the fibres altered the shape of the hole. Holes made in thicker parts of the dura tended to retract more rapidly than those in thinner areas.
Spread of radiopaque dye in the thoracic epidural space
Authors: SLAPPENDEL R. , GIELEN M.J.M. , HASENBOS M.A.W.M. , HEYSTRATEN F.M.J. 
Published: February 2007

SummaryA radiological study was performed in 23 patients to look for the position of thoracic epidural catheters and the spread of the contrast medium iohexol 300 mg/ml and 180 mg/ml when used in volumes of 3 and 8 ml. The dye was injected through the epidural catheter just after thoracic surgery. The spread of the dye showed no relation to the injected volume or the sensory spread after 2% lignocaine 3 ml. In three cases no contrast could be seen on the X ray, and in two the radiopaque dye was found just outside the epidural space. No relationship between the spread of the dye and the sensory blockade was found, but the position of the epidural catheter should be checked radiographically when the epidural route is to be used for long‐term pain relief.
Hypoxaemia during induction of anaesthesia—an audit of children who underwent general anaesthesia for routine elective surgery
Authors: Laycock G.J.A. , McNicol L.R. 
Published: February 2007

SummaryArterial oxygen saturation was measured using pulse oximetry during induction of anaesthesia in 108 children aged 10 days‐14 years. No restriction was placed on the method of induction. Oxygen saturation decreased to less than 90% in 29 children (26.8%) and less than 80% in seven children (6.4%). There was a significantly increased incidence of desaturation (to less than 90%) in children under one year of age, in those who had no premedication, in those who received only atropine as a premidicant and in children who were anxious or crying before intravenous induction. Oxygen saturation did not decrease below 90% in any child who received inhalational induction.
Hapten inhibition and dextran anaphylaxis
Authors: LJUNGSTRÖM K.‐G. , RENCK H. , HEDIN H. , RICHTER W. , WIHOLM B.‐E. 
Published: February 2007

SummaryHapten inhibition with dextran 1 has been used in Sweden since 1982 to prevent severe anaphylactic reactions to dextran. This has led to a reduction in the reports of severe reactions to dextran from 22 per 100 000 units of dextran used between 1975 and 1979, to 1.2 per 100 000 units between 1983 and 1985. The number of fatal reactions decreased from 23 to one. More than 600 000 units of dextran were used during each period.
Sufentanil to supplement nitrous oxide in oxygen during balanced anaesthesia
Authors: O'CONNOR M. , SEAR J. W. 
Published: February 2007

SummarySufentanil in doses of 0.4 and 1.0 μg/kg was used as an analgesic supplement to nitrous oxide‐oxygen anaesthesia in 28 patients whose lungs were ventilated during body surface or lower abdominal surgery. Significant decreases in arterial blood pressure followed drug administration (mean 35.6%). Decreases in arterial pressure of greater than 30% occurred in 5 out of 14 patients in the low dose group, and 12 out of 14 in the high dose sufentanil group. There was a blunting of the pressor response to laryngoscopy and intubation after sufentanil. Increases in blood pressure were seen in both treatment groups at the onset of surgery. The peak responses were 27% increase in mean arterial pressure in the low dose group, and 51% increase in the 1.0 μg/kg group. There was however no significant change in heart rate. Fourteen patients (8 in the low dose group) required volatile supplementation during surgery for clinical signs of inadequate anaesthesia. This occurred between 21 and 70 minutes after sufentanil administration, and plasma drug concentrations 0.06 and 0.54 ng/ml. Tracheal extubation was successfully achieved at the end of surgery in 26 out of 28 patients at plasma sufentanil concentrations which ranged from 0.03 to 0.37 ng/ml. The two remaining patients, neither of whom had received additional volatile supplementation, required naloxone to overcome postoperative ventilatory depression. No cases of intra‐operative awareness were noted.
Insulin treatment of the insulin‐dependent diabetic patient undergoing minor surgery
Authors: CHRISTIANSEN C. L. , SCHURIZEK B. A. , MALLING B. , KNUDSEN L. , ALBERTI K. G. M. M. , HERMANSEN K. 
Published: February 2007

SummaryIn a prospective randomised study in 20 insulin‐dependent diabetics who had minor surgery under general anaesthesia we compared the metabolic responses to intravenous glucose‐insulin‐potassium infusion with those who had conventional subcutaneous insulin administration. The former treatment resulted in lower blood glucose levels both during the infusion period (p < 0.05) as well as the entire observation period (operative, first and second postoperative days; p < 0.01). More blood glucose values were within the intended range of 5 to 10 mmol/litre in the glucose‐insulin‐potassium as compared to the conventional group (48% versus 24%; p < 0.01). The levels of lactate, 3‐hydroxybutyrate, glycerol, alanine, glucagon, insulin and growth hormone did not differ between the two groups. The infusion regimen resulted in better glycaemic control both peri‐and postoperatively than the conventional subcutaneous insulin regimen in insulin‐dependent diabetic patients who have minor surgery.
Diabetes mellitus and anaesthesia
Authors: DUNNET J. M. , HOLMAN R. R. , TURNER R. C. , SEAR J. W. 
Published: February 2007

SummaryA variety of methods are currently available for the management of the diabetic patient in the peri‐operative period. A questionnaire about current clinical practice was sent to all anaesthetists in the Oxford region. The majority reported that minor surgery in both insulin treated and noninsulin treated diabetic patients warranted no intervention other than avoidance of meals and medication before surgery, and that, for major surgery, a glucose‐insulin‐potassium infusion should be used. Fifty one out of 71 respondents in the junior staff grades preferred this latter approach for intermediate surgical procedures in insulin treated patients compared with 27 out of 69 of the consultant staff. Most anaesthetists aimed for blood glucose levels of 7–13 mmolilitre in the peri‐operative period. The literature is also reviewed.
Respiratory criteria of fitness for surgery and anaesthesia
Authors: NUNN J. F. , MILLEDGE J. S. , CHEN D. , DORE C. 
Published: February 2007

SummaryA retrospective analysis has been undertaken of 53 operations in 42 patients with severe chronic obstructive airway disease. All patients had a forced expiratory volume in 1 second between 0.3 and 1 litre, but the outcome of surgery was successful after their first operations, all of which were elective; 38 of the 42 had uneventful anaesthesia and surgery together with a normal postoperative period, while four had artificial ventilation of the lungs. The best predictors of the use of postoperative ventilation were the arterial Po2 and whether the patient was dyspnoeic at rest.
Complete heart block during anaesthesia in a patient with sarcoidosis
Authors: THOMAS D. W. , MASON R. A. 
Published: February 2007

SummaryAn apparently fit voting man with sarcoidosis developed complete heart block during an emergency mastoidectomy. A temporary transvenous pacemaker was inserted, but permanent pacing was required in the postoperative period. The clinical and pathological features of cardiac sarcoidosis are described; complete heart block is the commonest presentation of cardiac involvement. The role of anaesthesia as the precipitating factor in this case is discussed.
Postoperative sore throat related to the use of a Guedel airway
Authors: Browne B. , Adams C. N. 
Published: February 2007

SummaryEighty‐eight patients in ASA classes 1 or 2 and aged between 18 65 years, who were to undergo anaesthesia, were allocated randomly to a group with or without an airway. Methohexitone, nitrous oxide, alfentanil and enflurane were used, with the patients breathing spontaneously. This study showed that there was no significant difference between the two groups in the incidence of sore throat, or any other related symptom, and concludes that the use of an oropharyngeal airway does not increase morbidity among nonintubated patients.
Effect of propofol on cerebrospinal fluid pressure and cerebral perfusion pressure in patients undergoing craniotomy
Authors: RAVUSSIN P. , GUINARD J. P. , RALLEY F. , THORIN D. 
Published: February 2007

SummaryThe effects of propofol on cerebrospinal fluid pressure, mean arterial pressure, cerebral perfusion pressure and heart rate were studied during induction, tracheal intubation and skin incision in 23 patients scheduled for elective craniotomy. Premeditation consisted of midazolam 0.1 mg/kg intramuscularly and metoprolol 1 mg/kg orally. Measurements were made or derived at time zero and 0.5, 1, 1.5, 2 and 3 minutes after an induction dose of propofol 1.5 mg/kg. A continuous infusion of propofol was started at time zero at a rate of 100 mg/kg/minute. Fentanyl 2 μg/kg was added before tracheal intubation, application of the pin head holder and skin incision. Cerebrospinal fluid pressure and mean arterial pressure decreased significantly 2 minutes after propofol alone, by 32% and 10% respective/y, while a cerebral perfusion pressure above 70 mmHg was maintained. Heart rate did not change. Propofol combined with moderate dose of fentanyl, obtunded the usual cerebrospinal fluid and arterial pressure responses to intubation and other noxious stimuli. Thus propofol seems to be a suitable intravenous anaesthetic agent for induction and maintenance in neuroanaesthesia.
Propofol anaesthesia alters somatosensory evoked cortical potentials
Authors: MAURETTE P. , SIMEON F. , CASTAGNERA L. , ESPOSITO J. , MACOUILLARD G. , HERAUT L. A. 
Published: February 2007

Summary This study evaluated the effects of propofol on somatosensory evoked cortical potentials in 20 ASA grade 1 or 2 patients who underwent spinal surgery. Anaesthesia consisted of propofol, dextromoramide, 50% nitrous oxide and oxygen mixture. The induction dose of propofol was 2 mg/kg and was followed by an infusion of 6 mg/kg for the first hour and 3 mg/kg subsequently. Somatosensory evoked cortical potentials were recorded on the scalp and compared to pre‐operative values using Student's paired t‐test. We observed a significant depression of evoked potential 10 minutes after induction, which continued until the early phase of recovery. Because of its short and quickly reversible action, propofol is an acceptable agent when clinical monitoring of the spinal cord is indicated but is not satisfactory when monitoring has to he based on somatosensory cortical evoked potentials.
Multicentre study of propofol in day case surgery
Authors: Sanderson J. H. , Blades J. F. 
Published: February 2007

SummaryAn open multicentre study that involved 879 patients was set up after the launch of propofol to examine its use outside of the clinical trial programme and within the context of a routine clinical setting. Propofol was assessed as the main anaesthetic agent for a range of day case surgery that included gynaecological, urogenital, body surface, orthopaedic and dental procedures. For the purposes of the study, supplementary agents were restricted to fentanyl, alfentanil or nitrous oxide; no volatile anaesthetics were allowed. Induction of anaesthesia was smooth; 91.6% of patients experienced no excitatory or other adverse effect. The mean duration of anaesthesia was 12 minutes 12 seconds and the mean dosage of propofol was 10.6 mg/kg/hour. Maintenance was uneventful in the large majority of patients. Pain on injection affected approximately 25% of patients and the incidence was reduced when large veins were used for injection. Recovery was rapid with a short interval of approximately 1 minute between awakening and orientation (time to giving correct date of birth). There was a low incidence of postoperative nausea and vomiting.
Intubation under induction doses of propofol
Authors: Keaveny J. P. , Knell P. J. 
Published: February 2007

SummaryTwenty patients, ASA grades 1 and 2, aged 18–65 years were admitted to an open study to investigate the ease of tracheal intubation after induction of anaesthesia with propofol without the use of muscle relaxants after the chance observation that propofol 2.5 mg/kg allowed easy laryngoscopy and tracheal intubation. Satisfactory intubation conditions were achieved in 19 patients.