bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular response during cerebral angiography under general and local anaesthesia
Authors: Clayton D. G. , O'Donoghue B. M. , Stevens J. E. , Savage P. E. 
Published: February 2007

SummaryNineteen patients with subarachnoid haemorrhage who had cerebral angiography with the new contrast medium iohexol, were randomly allocated to receive either local anaesthesia plus sedation, or general anaesthesia. Arterial blood pressure, Pao2, Paco2 and patient acceptability were examined. Significant fiuctuations in arterial blood pressure occurred in the patients who received general anaesthesia. Local anaesthesia was associated with a stable blood pressure, adequate spontaneous ventilation and good patient acceptability. The quality of films obtained was examined and found to be of good or very good diagnostic quality in all cases in both groups of patients. Greater use of local anaesthesia with sedation for angiography is recommended.
Anaesthesia and brain damage in the newborn
Authors: CHARLTON A. J. , DAVIES J. M. , RIMMER S. 
Published: February 2007

SummaryEighty newborn babies were studied by ultrasound brain scan before and after their first general anaesthetic. Periventricular haemorrhage or ischaemia occurred in 23 patients (29%) and affected both term and premature babies. Four new lesions developed but only three of 19 existing lesions deteriorated. The very premature (< 33 weeks gestation) were most at risk (four of eight deteriorated). Deterioration or development of lesions occurred only in very ill babies with known risk factors. Anaesthesia did not appear to be implicated in any case.
Pain on injection of methohexitone The use of lignocaine to modify pain on injection of methohexitone during anaesthesia for electroconvulsive therapy
Authors: Simpson K. H. , Halsall P. J. , Sides C. A. , Keeler J. F. 
Published: February 2007

SummaryThe present study was designed to assess the incidence of pain when methohexitone was administered to 35 depressed patients who had electroconvulsive therapy, and to determine whether the use of lignocaine could modify this, without affecting seizure duration. The same patients were studied during three separate treatment sessions; they received either methohexitone alone or mixed with, or preceded by, lignocaine 10 mg. Six (17%) patients spontaneously complained of pain during injection of methohexitone alone; the use of lignocaine prior to methohexitone reduced this to zero (p < 0.05). A total of 49% patients reported pain during injection of methohexitone; the use of lignocaine either mixed with, or given prior to, methohexitone significantly reduced this to 23% and 20% respectively (p < 0.05). Seizure duration was not significantly different during the three treatments.
Anaesthesia in a gravid achondroplastic dwarf
Authors: BRIMACOMBE J. R. , CAUNT J. A. 
Published: February 2007

SummaryA patient with achondroplasia presented for elective Caesarean section under epidural anaesthesia. A block from C5 to S4 developed over 20 minutes after 12 ml plain bupivacaine 0.5%. This case serves to highlight the difficulties of regional anaesthesia in the gravid achondroplastic dwarf.
Omeprazole for prophylaxis of acid aspiration in elective surgery
Authors: WINGTIN L. NG , GLOMAUD D. , HARDY F. , PHIL S. 
Published: February 2007

SummaryThe aim of the study was to determine whether a single oral dose of omeprazole 40 mg is effective in increasing the pH of gastric residue above 2.5 at the time of anaesthetic induction in adult patients scheduled for elective gynaecological surgery. The patients were allocated to receive either chlorazepate dipotassium 25 mg alone or omeprazole 40 mg and chlorazepate dipotassium 25 mg on the night before surgery. Gastric volume and pH were measured after induction of anaesthesia. Patients who received omeprazole had a higher mean pH than control patients (p < 0.001). The pH was less than 3.5 in 50% of patients in the control group, but in only 4.5% of those who received omeprazole (p < 0.01). Mean (SEM) volume of gastric fluid was 15.2 (2.7) ml in the control group and 9.2 (1.8) ml in the omeprazole group, but the results were not statistically significant. A single dose of 40 mg omeprazole significantly decreased the number of patients at risk of aspiration pneumonitis.
The Fenem CO2 detector device An apparatus to prevent unnoticed oesophageal intubation
Authors: DENMAN W. T. , HAYES M. , HIGGINS D. , WILKINSON D. J. 
Published: February 2007

SummaryA new oesophageal intubation detector device, the Fenem CO2 detector, was used in 100 patients intubated during anaesthesia for elective surgery. This new device was 100% accurate in the differentiation between tracheal and oesophageal placement of a tube.
Ginger root—a new antiemetic The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery
Authors: Bone M. E. , Wilkinson D. J. , Young J. R. , McNeil J. , Charlton S. 
Published: February 2007

SummaryThe effectiveness of ginger (Zingiber officinale) as an antiemetic agent was compared with placebo and metoclopramide in 60 women who had major gynaecological surgery in a double‐blind, randomised study. There were statistically significantly fewer recorded incidences of nausea in the group that received ginger root compared with placebo (p < 0.05). The number of incidences of nausea in the groups that received either ginger root or metoclopramide were similar. The administration of antiemetic after operation was significantly greater in the placebo group compared to the other two groups (p < 0.05).
Combined air and oxygen entrainment. Effect on the percentage output of fixed performance masks
Authors: LYEW M. A. , HOLLAND A. J. , METCALF I. R. 
Published: February 2007

SummarySecondary oxygen was added to air entrained by the primary jet of a fixed performance mask. Twenty such masks, in each of six groups rated at 24%, 28%, 31%, 35%, 40% and 50%, gave higher O2 percentages equivalent to those calculated from an equation that related the O2 concentration to the secondary flow. Actual values of both were closely correlated, with regression slopes and intercepts similar to those derived from this equation. This technique is simple and predictable in altering the composition of an air‐oxygen mixture delivered to the patient.
Relief of injection pain in adults EMLA cream for 5 minutes before venepuncture
Authors: Nott M. R. , Peacock J. L. 
Published: February 2007

SummaryThe effectiveness of skin anaesthesia after 5 minutes’ topical application of a lignocaine‐prilocaine cream was evaluated. One hundred and twenty patients estimated the pain of antecubital venepuncture both on a linear scale and verbally after use of the cream for either 5 or 60 minutes, a placebo cream or no treatment. Reported pain was significantly less after only 5 minutes of the lignocaine‐prilocaine cream (p = 0.002). The cream can be used to relieve the pain of all routine injections.
Changes in haemodynamics and plasma catecholamine concentrations after field block for inguinal herniorrhaphy using lignocaine with adrenaline
Authors: HAYSE‐GREGSON P. B. , ACHOLA K. J. , SMITH G. 
Published: February 2007

SummaryHaemodynamic changes and plasma catecholamine concentrations were measured in 12 patients aged 24 to 87 years after performance of a field block for elective repair of inguinal or femoral hernia. The local anaesthetic used comprised a mixture of lignocaine 0.5% with adrenaline 1:200000; the dose of lignocaine administered varied from 3.8 mg/kg to 4.9 mg/kg. Plasma adrenaline increased by 326% and plasma noradrenaline by 75% at 10 minutes after completion of the block. Mean heart rate increased from 75 to 94 beats/minute after 20 minutes, whilst there were no obvious changes in systolic and diastolic arterial pressures. Potentially serious arrhythmias developed in two patients, thought to be related to the peak plasma concentrations of adrenaline produced. It is recommended that the dose of adrenaline used as described for this block should be reduced.
Obstetric anaesthesia in dystrophia myotonica
Authors: BLUMGART C. H. , HUGHES D. G. , REDFERN N. 
Published: February 2007

SummaryTwo patients with dystrophia myotonica presented for urgent Caesarean section. Their per‐ and postoperative courses illustrate the anaesthetic problems posed by this disease. Respiratory difficulties are compounded by pregnancy and there is increased susceptibility to uterine haemorrhage. Choice of anaesthetic agent is discussed. Both had general anaesthetics; muscle relaxation was achieved with vecuronium.
Admissions to the intensive care unit after complications of anaesthetic techniques over 10 years 2. The second 5 years
Authors: LEIGH J. M. , TYTLER J. A. 
Published: February 2007

SummaryCompared with the first 5 years there was a 19% increase in general anaesthetics, a 171% increase in local and (or) sedation techniques and a 9% increase in obstetric epidurals with no increase in anaesthetic staffing. In this second 5‐year period, 46 patients were admitted to the Intensive Care Unit as a result of a complication of an anaesthetic technique. These patients represented 1 in 2371 anaesthetic techniques carried out in the District compared with the previous 5 years where the incidence was 1 in 1543. Seven patients died (15.2%). The complication was considered to be wholly or partially avoidable in 14 instances (30.4%). Four of these subjects died.
Oral premeditation in children A comparison of trimeprazine with a trimeprazine, droperidol and methadone mixture
Authors: Phillips G. H. , Mian T. , Becker U. , Stone P. A. , Jones H. M. 
Published: February 2007

SummaryOne hundred children who presented for minor general surgical procedures were randomly assigned to receive one of two oral premedications. Those in group A (n = 50) were given 3 mg/kg of trimeprazine and those in group B (n = 50) a mixture of trimeprazine 1.0 mg/kg, droperidol 0.15 mg/kg and methadone 0.08 mg/kg. Patients in group B were more likely to be asleep on arrival in the anaesthetic room (p < 0.02) and were less likely to be distressed at induction of anaesthesia (p < 0.02). Thiopentone requirements were less in group B (p < 0.001). The incidence of side effects was similar in the two groups. It is concluded that the mixture produces more satisfactory sedation than trimeprazine.
Life‐threatening complications during anaesthesia in a patient with a ventriculo‐atrial shunt and pulmonary hypertension
Authors: BUTLER P. J. , WHEELER R. A. , SPARGO P. M. 
Published: February 2007

SummaryA 6‐year‐old patient with hydrocephalus who underwent revision of a ventriculo‐atrial shunt is described. Anaesthesia was complicated by the occurrence of systemic hypertension and arterial hypoxaemia. The patient was subsequently found to have pulmonary hypertension secondary to recurrent pulmonary thromboembolism. The pathophysiological mechanisms for the patient's deterioration are discussed and the anaesthetic management of children with pulmonary hypertension is outlined. It is concluded that patients with a ventriculo‐atrial shunt who present for surgery should be screened carefully for the presence of pulmonary hypertension.
Nitrobenzene poisoning and spurious pulse oximetry
Authors: KUMAR A. , CHAWLA R. , AHUJA S. , GIRDHAR K. K. , BHATTACHARYA A. 
Published: February 2007

SummaryThe successful management of nitrobenzene poisoning in a 21‐year‐old patient is presented. We report our experience of ventilatory care with additional intravenous methylene blue and ascorbic acid therapy. Pulse oximeters available at present are not useful in patients treated with methylene blue and should be used cautiously in the presence of cyanosis of unknown aetiology.
An evaluation of the Level 1 blood warmer series
Authors: BROWNE D. A. , DE BOECK R. , MORGAN M. 
Published: February 2007

SummaryThe Level 1 blood warmer series comprises three infusion sets and two blood warmers of different power outputs. All systems were found to be extremely efficient, with the larger 500 series capable of warming the equivalent of 80 units of blood an hour almost to body temperature.
Painless loss of vision after transurethral resection of the prostate
Authors: RUSSELL D. 
Published: February 2007

SummaryA 74‐year‐old män developed complete loss of vision after transurethral prostatectomy under spinal anaesthesia. Eyesight returned to normal over the next 12 hours. A direct inhibitory effect on the retina caused by glycine absorbed with the irrigation fluid is suggested as a possible cause.
The effects of propofol and thiopentone on forearm circulation
Authors: McKEATING K. , HOWE J. P. , McARDLE L. 
Published: February 2007

Summary Some effects of propofol and thiopentone induction on the peripheral circulation of healthy patients are examined using mercury strain gauge venous occlusion plethysmography of the forearm. Results indicate that both drugs produce a statistically significant decrease in mean arterial blood pressure and forearm blood flow. Forearm vascular resistance remains unchanged after either drug. These data suggest that bolus dose induction of anaesthesia with propofol does not cause arterial vasodilatation of the limb and that a cause for the reduction in mean arterial pressure must be sought elsewhere.
Neuroleptic malignant syndrome in the intensive therapy unit
Authors: MONTGOMERY J. N. , IRONSIDE J. W. 
Published: February 2007

Summary A case of the neuroleptic malignant syndrome occurred in a 40‐year‐old male after administration of chlorpromazine while on an Intensive Therapy Unit. Treatment with dantrolene sodium was successful, and a muscle biopsy was examined in the recovery phase of the illness. The importance of this condition and the difficulties in establishing a diagnosis at an early stage in patients on an Intensive Therapy Unit are discussed, along with implications for treatment .
Postmortem findings after epidural anaesthesia
Authors: WULF H. , STRIEPLING E. 
Published: February 2007

SummaryPostmortem specimens of 10 patients who had received continuous epidural anaesthesia postoperatively (ranging from 2–21 days) were examined. Slight epidural haemorrhage was observed in six patients and a macroscopically visible haematoma in a thrombocytopenic patient. Nonspecific epidural inflammatory reactions were observed microscopically in all patients. Specimens from seven patients with systemic infection showed signs of epidural infection. No similar pathology was found in a control group without epidural catheters. The aetiology and risk factors of the above findings are discussed, and recommendations given to prevent such sequelae after epidural anaesthesia.
A comparison of the performance of 20 pulse oximeters under conditions of poor perfusion
Authors: CLAYTON D. G. , WEBB R. K. , RALSTON A. C. , DUTHIE D. , RUNCIMAN W. B. 
Published: February 2007

SummaryThe performance of 20 pulse oximeters with finger probes was evaluated by comparison of their readings with directly measured arterial blood oxygen saturations. The samples were taken from patients who had undergone cardiac surgery under hypothermic cardiopulmonary bypass and had poor peripheral perfusion. The mean difference (bias, accuracy), standard deviation (precision) and drop‐out rate for each pulse oximeter was determined. An overall ranking of performance of each pulse oximeter was calculated using five criteria (accuracy, precision, number of readings within 3% of standard, percentage of readings given within 3% of standard, expectedoverread limit in 95% of cases). Two pulse oximeters achieved a combination of accuracy and precision such that 95% of measurements would be expected to be within 4% of the co‐oximeter value; these two also had the lowest dropout rate.
Midazolam‐induced benzodiazepine withdrawal syndrome
Authors: METS B. , HORSELL A. , LINTON D. M. 
Published: February 2007

SummaryA case history of a patient who developed severe anxiety and agitation on two occasions after discontinuation of a midazolam infusion is presented. The withdrawal symptoms interfered with effective mechanical ventilation and the patient required the reintroduction of a long‐acting benzodiazepine to treat the withdrawal state and to facilitate weaning from mechanical ventilation.
Accidental bronchial intubation with RAE tubes
Authors: BLACK A. E. , MACKERSIE A. M. 
Published: February 2007

SummaryPreformed tracheal tubes are used frequently in paediatric anaesthesia. A feature which contributes to their popularity is the belief that they can be positioned more reliably than conventional tracheal tubes because of their design. We studied a group of 40 patients in whom the incidence of bronchial intubation was 20%. The tube was too long in 32% of patients, although the tube size was appropriate for the child's age in all patients. The consequences and outcome of this complication are discussed.
A comparison of patient rewarming devices after cardiac surgery
Authors: IMRIE M. M. , WARD M. , HALL G. M. 
Published: February 2007

SummaryThree regimens for rewarming patients after cardiac surgery involving hypothermic cardiopulmonary bypass were studied in 30 patients. The control group (n = 10) received no active rewarming, the oesophageal group (n = 10) was warmed centrally using an oesophageal heat exchanger and the radiant group (n = 10) was warmed peripherally with an overhead radiant heater. There were no statistically significant differences between the groups apart from the higher mean skin temperatures in the peripheral group.
Coagulation screening before epidural analgesia in pre‐eclampsia
Authors: Barker P. , Callander C.C. 
Published: February 2007

SummaryA questionnaire survey of current practice at a small cross‐section of obstetric units, covering 22% of all United Kingdom deliveries, revealed a marked lack of standard practice regarding requests for coagulation screens on pre‐eclamptic patients who require epidural procedures. A retrospective audit was therefore carried out on 434 coagulation screens requested for pre‐eclamptic patients in whom epidural analgesia might have been considered. Borderline abnormalities of coagulation were found in only 10 patients (2%). Platelet counts of less than 150 × 109/litre were present in 28% of cases. ‘Significant’ thrombocytopenia (< 100 × 109/litre) and all coagulation abnormalities were only encountered in severe pre‐eclampsia (diastolic blood pressure of greater than 110 mmHg and proteinuria of ++ or greater). Furthermore, coagulation abnormality was always associated with a reduced platelet count (mean, 97 × 109/litre). This study would therefore support anaesthetic practice which restricted any requests for coagulation testing to severe pre‐eclamptic patients only. For these patients first line testing could be limited to a platelet count.
Depth of extradural space and dural puncture
Authors: SUTTON D. N. , LINTER S. P. K. 
Published: February 2007

SummaryThe records of 3011 obstetric extradural blocks were examined to determine the depth of the extradural space and the relative risk of dural puncture. The overall incidence of dural puncture was 0.7%. A disproportionate number of punctures occurred when the space was superficial (1.45%), with a risk factor three times greater than that associated with normal depth spaces (0.48%). Caution is advised when infiltrating with local anaesthetics before extradural procedures, and when initially introducing the extradural needle.
Oxygen delivery Systems–a comparison of two devices
Authors: Fairfield J.E. , Goroszeniuk T. , Tully A.M. , Adams A.P. 
Published: February 2007

SummaryTwo low‐volume, variable performance oxygen delivery Systems were compared in conscious spontaneously breathing volunteers. Oropharyngeal oxygen concentrations were measured during periods of nose and mouth breathing. The Systems were studied at oxygen flow rates of 2 or 4 litres/minute. The performance of both Systems was similar under the test conditions but the nasal catheter is preferable in terms of cost.
Epidural infusion of diamorphine with bupivacaine in labour
Authors: ENEVER G. R. , NOBLE H. A. , KOLDITZ D. , VALENTINE S. , THOMAS T. A. 
Published: February 2007

SummaryWe have compared the analgesic effects of three epidural infusions in a randomised, double‐blind study of 61 mothers in labour. An initial dose of bupivacaine 0.5% 8 ml was followed by either bupivacaine 0.125%, bupivacaine 0.125% with diamorphine 0.0025% or bupivacaine 0.125% with fentanyl 0.0002%. All infusions were run at a rate of 7.5 ml/hour. Analgesia was significantly better in both the groups receiving opioids. Diamorphine was shown to be the more effective supplement to bupivacaine. The 5% incidence of pruritis in the opioid groups was less than that reported by earlier authors.
Computerised axial tomography of the trachea
Authors: BARKER P. , MASON R. A. , THORPE M. H. 
Published: February 2007

SummaryCase histories are reported of three patients who had large retrosternal goitres which were responsible for significant abnormalities of the airway. Computerised axial tomography demonstrated the exact anatomy. The site of tracheal compression was shown and accurate measurements of the diameter of the trachea at its narrowest point were made. This information was useful when the management of the patient was planned.
Modified occlusion tests for the Bain breathing system
Authors: HEATH P. J. , MARKS L. F. 
Published: February 2007

SummaryUndetected defects in the inner tube of the Bain coaxial anaesthetic breathing system may result in a greatly increased apparatus deadspace. Several authorities have advocated tests intended to detect inner tube problems; however, the efficacy of these tests has never been validated. In this study none of the tests were able to detect all the induced defects. A modification of an existing test using the backbar pressure‐relief valve and a new double occlusion test were sufficiently sensitive to detect all defects.
Can esmolol manage surgically‐induced tachycardia?
Authors: Whirley‐Diaz J. , Gold M. I. , Helfman S. M. , DeLisser E. A. 
Published: February 2007

SummaryA double‐blind, randomised study was conducted to examine the efficacy of a single bolus dose of esmolol in treating surgically‐induced tachycardia. Anaesthetic technique was identical in all patients, and consisted of premedication with midazolam and glycopyrronium, induction with thiopentone followed by suxamethonium, tracheal intubation, and maintenance with isoflurane 0.6% (end‐tidal) and60% nitrous oxide in oxygen. Forty‐eight patients developed a heart rate of greater than 95 beats/minute or 20% more than pre‐induction values at an average time of 34 minutes after tracheal intubation and received placebo (15 patients), esmolol 50 mg (16 patients), or esmolol 100 mg (17 patients). Controlled intervention was instituted if heart rate or blood pressure was not adequate. Both 50 and 100 mg of esmolol resulted in lower heart rates compared to placebo (p < 0.05), with no difference between the two esmolol groups (p > 0.05). Patients who received placebo had more episodes of medical intervention than those given esmolol (p < 0.05). No adverse effects occurred in any patient.
Premedication: An audit
Authors: Kluger M. T. , Owen H. 
Published: February 2007

SummaryA prospective study of routine premedication management was carried out at a large teaching hospital. Many patients received their premedication at times inappropriate for it to be effective. Several patients receiving regular medication had this suddenly stopped pre‐operatively. Prolonged fasting occurred in both elective and emergency groups of patients. Benzodiazepines and opioids were prescribed most frequently and drying agents were used widely. Antacids, H2‐blockers and agents to promote gastric emptying were used very little despite the potential of aspiration in many groups of patients. This audit of activity has revealed several areas of practice that can either be improved immediately or warrant detailed investigation.