bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged curarisation following renal transplantation
Authors: ROUSE JANE M. , GALLEY R. L. A. , BEVAN D. R. 
Published: February 2007

SummaryA retrospective study of postoperative respiratory morbidity in 247 patients requiring renal transplantation between 1955 and 1973 showed that 7 patients required postoperative controlled ventilation for up to 6 days. The non‐depolarising relaxants tubocurarine and pancuronium were used in only 65 patients, but all 7 cases of respiratory failure occurred in this group. This suggests that the use of these drugs in anephric patients is potentially hazardous so far as postoperative respiratory insufficiency is concerned.
Changes in serum enzyme levels following ketamine infusions
Authors: DUNDEE J.W. , FEE J.P.H. , MOORE J. , McILROY P.D.A. , WILSON D.B. 
Published: February 2007

SummaryThe levels of four serum enzymes, known to be elevated in toxic hepatitis, were measured preoperatively and on the 3–4th and 13–15th postoperative days in patients anaesthetised with ketamine infusions (54) or with a standard technique (64). Significant elevations in enzyme levels were considered to have occurred when the postoperative levels were outside the accepted normal range and had increased by more than 3 × SD from controls. About half the patients in each group had minor gynaecological operations and 2120 in the ketamine series had postoperative elevation of enzyme levels, with no changes in the non‐ketamine group. Following intermediate operations 14134 anaesthetised with ketamine showed abnormal enzyme levels compared with 7/34 who had standard operations. None, of the latter had more than one abnormal test as compared with six in the ketamine series. The causes and significance of these findings are not known.
Antagonists of morphine‐induced respiratory depression
Authors: GAIROLA R.L. , GUPTA P.K. , PANDLEY K. 
Published: February 2007

SummaryThis double blind study showed the effect of four drugs, levallorphan, naloxone, doxapram and amiphenazole, on opiate‐induced analgesia and respiratory depression. Satisfactory analgesia was induced by administration of morphine intravenously in a dose of up to 0‐33 mg/kg; such a dose, however, produced significant depression of respiration. Administration of levallorphan, naloxone, and amiphenazole produced reversal of respiratory depression and analgesia. Doxapram reversed the respiratory depression but did not alter analgesia.
A case of respiratory failure complicated by acute hypophosphataemia
Authors: BROWN E.L. , JENKINS B.A. GWYNNE 
Published: February 2007

SummaryRespiratory failure due to an exacerbation of chronic obstructive airways disease is often seen by clinicians. A case in which respiratory failure was further complicated by acute hypophosphataemia is reported. Replacement phosphate therapy resulted in a dramatic improvement in the clinical condition of the patient.The aetiology of the hypophosphataemia was thought to be a combination of acidosis, and the administration of corticosteroids, 5% dextrose and antacids.It is suggested that hypophosphataemia may account in part for the poor prognosis associated with severe exacerbations of chronic obstructive airways disease.
Plasma cholinesterase variants and the anaesthetist
Authors: WHITTAKER MARY 
Published: February 2007

SummaryBiochemical properties of plasma cholinesterase of significance to the anaesthetist are reviewed.The role of the genetic variants of the enzyme in suxamethonium sensitivity and hyperthermia are discussed with emphasis on the pregnant patient. Altered gene frequencies of the enzyme variants in some mental disorders is commented upon.
Total intravenous anaesthesia for neurosurgery and neuroradiology
Authors: DALLAS STUART H. 
Published: February 2007

SummaryA method of total intravenous anaesthesia for neurosurgery and neuroradiology is described using a continuous infusion of alphaxalone/alphadolone (Althesin) with analgesics and muscle relaxants. It has been used successfully on 272 occasions in 243 patients. The reasons for using such a technique and the advantages and disadvantages inherent in it are discussed.
An integrated pain relief service for labour: co‐operation between obstetricians, anaesthetists and midwives
Authors: Ghosh‐Ray Goures C. , Taylor A. Barrie , Alberts Frank 
Published: February 2007

SummaryEpidural injections were performed by obstetricians on 1012 patients in a pain relief service in which there was clinical co‐operation between anaesthetists and obstetricians. A consultant anaesthetist collaborated in the training of staff providing the service. Midwives maintained the epidural analgesia with top‐up doses as part of their traditional role in providing pain relief in labour. Eighty‐eight per cent of patients were fully satisfied, 10‰ were helped and 2‰ had failed epidurals. The forceps rate was 30‰ and the dural tap rate 1.4‰ Junior obstetric staff in training grades can with adequate safeguards make a significant contribution to running an obstetric epidural service.
Anaesthesia for removal of carcinoid metastases
Authors: RAWLINSON W.A.L. , MARSH R.H.K. , GOAT V.A. 
Published: February 2007

SummaryA case of general anaesthesia for removal of carcinoid metastases is presented. Evidence of serotonin hypersecretion was shown by raised levels of 5‐hydroxyindoleacetic acid, hypertension and tachycardia. The rarity of osteoblastic carcinoid metastases is discussed.
Respiratory effects of Minaxolone
Authors: Puchihewa V. G. , Whitwam J. G. , Morgan M. , Lumley Jean 
Published: February 2007

SummaryThe respiratory effects of induction of anaesthesia with Minaxolone 0·4 mg/kg were studied following premediction with either atropine alone, lorazepam and atropine or papaveretum and hyoscine. There was no significant difference in the incidence of apnoea in the three groups, Those who received non‐narcotic premedication showed a significant increase in respiratory rate, but the minute volumes in these patients did not differ significantly from control values in the third minute after injection of minaxolone. In those who received papaveretum and hyoscine, there was no change in respiratory rate and a highly significant reduction in minute volume.
Anaphylactoid reaction to infusion of polygelatin (Haemaccel)
Authors: LUND NIELS 
Published: February 2007

SummaryA series of allergic reactions to infusion of polygelatin (Haemaccel®) in six pregnant women is reported. These women and a control group of five pregnant women were studied with analysis of complement, ELISA and skin tests. No differences were found between the groups in the factors studied. It is concluded that the reactions to polygelatin were caused through direct liberation of histamine, that is, an anaphylactoid reaction.
Low dose intravenous infusion technique with ketamine
Authors: PANDIT SUJIT K. , KOTHARY SARLA P. , KUMAR SURENDRA M. 
Published: February 2007

SummaryLow dose ketamine is a relatively new technique. The recommended doses vary considerably. It was therefore decided to establish the minimum dose of ketamine required to produce satisfactory analgesia, sedation and amnesia in 50% of a population of adult volunteers. Twenty adult volunteers aged 20 to 42 years were the subjects of the study. Twenty minutes following intravenous (iv) pre‐treatment with 0·3 mg of atropine and 0·2 mg/kg of diazepam each volunteer received a bolus of ketamine 1·0 mg/kg iv followed by ketamine iv infusion at the rate of either0·5 mg/kg/hour(10cases) or 1·0 mg/kg/hour (10 cases). The grade of sedation was determined on a scale of 1–5 and the frequency of amnesia was assessed using visual memory cards. Analgesia was determined by pin prick.Diazepam alone produced no analgesia and only moderate degree of sedation. Ketamine produced satisfactory analgesia to pin prick in both the groups. Ketamine bolus produced marked sedation for about 20 min followed by moderate sedation during iv infusion in both the groups. During the iv infusion of ketamine at arate of 0·5 mg/kg/hour the amnesic effects declined to 20% in 45 minutes, while during infusion of 10 mg/kg/hour the frequency reached a maximum at 50–60%. The minimum dose of ketamine required to produce amnesia in 50% of this population was therefore 1·0 mg/kg/hour after a bolus injection of 1·0 mg/kg given iv.
Assessment of pain using a computer
Authors: Gerson G. R. , Gerson J.N. 
Published: February 2007

SummaryVisual analogue scales are of value in the assessment of a subjective phenomenon such as pain. A method of producing such a visual scale on a computer screen is described, an audible component has also been provided on the computer to assist the patient in estimating the severity of his pain. Guidance is provided on the preparation of a programme to incorporate such a scale on a computer for use in an outpatient clinic.
Deflection of spinal needles by the bevel
Authors: DRUMMOND G.B. , SCOTT D.H.T. 
Published: February 2007

SummaryBevelled spinal needles sizes 22 and 25 gauge were passed through tough meat to assess the influence of bevel orientation on the path of the needle. The needle bent away from the bevel surface by about I mm for each centimetre of needle travel through the tissue. With an introducer, the deviation was reduced by a reduction of the distance of unsupported travel. Pencil‐point needles were less deviated.
Reversal of non‐depolarising neuromuscular block in children: a comparison of atropine and glycopyrrolate in a mixture with neostigmine
Authors: Black G. W. , Mirakhur R. K. , Keilty S. R. , Love S. H. S. 
Published: February 2007

SummaryAtrapine and glycopyrrolate were compared when given in a mixture with neostigmine for the reversal of non‐depolarising neuromuscular block in children. Glycopyrrolate was an effective antimuscarinic agent and could be safely used as an alternative to atropine, although the advantages in this age group were not as marked as have been observed in adults.
Cardiovascular responses to anaesthesia
Authors: COLEMAN A.J. , JORDAN C. 
Published: February 2007

SummaryObservations of heart rate, rhythm and arterial pressure during induction of anaesthesia, intubation of the trachea, and commencement of surgery were made in 42 patients divided into three comparable groups. Group 1, the control group of 15 patients, received an intravenous placebo injection prior to induction of anaesthesia; group 2, 14 patients, was given an intravenous injection of 2 mg of metoprolol, a beta‐adrenoreceptor blocking agent; group 3, 13 patients, received 4 mg metoprolol intravenously. In the placebo group, significant mean increases in heart rate of 27 and 38 beats/minute were noted at induction of anaesthesia and at intubation of the trachea respectively (p< 0·001). Heart rate was significantly reduced after metoprolol in groups 2 and 3 before anaesthesia (7·6 beats/minute, p < 0·05; and 12·9 beats/minute, p < 0·001). The increases which occurred after induction of anaesthesia (13·7 beats/minute, p < 0·01; and 15 beats/minute, p < 0·001), were significantly less than those in the control group (p < 0·05). Further increases in heart rate of 10 and 11 beats/minute were noted at intubation in groups 2 and 3 respectively (significantly less than placebo, p< 0·05).Although no change in systolic arterial pressure was noted in the control group following induction of anaesthesia and the mean increase after intubation was modest (9·8 mmHg), increases in three patients exceeded 50 mmHg. Arterial pressure was reduced by metoprolol in the period before anaesthesia in groups 2 and 3 by 7·1 mmHg (p< 0·05) and 8·1 mmHg (p < 0·01). Again no changes were noted at induction. Mean increases in blood pressure after intubation did not exceed control levels, and increases of 20–30 mmHg were noted in six patients.Cardiac rhythm disturbances, of short duration and of no apparent clinical consequence, were noted in association with induction of anaesthesia and intubation. ST segment changes were commonest and occurred in eight patients; five of these were in the placebo group. Six patients had short‐lived ventricular and supraventricular ectopics at induction or intubation of the trachea.
Malignant hyperthermia in a patient with an ankylosed jaw
Authors: JONES SUSAN E.F. , THOMAS COLIN H. 
Published: February 2007

SummaryDifficult intubation was followed by malignant hyperthermia in a girl with an ankylosedjaw. The treatment, including the use of intravenous dantrolene, is described. The patient's subsequent management, and the anaesthetic implications of these two conditions are discussed.
Radial artery cannulation Potential hazard in patients with acromegaly
Authors: Campkin T. Victor 
Published: February 2007

SummaryUsing Allen's test, impaired ulnar artery circulation to one or both hands was detected pre‐operatively in five out often acromegalic patients scheduled for transphenoidal hypophysectomy. Three of these patients also had symptoms of compression of the median nerve at the wrist (carpal tunnel syndrome). If ulnar flow is considered to be inadequate cannulation of a dorsalis pedis artery provides one possible alternative route for continuous measurement of the blood pressure during induced hypotension. In the three patients in this report in whom this vessel was cannulated no ischaemic complications in the foot were seen.
Calcium and cardiac arrest
Authors: BULL JOHN , BAND D.M. 
Published: February 2007

SummaryVarious preparations of calcium are recommended for use in treatment of cardiac arrest and advantages are claimed for one preparation over another because of increased availability of the calcium to the heart.Ionised calcium levels in human blood have been assayed following the addition of calcium increments by use of the calcium electrode. The results showed no difference between calcium chloride and calcium gluconate.
Dental treatment in young handicapped patients
Authors: MANFORD MARGARET L.M. , ROBERTS GRAHAM J. 
Published: February 2007

SummaryA trial was undertaken to assess the suitability of oxygen/nitrous oxide sedation (relative analgesia) for dental treatment in unmanageable handicapped young patients.Fifty patients with chronological ages 5–22 years and mental ages 1½–14 years participated in the double blind trial to see if premedication with diazepam 0·2 mg/kg would be a useful adjunct. After the trial, previous dental histories and behaviour at regular recall visits over the next 12–18 months were studied.Seventeen of 19 patients previously treated with general anaesthesia and 27 of 31 formerly untreated patients accepted treatment in the trial; of the 50 patients, 33 are continuing treatment with oxygen/nitrous oxide sedation, seven need general anaesthesia and 10 have moved from the district. It appears that the use of diazepam premedication improves patient demeanour and operating conditions although this improved effect is not carried over to recall visits.The results obtained indicate that routine dental procedures can be safely carried out by an experienced operator‐sedationist in young handicapped patients using oxygen/nitrous oxide sedation. The frequency with which potentially hazardous techniques need to be used can be reduced, as can hospital admissions.
Exposure of nitrous oxide to X‐rays
Authors: YANAGIDA HISASHI , NAKAJIMA MICHIAKI 
Published: February 2007

SummaryX‐radiation has been shown to produce nitric oxide (NO) and nitrogen dioxide (NO2) in the presence of nitrous oxide (N2O) The purpose of the present study was to confirm how much NO and NO2 was produced when constant amounts of nitrous oxide were exposed to constant X‐radiation. Twenty polyethylene bottles (capacity 10 litres) were filled with nitrous oxide alone. Another 20 bottles were filled with nitrous oxide and 30% oxygen. Each bottle was placed at a distance of 30 cm from the X‐ray tube and they were directly in the line of the X‐ray beam at a setting of 90 kV at 0·5 mA, a standard setting for chest fluoroscopy. The range of duration of X‐ray exposure was from 0 (control), to 2, 3, and 5 minutes in five bottles each, respectively. A colorimetric recording method (Saltzman) and a chemiluminescent monitor were used for measurement of NO and NO2. In the bottles filled with nitrous oxide alone, the production of NO was not affected by the duration of X‐ray exposure, but the longer duration of X‐ray exposure produced a larger amount of NO2. In the bottles filled with nitrous oxide and 30% oxygen, the longer duration of X‐ray exposure produced larger amounts of both NO and NO2. These finding confirmed a previous investigation in which nitrous oxide was not inert under X‐ray exposure. As the presence of oxygen plays an important role in the oxidation of nitrous oxide under X‐ray, this study suggests another potentially hazardous interaction that may occur secondary to the administration of an anaesthetic in the presence of X‐irradiation such as pulmonary angiography, cardiac catheterisation, and fluoroscopic bronchoscopy or biopsy.
Alfentanyl (R39209): initial clinical experience with a new narcotic analgesic
Authors: KAY B. , STEPHENSON D.K. 
Published: February 2007

SummaryR39209 (Alfentanyl), a new narcotic analgesic with a uniquely short duration of effect, was used to supplement nitrous oxide and oxygen for the maintenance of anaesthesia. Twenty‐two patients undergoing minor surgery were studied.Clinical anaesthesia was excellent or good in most (16) of the patients, and recovery was excellent or good in 18 patients, waking time being less than one minute in 15 patients. However the incidence of complications and side‐effects, mainly movement, apnoea, difficulty in assisting ventilation, nausea and vomiting was high.Intravenous administration of R39209 during anaesthesia induced significant depression of respiratory rate and minute volume during the second, third and fourth minutes after injection. There was an unexplained significant rise in respiratory rate and minute volume in the first 30 seconds after the first injection.The first administration ofR39209 also caused an unexplained, significant reduction in cardiac rate. An insignificant rise in mean systolic blood pressure followed injection of the drug.The transient effect of R39209 was confirmed in clinical practice, and the drug exhibited the features of a typical narcotic analgesic. It is concluded that R39209 will have a useful place in anaesthetic practice, and that better clinical results will be obtained with more experience of the drug, and better selection of indications for its use.
Delayed adverse responses to both methohexitone and Althesin
Authors: BEAMISH DAVID , BROWN DAVID T. 
Published: February 2007

SummaryA patient who reacted to both methohexitone and Althesin on separate occasions is described. On each occasion the reaction was delayed following anaesthesia. Underlying chronic infection had sensitised the patient's complement pathway, allowing it to be activated by two unrelated intravenous anaesthetic agents.
Interruption of pain pathways in the treatment of the cervical syndrome
Authors: Sluijter Menno E. , Koetsveld‐Baart Cobie C. 
Published: February 2007

SummaryIn the cervical syndrome a distinction should be made between an upper and a lower type. The upper type is usually emanating from the intervertebral or facetal joints, since pathology causing nerve‐root irritation is confined to the more caudal segments. In the lower type nerve‐root irritation is usually the cause of pain but secondary irritation of the facetal joints can be an important contributing factor.Treatment should primarily be conservative. If this fails and if surgical intervention is not indicated an attempt should be made to interrupt pain pathways. This can be done by division of the posterior primary rami or by making a radio‐frequency lesion in the dorsal root ganglion. The results indicate these procedures can be of considerable help in a group of patients who do not respond to any other treatment.
Plasma phosphate and red cell 2,3‐diphosphoglycerate following abdominal surgery
Authors: MACDONALD ROSEMARY , GUILLOU P. J. , KESTER R. C. 
Published: February 2007

SummaryChanges in plasma phosphate have been serially examined in 20 patients undergoing uncomplicated abdominal surgery. These studies confirm previous reports that a fall in plasma phosphate occurs in the postoperative period, but this does not appear to be metabolically deleterious to the patient since it is not accompanied by a significant concomitant fall in red cell 2,3‐DPG. These investigations form a basis for studies in complicated patients and serve to refute the suggestion that phosphate supplements should be added to all routine postoperative infusions.
Epidural pethidine in labour
Authors: Perriss B.W. 
Published: February 2007

SummaryThe degree of pain relief and duration of action were assessed after various doses of epidural pethidine had been given to 12 primigravid mothers in labour. Evidence of sympathetic and motor blockade was sought. Twenty‐eight doses were administered and of these 50% gave good pain relief and a further 43% of doses produced some relief. The duration of action was related to dose and varied between 55 min after 25 mg pethidine and 150 min after 100 mg. The blood pressure remained constant and there was no motor blockade. In the postpartum period five mothers expressed full satisfaction and seven were helped by the injection.
Adverse reactions to ketamine Anaesthesia
Authors: SKLAR GARRY S. , ZUKIN STEPHEN R. , REILLY THOMAS A. 
Published: February 2007

SummaryKetamine, a phencyclidine derivative, has been used as a general anaesthetic since 1965. Numerous reports of adverse psychological reactions have caused diminished use of this drug. Many investigators have tried by pharmacological means to modify these reactions with limited success. In this study, a psychological strategy has resulted in the absence of any adverse psychological reactions and acceptance of ketamine Anaesthesia by all patients. Additionally, all surgeons were satisfied with operating conditions.
Veno‐venous extra‐corporeal membrane oxygenation
Authors: HOPKINSON R. , CARNIE J. 
Published: February 2007

SummaryA case of post‐traumatic respiratory insufficiency is presented in whom a prolonged period of veno‐venous membrane oxygenation was utilised in an effort to provide life support and allow resolution of pulmonary damage. Stabilisation of respiratory function was achieved. Withdrawal of support was required because of surgical haemorrhage while the patient was fully heparinised. Respiratory function deteriorated and the patient died 4 days after discontinuing membrane oxygenation. The procedure was undertaken in the Intensive Care Unit of a District General Hospital where cardiopulmonary bypass facilities are not normally available.
An unusual cause of neonatal respiratory distress.
Authors: CAHILL J.F. 
Published: February 2007

SummaryA 2·5 kg male infant developed respiratory distress in the neonatal period. A diagnosis of idiopathic hyaline membrane disease was made and he was treated accordingly. At 24 hours of age he required intubation, and the immediate and dramatic improvement in his condition suggested that the original diagnosis was incorrect. Closer examination of the chest X‐ray revealed an intrathoracic cyst and abnormal vertebrae. The cyst was removed surgically, and histological examination showed it to be a neuro‐endodermal cyst.
Inhalation of a foreign body. A hazard of protective rubber sleeves on the jaws of mouth gags
Authors: MULLIGAN I.P. , MARSHALL R.D. 
Published: February 2007

SummaryA case is reported in which a young man who required tracheal intubation and intermittent positive pressure ventilation for head and chest injuries, inhaled a foreign body after extubating himself. The unusual nature of the foreign body and the manner of its entering the tracheobronchial tree is reported. The case suggests that the practice of using protective rubber sleeves on the jaws of mouth gags be reviewed and highlights the need to inspect all instruments after use, particularly those that have been employed in the mouth and upper airways.