bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of accidents associated with air‐oxygen mixers
Authors: KARMANN U. , ROTH F. 
Published: February 2007

SummarySome time ago three patients were threatened by severe hypoxia. They did not demonstrate any adverse late effects, though the situation could as well have brought a fatal outcome. The incidents were related to the use of an oxygen‐air mixing device. As this apparatus is widely used it is worthy of comment regarding its potential danger.
Acute cardiovascular changes following disoprofol
Authors: AL‐KHUDHAIRI D. , GORDON G. , MORGAN M. , WHITWAM J. G. 
Published: February 2007

SummaryThe acute cardiovascular changes following induction of anaesthesia with disoprofol 2 mg/kg have been studied in eight heavily premedicated patients with coronary artery disease. There was a significant increase in heart rate (+ 19%) and significant falls in mean arterial blood pressure (− 23%), peripheral vascular resistance (− 19%) and stroke volume (− 26%). Cardiac output did not change significantly. The extent and pattern of these changes are very similar to those seen after other intravenous induction agents.
Ventilation at high respiratory frequencies
Authors: SMITH R. B. 
Published: February 2007

SummaryThis paper reviews the development of different methods of ventilation at respiratory rates higher than 60 per minute (1 Hz) along with data on experimental and clinical uses of the techniques. The definitions and terms that have been used for these high rates at the present time are confusing. An attempt to clarify the terms has been made. Whereas high frequency positive pressure ventilation (HFPPV) refers to respiratory rates between 60–110 per minute (1–1.8 Hz), high frequency jet ventilation (HFJV) usually refers to rates between 110–400 per minute (1.8–6.7 Hz) and high frequency oscillation (HFO) refers to rates above 400 and up to 2400 per minute (40 Hz). It should be recognised that this differentiation in terminology is rather arbitrary and does not necessarily represent a sudden switch to different physiological methods of ventilation.In view of the various techniques which are involved in ventilation methods utilising rates greater than 60 per minute (1 Hz), it is the purpose of the present work to review the literature. In so doing, the contrasting rates, mechanical equipment, and experimental and clinical uses of these different methods will be discussed in order to clarify their potential contribution to clinical medicine.
The anaesthetists and distinction awards
Authors: LODER R. E. 
Published: February 2007

SummaryThe author retired from active practice as a consultant anaesthetist in the british National Health Service during 1980 at the age of 60. He kept a detailed diary for the last full year as a consultant. One of the editors suggested that the diary, augmented by his considered views culled from the experiences of a professional lifetime, could form the basis of a series of essays on various aspects of the life and practice a, a consultant anaesthetist during the second half of the twentieth century. This essay considers the history and me cranks of the distribution of distinction awards in the British National Health Service as it has affected anaesthetists.
Intensive care after fresh water immersion accidents in children
Authors: PFENNINGER J. , SUTTER M. 
Published: February 2007

SummarySix children who remained in deep coma after immersion accidents in fresh water received therapy to maintain normal intracranial pressure (ICP). This involved controlled ventilation to ensure hypocapnia and hyperoxaemia, maintenance of low normothermia, fluid restriction, dexamethasone (1–1.5 mg/kg initially, 1–1.5 mg/kg/day as maintenance) and barbiturates (phenoharbitone and thiopentone). The latter were given in a wide range of dosage. Increased ICP was common to all patients, but could always be kept at acceptable levels. All patients suffered from pulmonary oedema; three developed bronchopneumonia and two developed adult respiratory distress syndrome. All children survived with good recovery, two needed active rehabilitation for several months.
Recovery from intravenous anaesthesia
Authors: BAHAR M. , DUNDEE J. W. , O'NEILL M. P. , BRIGGS L. P. , MOORE J. , MERRETT J. D. 
Published: February 2007

SummaryUsing the endpoints of spontaneous opening of eyes, giving date of birth, sitting up unaided and normal pegboard time, recovery from 2 and 3 mg/kg disoprofol was compared with that from 4 and 6 mg/kg thiopentone and 1.5 mg/kg methohexitone in groups each of 10 unpremedicated patients. The study method differentiated between recovery from the two doses of disoprofol and thiopentone at the first two endpoints only. A between‐drug comparison showed early recovery was slightly faster with thiopentone than with equivalent doses of the new drug while no differences were detected between the recovery from equivalent doses of methohexitone and thiopentone. The differences found in this study are felt to be of no clinical significance and recovery from anaesthesia with disoprofol would not be expected to be any slower than that from equivalent doses of thiopentone.
Caudal analgesia in children
Authors: McGOWN R. G. 
Published: February 2007

SummaryThe author's first 500 caudal anaesthetics in children up to the age of 10 years are reviewed. Emphasis is laid upon sedation, both by premedication and by the anaesthetic technique. Nearly all the children were anaesthetised briefly for the sacral injection. Despite high levels of blockade, cardiovascular stability was well maintained, particularly in the younger children. There was a good correlation between volume of injection per unit of body weight and level of blockade. Dosage can be calculated on this basis for operations on the perineum, lower limb and groin with 97 to 98% confidence. The volume of solution appeared to be more important than its concentration in determining extent of blockade.
A rare intra‐operative complication in a child with Von Recklinghausen's neurofibromatosis
Authors: VAN AKEN H. , SCHERER R. , LAWIN P. 
Published: February 2007

SummaryA case of a boy with neurofibromatosis including unsuspected cerebral involvement and subsequent development of severe neurogenic pulmonary oedema during surgery in the prone position is reported. The importance of careful positioning is emphasised.
Airflow obstruction after smoke inhalation
Authors: COOKE N. T. , COBLEY A. J. , ARMSTRONG R. F. 
Published: February 2007

SummaryA case of persisting airflow obstruction following the acute effects of smoke inhalation injury is reported. Despite severe persistent abnormalities of pulmonary function the patient complained of no major disability. Serial pulmonary function tests should be performed after smoke inhalation injury as residual lung damage may have been underestimated.
High frequency venturi jet ventilation
Authors: DAVEY A. J. , LAY G. R. , LEIGH J. M. 
Published: February 2007

SummaryA tracheal tube with a facility for delivering a jet of gas near its tip (Portex Profile tube incorporating gas delivery line) has been used in high frequency jet ventilation. It appears to be more efficient at pulmonary gas exchange than the system using a short catheter jet placed co‐axially in the tracheal tube. It also provides a facility for tracheal toilet without interruption of ventilation.
Pre‐operative ranitidine
Authors: MAILE C. J. D. , FRANCIS R. N. 
Published: February 2007

SummaryNinety‐four patients undergoing elective surgery received ranitidine 100 mg or 50 mg intravenously one hour pre‐operatively, or acted as controls. A gastric aspirate pH in excess of 2.5 one to two hours after administration was achieved in 93% of patients given 100 mg. 88% of those given 50 mg, and 61%, of controls. There were no significant differences in the volumes of gastric aspirate.
Exsanguination in a Jehovah's Witness
Authors: HARRIS T. J. B. , PARIKH N. R. , RAO Y. K. , OLIVER R. H. P. 
Published: February 2007

SummaryA case is reported in which death occurred after a patient's adamant refusal to accept blood transfusion, despite prompt control of blood loss. The management of this situation is discussed. Reconstitution of the circulating volume was followed by survival for 2 hours after surgery. The haemoglobin level fell to 1.8g/dl.
Changes in body heat during transvesical prostatectomy
Authors: JENKINS J. , FOX J. , SHARWOOD‐SMITH G. 
Published: February 2007

Summary The superficial and deep body temperatures of 15 patients were measured before, during and for 6 hours after transvesical prostatectomy. The patients were divided randomly into two groups who received either a standard general anaesthetic or epidural analgesia. Total body heat and mean body temperature fell more rapidly in the epidural group, reaching statistical significance in the early postoperative period. Both groups showed a net heat gain 6 hours postoperatively. One patient in each group became hypothermic (core temperature <35°C). Warming of both intravenous and bladder irrigation fluids to body temperature is recommended for patients receiving epidural or general anaesthesia.
Long‐term tracheal intubation practice in the United Kingdom
Authors: Pippin Lynne K. , Short D. H. , Bowes J. B. 
Published: February 2007

Summary A questionnaire was circulated to members of the Intensive Care Society and hospitals with more than 120 acute beds in the United Kingdom. The object was to determine the usage of the various types of cuffs on tracheal tubes and the practice of long‐term tracheal intubation in contrast to tracheostomy. One hundred and fifty two replies were received (a 55% response rate). The majority of units favoured the high volume cuff for long term ventilation (61% for tracheal tubes and 69.2% for tracheostomy tubes). The cuffs were mainly inflated to ‘no‐leak' ventilation and pressure was not measured. The majority of units changed from tracheal lubes to tracheostomy after about one week but, for children, a longer period of tracheal intubation is employed. The results are discussed.
Plasma cholinesterase and trophoblastic disease
Authors: DAVIES J. M. , CARMICHAEL D. , DYMOND C. 
Published: February 2007

SummaryA case of prolonged action of suxamethonium in a patient with gestational trophoblastic disease is reported. Postoperatively the patient was found to have markedly reduced plasma cholinesterase activity (363 IU/litre) with a normal cholinesterase phenotype. Consequently plasma cholinesterase activity and phenotype were measured in six other patients with the condition and these results compared with those of 22 patients with normal first trimester pregnancies undergoing therapeutic abortion. Plasma cholinesterase phenotype was normal in all patients studied. The activity was significantly decreased (p < 0.05) from the normal range (620–1370 lU/litre) in all patients with trophoblastic disease. In the 22 patients with normal pregnancies, 14 had activity values in the abnormal range (< 620 IU/litre) while the mean cholinesterase activity of the group as a whole was significantly decreased (561.8 IU/litre, p < 0.05) below the normal range. These results confirm the presence of a decrease in plasma cholinesterase activity in early pregnancy and provide new evidence for a decrease in activity in a pseudopregnancy state.
The effect of age on recovery
Authors: SEAR J. W. , COOPER G. M. , KUMAR V. 
Published: February 2007

SummaryEighty unpremedicated patients undergoing dilatation and curettage were randomly allocated to receive induction of anaesthesia with either Althesin or thiopentone prior to maintenance with nitrous oxide, oxygen and halothane. Patients in each group were divided into those under 50 years (‘young’) or over SO years (‘old’). Recovery was assessed by the time taken to opening their eyes, to give correct date of birth and to achieve their baseline ability of manipulative skill with a children's post box toy. There was no difference in the time taken to open eyes or give correct birth date whether the patients received Althesin or thiopentone, or whether they were ‘young’ or ‘old’. An age‐related difference emerged with the post box test inpatients who had received thiopentone, the older patients recovery time being increased from 28.5 minutes to 45.1 minutes. There was no difference between the old and young patients who received Althesin in the time taken to complete the post box test.
Cardiac dysrhythmia associated with general anaesthesia for oral surgery
Authors: HANNA M. H. , HEAP D. G. , KIMBERLEY A. P. S. 
Published: February 2007

SummaryNinety patients, divided randomly into three groups, received either no metoprolol, 50 mg or 100 mg metoprolol as an oral premedication. The electrocardiogram was monitored throughout the procedure. It was found that both doses of metoprolol significantly reduced the incidence of cardiac dysrhythmia.
Narcotic antagonism by naloxone
Authors: MAGNUSSON J. , WERNER O. , CARLSSON C. , PETTERSSON K. I. 
Published: February 2007

SummaryTwenty patients undergoing microlaryngoscopy were anaesthetised with thiopentone and nitrous oxide. Half of the patients received 1.0–1.5 mg of fentanyl during anaesthesia, the effect of which was antagonised by naloxone 0.4 mg intravenously and 0.4 mg subcutaneously. The other patients served as controls and received saline instead of fentanyl and naloxone. Fentanyl markedly reduced mean arterial pressure and the heart rate‐systolic arterial pressure product during microlaryngoscopy. Conversely, there were significant increases in these measurements after naloxone had been given. However, there were no significant differences between patients given fentanyl with naloxone, and those given saline, in respect of arterial pressure, heart rate or dysrhythmia during recovery. No patient vomited, or appeared nauseated when observed afterwards in the operating room. One patient vomited several hours after naloxone.
Pneumoretroperitoneum
Authors: HILLMAN K. M. 
Published: February 2007

SummaryPneumoretroperitoneum is rare, but sometimes seen in association with pneumoperitoneum as a result of barotrauma to the lungs. However, there have only been two previous cases of pneumoretroperitoneum without pneunoperitoneum following barotrauma. This case discusses several of the possible mechanisms by which this could occur and what associated signs, especially on chest X‐ray, one should look for to confirm the aetiology of gas in the retroperitoneal space.
Subdural haematoma and spinal anaesthesia
Authors: JONSSON L. O. , EINARSSON P. , OLSSON G. L. 
Published: February 2007

SummaryA case report of an intracranial subdural haematoma following spinal anaesthesia in a 63‐year‐old man is presented. The pathophysiology of this possible complication seems similar to that of post‐spinal headache. A survey of patients in this hospital failed to reveal any likely case of subdural haematoma as a complication of spinal anaesthesia in almost 24000 anaesthetics.
Sequential use of thiopentone and etomidate in anaesthesia for termination of pregnancy
Authors: Cundy J.M. , Scott Wendy E. 
Published: February 2007

SummaryA study has been undertaken of a combined thiopentone‐etomidate sequence of anaesthesia for termination of pregnancy. The side‐effects of pain on injection and abnormal movements have been minimised by the technique. The pattern of recovery is satisfactory but the optimum dosage of thiopentone requires further study.
Epidural analgesia and anticoagulant therapy
Authors: ODOOM J. A. , SIH I. L. 
Published: February 2007

SummaryOne thousand lumbar epidural blocks in 950 patients undergoing vascular surgery are reported. All patients were receiving oral anticoagulants pre‐operatively. Mean thrombotest (TT) was 19.3% (normal range 70–130%). During surgery intravascular heparin was administered. At the end of surgery, the kaolin cephalin clotting time (KCCT) was 68 (±0.8) seconds (normal range 35–60 seconds), and partial thromboplastin time (PTT) was 536 (77.9%, normal control of 100%). Despite the anticoagulant therapy, no side effects were observed in any patient which could be related to haemorrhage or haematoma formation in the epidural space. It is concluded that, provided adequate precautions are taken, epidural analgesia can be safely used in patients receiving anticoagulant therapy.
Alfentanil and recovery
Authors: SINCLAIR M. E. , COOPER G. M. 
Published: February 2007

SummaryForty patients were given alfentanil 8 μg/kg as a supplement to either methohexitone or Althesin anaesthesia. Satisfactory anaesthesia and recovery were seen in all patients. Testing revealed very rapid recovery of psychomotor function. There were no differences between the two groups.
The application of cricoid pressure
Authors: HOWELLS T. H. , CHAMNEY ANNE R. , WRAIGHT W. J. , SIMONS R. S. 
Published: February 2007

SummaryA simple test rig was developed to assess the force applied during the application of cricoid pressure. Anaesthetists and paramedical personnel familiar with Sellick's manoeuvre were tested yielding results which indicate an unacceptably wide variation in performance in each group. The mean force was 46.4 N but 47% failed to reach a force of 44 N.In addition a survey was undertaken of trained anaesthetic staff to identify the current status of the manoeuvre. Of those sampled 78% routinely employed Sellick s manoeuvre and over 70% had experienced a problem with its application which exposed the patient to the risk of regurgitation.
Midazolam versus atropine plus pethidine as premedication in children
Authors: SJÖVALL S. , KANTO J. , IISALO E. , HIMBERG J.‐J. , KANGAS L. 
Published: February 2007

SummaryThe effects of oral midazolam or intramuscular atropine and pethidine used as premedication in two groups of 35 children over 5 years of age were studied. There was some evidence that the anxiolytic effect of midazolam was rather better than that of atropine plus pethidine, but, in other respects, subjective assessments in the two patient groups were similar. Intramuscular atropine caused tachycardia and subjective side‐effects, nevertheless children appear to require anticholinergics during premedication because of excessive salivary secretion, especially during extubation. Oral midazolam is a new anxiolytic drug which can be used as an alternative to existing premedicant drugs, but, in children, it should still be combined with an anticholinergic agent. No correlation between serum levels of midazolam or atropine and their clinical effects was found.
The use of atracurium besylate for laparoscopy
Authors: Sleigh J.W. , Matheson K.H. , Boys J. E. 
Published: February 2007

SummaryAn anaesthetic technique is described for laparoscopy using an intravenous induction, atracurium 0.2 mg/kg for muscle relaxation and intermittent positive pressure ventilation of the lungs with nitrous oxide and oxygen. It was found to be a suitable and simple technique. Recovery of spontaneous ventilation was achieved without the use of reversal agents in all 40 patients. A 15% incidence of cutaneous histaminoid reactions was noted. This is no higher than reported in other studies of atracurium, and further clinical trials are awaited.
Non‐parenteral postoperative analgesia
Authors: DERBYSHIRE D. R. , VATER M. , MAILE C. I. D. , LARSSON I. M. , AITKENHEAD A. R. , SMITH G. 
Published: February 2007

SummarySixty‐nine patients undergoing upper and lower abdominal surgery were studied after operation to compare the analgesic effects of sublingual buprenorphine (0.4 mg) and slow release morphine sulphate tablets (MST, 20 mg) given 6 hourly in a double‐blind, double‐dummy trial. Both MST and buprenorphine produced satisfactory postoperative analgesia but the linear analogue pain scores were significantly lower on the second post operative day with MST.
Extensive spread of local anaesthetic solution following subdural insertion of an epidural catheter during labour
Authors: SMITH G. BRINDLE , BARTON F. L. , WATT J. H. 
Published: February 2007

SummaryA case is described where a small dose of bupivacaine was accidentally injected into the subdural, extra‐arachnoid space resulting in extensive unilateral block and hypotension. The spread of solution was confirmed radiologically.
Oxazepam premedication in neurosurgical patients
Authors: BARRETT R. F. , JAMES P. D. , MACLEOD K. C. A. 
Published: February 2007

SummaryIn a double‐blind study, a new fast‐dissolving formulation of oxazepam used as sole premedicant in patients undergoing neurosurgery, was assessed with particular reference to its effect on the levels of anxiety, consciousness and orientation of the patients pre‐ and postoperatively. The results show that when given at least one hour pre‐operatively the new preparation is a highly effective anxiolytic with minimal sedative or other side‐effects, is convenient to administer and has high patient acceptability.
Oral ranitidine in labour
Authors: McAULEY D. M. , MOORE J. , DUNDEE J. W. , McCAUGHEY W. 
Published: February 2007

SummaryRanitidine 150 mg orally was given every 6 hours to 909 women in labour, while a control group of 378 women received conventional alkali therapy. No differences in incidences of operative intervention, placental retention or post‐partum haemorrhage were observed between groups. Gastric sampling during emergency anaesthesia revealed a pH less than 2.5 in four of 51 women who received ranitidine and in two of 31 women who received magnesium trisilicate. Gastric volumes were slightly lower (mean 83 ml) in the study group than in the control group (mean 122 ml). Absorption of ranitidine was greatly slowed following narcotic administration and gastric volume was significantly higher in those patients given narcotics in labour. Apgar scores were similar in both groups of infants, and babies whose mothers were given ranitidine showed no delay in achieving high gastric acidity and no increase in bacterial colonization of the gastro‐intestinal tract. Low levels only of ranitidine were found in the blood of babies at 2—3 hours and approximately 12 hours after birth.
The anaesthetic management of bone marrow harvest for transplantation
Authors: Filshie J. , Pollock A. N. , Hughes R. G. , Omar Y. A. 
Published: February 2007

SummaryThe anaesthetic management of 217 donors undergoing 236 operative procedures to donate bone marrow for allogeneic transplantation or for autologous grafting is described. The procedures were those performed between November 1979 and the end of October 1982.
The oculocardiac reflex in adults
Authors: KARHUNEN U. , COZANITIS D. A. , BRANDER P. 
Published: February 2007

SummaryNinety adult patients about to undergo strabismus surgery received glycopyrrolate or atropine intramuscularly. Three doses of each anticholinergic were studied. Cardiac rate and rhythm were recorded during halothane anaesthesia. The oculocardiac reflex, defined as a fall of 20% in heart rate during traction of the extraocular muscle was inhibited in a dose‐dependent manner by the drugs studied. The potency ratio of glycopyrrolate to atropine according to the oculocardiac reflex was established as 1:2.
Neurogenic pulmonary oedema
Authors: WAUCHOB T. D. , BROOKS R. J. , HARRISON K. M. 
Published: February 2007

SummaryTwo young patients with head injuries subsequently developed neurogenic pulmonary oedema. The origin and pathways of the reflex response to cerebral trauma are discussed, with emphasis on the role of raised intracranial pressure and the sympathetic division of the autonomic nervous system in precipitating movement of systemic circulatory volume into the pulmonary circulation, Therapeutic measures are discussed which correct the progression of this condition by reducing intracranial pressure and blocking the systemic effects of autonomic reflex activity. This leads to the basis of a simple regime to treat future cases.