bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous fluid load and recovery A double‐blind comparison in gynaecological patients who had day‐case laparoscopy
Authors: COOK R. , ANDERSON S. , RISEBOROUGH M. , BLOGG C. E. 
Published: February 2007

SummaryThe effect of intra‐operative fluid and dextrose administration upon recovery was tested in a randomised, double‐blind trial. Three groups of 25 patients, each undergoing laparoscopic examination as day cases, were studied. The two groups who received fluid (20 ml/kg compound sodium lactate solution) showed significant improvement (p < 0.05) in the variables that reflected hydration. The fluid group who also received dextrose (1 g/kg) exhibited further significant improvement. Intra‐operative fluid and dextrose administration appears to confer some benefit upon recovery in patients who have minor surgery.
The Woolley and Roe case. A reassessment
Authors: HUTTER C. D. D. 
Published: February 2007

SummaryIn 1953, two patients, Cecil Roe and Albert Woolley, sued their anaesthetist for alleged negligence because they had developed painful spastic paraparesis after spinal anaesthesia. The court found that phenol, which was used to sterilise the outside of the ampoules of local anaesthetic, had percolated the glass through invisible cracks, contaminating the solution, but that the anaesthetist could not have been aware of this risk. The case was important, despite the fact that judgement was in favour of the anaesthetist, because of the fears that it generated over the incidence of paralysis after spinal anaesthesia. The ’invisible crack’ theory has been the subject of much scepticism. New information has been obtained, and the case re‐examined objectively. The most probable source of contamination, which led to paralysis in the two patients, and in a third who received spinal anaesthesia on the same day, has been identified. A similar explanation may lie behind a number of other episodes of paralysis associated with spinal anaesthesia.
Platelet function after intramuscular diclofenac
Authors: POWER I. , CHAMBERS W. A. , GREER I. A. , RAMAGE D. , SIMON E. 
Published: February 2007

SummaryA randomised double‐blind controlled study was performed to examine the effect of diclofenac on skin bleeding time and in vitro whole blood platelet aggregation. Twenty thoracotomy patients were studied; 10 were given diclofenac 75 mg intramuscularly at induction of anaesthesia, and 10 formed a control group. Skin bleeding times and platelet aggregation tests were performed the day before and repeated one hour after induction of anaesthesia. Diclofenac prolonged skin bleeding time and reduced platelet aggregation. There were no significant changes in the control group.
Retracted: Volume therapy with hypertonic saline hydroxyethyl starch solution in cardiac surgery
Authors: BOLDT J. , KLING D. , HEROLD C. , DAPPER F. , HEMPELMANN G. 
Published: February 2007

SummaryThe ideal solution for volume therapy remains controversial. In cardiac surgery, haemodynamic efficacy as well as the influence of extracorporeal oxygenation are of major interest when administering volume. The present study examines the effects of a new hypertonic saline hydroxyethyl starch solution in comparison to a 6% hydroxyethyl starch solution on haemodynamics and laboratory variables. Patients scheduled for elective aortocoronary bypass grafting received hypertonic saline hydroxyethyl starch (n = 10) or hydroxyethyl starch (n = 10) after induction of anaesthesia in order to double baseline pulmonary capillary wedge pressure. Ten patients without volume therapy served as a control group. Significantly less hypertonic solution than standard solution was effective in doubling pulmonary capillary wedge pressure. Fluid requirements in the patients who received the hypertonic solution were significantly less during, as well as after, cardiopulmonary bypass in comparison to those in the other groups. Cardiac index increased most in the patients who received the hypertonic solution (+ 34.8%), as did right ventricular end‐diastolic volume. Patients in that group showed the highest decrease in total systemic resistance (‐ 29.8%), whereas arterial pressure and right ventricular ejection fraction remained almost unchanged in all groups. No negative alteration in coagulation or organ function was demonstrated within the investigation period. It can be concluded that hypertonic saline hydroxyethyl starch solution seems to be a valuable alternative to conventional volume therapy in cardiac surgery.
Alkalinisation of prilocaine for intravenous regional anaesthesia. Suitability for clinical use
Authors: ARMSTRONG P. , WATTERS J. , WHITFIELD A. 
Published: February 2007

SummaryEighty unpremedicated patients undergoing day‐case hand surgery under intravenous regional anaesthesia were randomly allocated to receive, in a double‐blind study, either 40 ml 0.75% prilocaine hydrochloride, with 5 ml 8.4% sodium bicarbonate or 5 ml 0.9% saline. The alkalinised group had significantly less pain on injection (p = 0.0045), during surgery (p = 0.0074) and 5 minutes after the tourniquet was deflated (p = 0.0027). The time elapsed between insertion of the block and commencement of surgery was not affected.
Anaesthesia in the field. Spontaneous ventilation–a new technique
Authors: Restall J. , Thompson M. C. , Johnston I. G. , Fenton T. C. 
Published: February 2007

SummaryIn recent years the British Army has used the Triservice Anaesthetic Apparatus in the field. Trichloroethylene is no longer manufactured in the United Kingdom and halothane is not recommended for closely repeated anaesthetics. A method based on existing equipment is described for patients breathing spontaneously. A background infusion of ketamine, midazolam and alfentanil supplements the inhalation of isoflurane in oxygen‐enriched air.
Acute viral myocarditis A death associated with anaesthesia
Authors: BRAMPTON W. J. , JAGO R. H. 
Published: February 2007

SummaryThe death of a 35‐year‐old woman in the immediate postoperative period as a result of undiagnosed acute viral myocarditis is described. The presentation, diagnosis and course of the disease is discussed, It is recommended that wider use be made of routine electrocardiographs as a screening test.
Intra‐operative pulmonary embolism Detection by pulse oximetry
Authors: MICHAEL S. , FRASER R. B. , REILLY C. S. 
Published: February 2007

SummaryA case is presented of a 49‐year‐old patient who had a pulmonary embolism during ovarian cystectomy. The only evidence of its occurrence was a sudden, marked reduction in arterial oxygen saturation as detected by a pulse oximeter. The diagnosis was confirmed 24 hours later by a chest radiograph and a ventilation perfusion scan. Anticoagulant treatment was instituted.
Laryngeal mask airway for Caesarean section
Authors: McCLUNE S. , REGAN M. , MOORE J. 
Published: February 2007

SummaryThe use of a laryngeal mask airway is described in a patient for emergency Caesarean section, when tracheal intubation was not possible. Provision of the laryngeal mask airway for use in the Maternity Unit is discussed.
The effect of exhaled alcohol on the performance of the Datex Capnomac
Authors: FOLEY M. A. , WOOD P. R. , PEEL W. J. , JONES G. M. , LAWLER P. G. 
Published: February 2007

SummaryWe investigated the response of the Datex Capnomac to alcohol in expired air. The greatest response was seen when the Capnomac was set to monitor halothane. There was an approximately linear correlation with blood alcohol levels. This effect is of sufficient magnitude to introduce inaccuracies in the measured concentration of halothane.
Is crystalloid preloading useful in spinal anaesthesia in the elderly?
Authors: Coe A.J. , Revanäs B. 
Published: February 2007

SummarySixty ASA grude 1 or 2 patients, aged 60 years or over, scheduled for surgery to the lower abdomen or lower limbs under spinal anaesthesia were allocated randomly to one of three treatment groups. Group A received 16 ml/kg of Ringer's acetate solution immediately before spinal anaesthesia, group B received 8 ml/kg and group C received no volume preload. Heart rate, arterial pressure and anaesthetic level were recorded by an independent observer. The overall incidence of systemic arterial hypotension (defined as a decrease of 25% or more in systolic arterial pressure) was 27%; there were no significant differences among groups. The overall incidence of hypotension was 60%, when temperature sensation was blocked to T7 and above (n = 25). The number of patients with hypotension which required treatment increased as block height increased above T7; at a level of T4 or higher, all patients required ephedrine. Crystalloid preloading had no effect on the incidence of hypotension after spinal anaesthesia in fit, elderly patients.
Pressor responses to tracbeal intubation after sublingual captopril A pilot study
Authors: McCarthy G. J. , Hainsworth M. , Lindsay K. , Wright J. M. , Brown T. A. 
Published: February 2007

SummaryThe effect of sublingual captopril on the pressor response to intubation was studied in 40 patients. Captopril was used in one of two doses (12.5 mg and 25 mg) 25 minutes before tracheal intubation. Both doses were associated with a significant reduction in the pressor response to intubation (p < 0.05) compared to placebo, but no significant difference existed between the two doses. Neither dose controlled changes in heart rate at intubation. Untoward hypotension occurred in the treatment groups. Caution is advised in the peri‐operative use of angiotensin‐converting enzyme inhibitors.
Haemodynamic and neurohumoral effects of xenon anaesthesia A comparison with nitrous oxide
Authors: BOOMSMA F. , RUPREHT J. , VELD A. J. MAN IN'T , JONG F. H. DE , DZOLJIC M. , LACHMANN B. 
Published: February 2007

Summary Thirty‐two patients were randomly allocated to be anaesthetised either with nitrous oxide or xenon. Those who received nitrous oxide required significantly more fentanyl peroperatively. Arterial blood pressure and heart rate were adequately controlled during surgery in both groups. Plasma noradrenaline and prolactin increased peroperatively in both groups, but plasma adrenaline and cortisol, which increased in the nitrous oxide group, did not change in the xenon group. Growth hormone was below control in those given xenon, but not in the nitrous oxide group, while dopamine remained unchanged in both groups. Postoperative plasma concentrations of noradrenaline, adrenaline, cortisol and prolactin (in both groups) and dopamine (in the nitrous oxide group) were elevated, and slowly returned to control. No differences were seen between the two gases in effects on plasma sodium and potassium. Xenon, because of its favourable haemodynamic, neurohumoral and antinociceptive properties, deserves a more prominent place in anaesthetic practice than it has so far occupied.
Detecting awareness during general anaesthetic Caesarean section An evaluation of two methods
Authors: BOGOD D. G. , ORTON J. K. , YAU H. M. , OH T. E. 
Published: February 2007

Summary Seventy‐four patients received general anaesthesia for Caesarean section. Seven percent of the elective group and 28% of the emergency patients reported dreaming or recall of voices during the procedure (p < 0.05) at postoperative interview. One patient from each group reported feeling pain or suffocation. All patients were monitored for awareness using the isolated forearm technique and lower oesophageal contractility. Provoked lower oesophageal contractility was the most effective of the different indices. A value greater than 35 mmHg on at least one occasion had a false negative rate of 33%, a false positive rate of 28% and a predictive value of 25%. A value greater than 13 mmHg picked up all patients who dreamed, with a false positive rate of 68%. Both of the ‘aware’patients had provoked lower oesophageal contractility response of greater than 70 mmHg, an attribute shared by only 8% of the rest. The isolated forearm was particularly ineffective.
Latency of brachial plexus block The effect on onset time of warming local anaesthetic solutions
Authors: HEATH P. J. , BROWNLIE G. S. , HERRICK M. J. 
Published: February 2007

Summary A double‐blind study was set up to investigate the effect of warming local anaesthetic solutions on the latency of onset of subclavian perivascular brachial plexus blocks. Twenty‐four adult patients were randomly allocated into two equal groups. In group A the local anaesthetic was injected at room temperature, while in group B the local anaesthetic solution was prewarmed to 37°C in a thermostatically controlled heating block. All blocks were performed using 0.5 ml/kg of a solution prepared by mixing equal volumes of 0.5% bupivacaine with adrenaline 1:200 000, and 1% prilocaine. The speed of onset of sensory blockade was significantly increased when the temperature of the local anaesthetic solution was increased to 37°C. There were no adverse side effects in either group.
Postoperative nefopam and diclofenac Evaluation of their morphine‐sparing effect after upper abdominal surgery
Authors: MOFFAT A. C. , KENNY G. N. C. , PRENTICE J. W. 
Published: February 2007

Summary The aim of the study was to assess the relative morphine‐sparing effects of nefopam and diclofenac when used singly or in combination after upper abdominal surgery. Eighty‐four patients of ASA grade 1 or 2 were allocated randomly to one of three groups. Group A received nefopam 20 mg by intramuscular injection 6 hourly after surgery for the 24‐hour study period. Group B received diclofenac 75 mg 12‐hourly and placebo injections at 6 and 18 hours after surgery. Group C received both 6‐hourly nefopam and 12‐hourly diclofenac. Supplemental analgesia was given on demand via a patient‐controlled analgesia system which delivered intravenous morphine. Morphine requirements in the diclofenac group were significantly lower than in either of the other groups (p < 0.01). Patients who received the combination of nefopam and diclofenac required significantly less morphine than those who received nefopam alone (p < 0.01). Pain scores assessed 6 hours after surgery were significantly lower in the diclofenac and combination groups compared with the nefopam group (p < 0.01).
Recovery of bowel motility after high dose fentanyl or morphine anaesthesia for cardiac surgery
Authors: YUKIOKA H. , TANAKA M. , FUJIMORI M. 
Published: February 2007

SummaryRecovery of bowel function was investigated after cardiac surgery. The time to first passage of flatus was measured using a carbon dioxide analyser as an indication of the return of coordinated bowel motility in 22 adult patients who received high‐dose fentanyl (56.3, SD 20.9 μg/kg) or morphine (1.3, SD 0.7 mg/kg) anaesthesia. The time from the patient's arrival in the intensive care unit to passage of the first flatus in patients who received fentanyl anaesthesia was significantly longer than in those who received morphine (p < 0.05). There was a significant relationship between the time to first flatus and the total dose of fentanyl, but no such relationship could be demonstrated for morphine. It is concluded that high‐dose fentanyl anaesthesia delays recovery of bowel motility in a dose‐dependent manner.
Iatrogenic anaemia? A survey of venesection in patients in the Intensive Therapy Unit
Authors: Tarpey J. , Lawler P. G. 
Published: February 2007

SummaryIn 30 consecutive patients admitted to the Intensive Therapy Unit, the volume of blood taken for investigations was recorded. Results were available for 26 patients. Total venesection volume averaged 336 ml. Venesection volume averaged 55.7 ml/day after the first 24 hours. The mean haemoglobin on admission was 11.5 g/dlitre. Blood loss was related to both APACHE score and length of stay (APACHE.day), to the presence of arterial and central venous catheters, and to the need for mechanical ventilation. Iatrogenic blood loss of this magnitude will cause anaemia if it continues.
Intravenous cannulae colour coding A perennial source of confusion
Authors: Tordoff S. G. , Sweeney B. P. 
Published: February 2007

SummaryThere is no standard colour code for intravenous cannulae in the United Kingdom. A questionnaire was sent to the manufacturers to compile a table of available cannulae, and to assess their views and plans with regard to colour coding. Present moves to establish an international standard are outlined. A simple colour coding standard is proposed.
Introducing patient‐controlled analgesia for postoperative pain control into a district general hospital
Authors: Notcutt W. G. , Morgan R. J. M. 
Published: February 2007

SummaryPatient‐controlled analgesia was introduced in a district general hospital in order to improve postoperative pain control. Techniques of management were developed with effectiveness, safety and practicality as the main objectives. An analysis of the first 1000 patients to use the system is presented. Problems were encountered with slow respiratory rate, monitoring, equipment function and ward management. Identification of specific hazards and management problems led to improvements in system safety. Patient‐controlled analgesia has become the standard technique for postoperative pain control after major surgery in this hospital.
Postoperative analgesia in children who have genito‐urinary surgery A comparison between caudal buprenorphine and bupivacaine
Authors: Girotra S. , Kumar S. , Rajendran K.M. 
Published: February 2007

SummaryA study conducted on 40 children, aged 1–11 years, who had genito‐urinary surgery compared the quality and duration of analgesia after caudal blocks in two groups of patients. Group 1 (n = 20) received caudal bupivacaine 0.25% and group 2 (n = 20) caudal buprenorphine 4 μg/kg; each received 0.5 ml/kg body weight. Patients were operated on under general anaesthesia. Postoperative behaviour and severity of pain were measured on a 3‐point scale. The results indicate that caudal buprenorphine provides excellent postoperative analgesia in children comparable to caudal bupivacaine in the early postoperative period. Buprenorphine proved better in the late postoperative period. Analgesia lasted from 20 hours to more than 24 hours after caudal buprenorphine with fewer side effects.
An unusual complication of tracheal intubation
Authors: GRAY B. , HUGGINS N. J. , HIRSCH N. 
Published: February 2007

SummaryWe report a previously undescribed complication of tracheal intubation. The complication arose as a result of tracheal intubation performed as an emergency procedure in a patient with an abnormal anteriorly placed larynx. Subsequent corrective laryngeal surgery was required after a temporary tracheostomy had been performed.
Cytogenetic damage in operation theatre personnel
Authors: Natarajan D. , Santhiya S. T. 
Published: February 2007

SummaryThe study in a group of 24 (11 anaesthetists and 13 support staff) was planned to ascertain the cytogenetic risk in a group of theatre personnel who worked in various city hospitals. Their exposure in terms of duration of service vary from 3–30 years. The control group (n = 24) consisted of people with different occupations matched for possible confounding variables. Cytogenetic risk was assessed in terms of chromosome aberration and sister chromatid exchange in 72‐hour lymphocyte cultures. A significant increase in the percentage of chromosome aberration was observed. The sister chromatid exchange was double that of the baseline value in 20% of the exposed individuals. These findings indicate the possible risk of cytogenetic damage for staff working in unscavenged rooms.
Influence of temperature of bupivacaine on spread of spinal analgesia
Authors: CALLESEN T. , JARNVIG I. , THAGE B. , KRANTZ T. , CHRISTIANSEN C. 
Published: February 2007

SummaryA prospective, randomised study was performed to investigate the influence of temperature on sensory blockade in spinal anaesthesia. Three ml of plain bupivacaine 0.5% were injected intrathecally at either 4°C, room temperature, or 37°C. There were 10 patients in each group, who were kept sitting for 2 minutes after injection. The maximum level of sensory blockade was significantly higher (p < 0.01) in the group who received the solution adjusted to 37°C, and variability of level was smaller (p < 0.05). Time to two‐segment regression was shorter in the 37°C group than in the 4°C group (p < 0.05). Hypotension required administration of ephedrine more often in the 37°C group (p < 0.05). It is concluded that the use of plain bupivacaine 0.5% adjusted to 37°C results in a higher and more predictable sensory blockade.
Propofol for induction and maintenance of anaesthesia at Caesarean section A comparison with thiopentone/enflurane
Authors: YAU G. , GIN T. , EWART M. C. , KOTUR C. F. , LEUNG R. K. W. , OH T. E. 
Published: February 2007

SummaryA propofol infusion regimen and a standard general anaesthetic were compared in 40 Chinese women undergoing elective Caesarean section. Twenty patients received propofol 2 mg/kg for induction of anaesthesia followed by propofol 6 mg/kg/hour, while 20 patients received thiopentone 4 mg/kg with enflurane 1% for maintenance of anaesthesia. All patients were given atracurium and their lungs ventilated with nitrous oxide 50% in oxygen until delivery of the neonate. The hypertensive response after intubation was of shorter duration in the propofol group compared with the thiopentone group. Induction to delivery times ranged from 5 to 14 minutes and neonates from both groups had similar and satisfactory Apgar scores, Neurologic and Adaptive Capacity Scores and umbilical cord blood gas analysis. However, a prolonged propofol infusion time before delivery may cause lower Neurologic and Adaptive Capacity Scores. There were no differences in maternal recovery times or psychomotor performance.
Non‐drug related asystole associated with anaesthetic induction
Authors: KEANE T. K. , HENNIS P. J. , BINK‐BOELKENS M. TH. E. 
Published: February 2007

SummaryA patient is presented where routine venepuncture associated with anaesthetic induction resulted in bradycardia and asystole. The case highlights the need for special caution with, and ECG monitoring throughout induction for, patients with a history of syncope. It also demonstrates the need for caution when attributing cardiovascular events during induction to the effect of the induction agents used.
Awareness during Caesarean section
Authors: Lyons G. , Macdonald R. 
Published: February 2007

SummaryBetween 1982 and 1989 over 3000 patients were questioned about recall and dreaming after general anaesthesia for Caesarean section. Some 28 (0.9%) patients were able to recall something of their operation and 189 (6.1%) reported dreams. There was uniform adherence to a rigid anaesthetic protocol up to and including 1985, but a much publicised incident reported from the courtroom stimulated a relaxation of this regimen. Consequently the incidence of awareness decreased from 1.3% to 0.4%, and the incidence of dreaming was also reduced. Recollections of surgery were confined to manipulations, noises and voices. None of our patients complained of pain at the time of interview, although one since has. The inadequacies of the initial protocol and an approach to informed consent are discussed.
Evaluation of local anaesthetic blockade of the lateral femoral cutaneous nerve
Authors: HOPKINS P. M. , ELLIS F. R. , HALSALL P. J. 
Published: February 2007

SummaryAn assessment of local anaesthetic blockade of the lateral femoral cutaneous nerve using a standard technique was made. The rate of successful blockade was high, but the area of sensory loss was inconsistent between patients and was more anterior and distal than described in textbooks of anatomy.