bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypotension during epidural anaesthesia for Caesarean section
Authors: HALLWORTH D. , JELLICOE J. A. , WILKES R. G. 
Published: February 2007

SummaryThe incidence of hypotension occurring in women undergoing elective Caesarean section with epidural anaesthesia was investigated in 20 patients receiving an intravenous preload of 1 litre of Hartmann's solution and in 20 patients receiving 0.5 litre of polygelatin (Haemaccel) and 0.5 litre of Hartmann's solution. Hypotension occurred in 45% of the Hartmann's group but in only 5% of the polygelatin and Hartmann's group. An argument for the use of a 2‐litre intravenous preload of crystalloid solution is offered to provide prophylaxis against hypotension occurring during Caesarean section under epidural anaesthesia.
Regional hip blockade in osteoarthrosis
Authors: EDMONDS‐SEAL J. , TURNER A. , KHODADADEH S. , BADER D. L. , FULLER D. J. 
Published: February 2007

SummaryEighteen patients with unilateral osteoarthrosis of the hip were investigated in a trial which involved the injection of nine with bupivacaine and nine with normal saline. All the patients completed daily pain analogue charts. Their pain, mobility and functional activity were assessed and gait characteristics analysed, once before the injection and then at three monthly intervals. All the patients recorded a decrease in pain level within two weeks of injection, but it subsequently rose to pre‐injection levels. There were no other significant general improvements after the injection. A significant increase in the maximum force at toe‐off for the good leg was recorded one month after the injection. However, no further significant differences were found in the gait performance of either group of patients throughout the study. It is concluded that the hip nerve regional blockade offers no useful relief to the pain of osteoarthrosis of the hip joint.
Tapered connectors in patient breathing systems
Authors: SHAW A. , DAVIS P. D. , ANDERSON I. M. 
Published: February 2007

SummaryInvestigations using recommended gauging tools have shown that many tapered connectors on breathing systems do not meet the relevant standard. It would be important to improve dimensional tolerances so that better inter changeability is achieved. This improvement may make it unnecessary to employ ‘anti‐disconnexion’ fittings.
Laparoscopy — a stressful procedure
Authors: COOPER G. M. , SCOGGINS A. M. , WARD I. D. , MURPHY D. 
Published: February 2007

SummaryThe metabolic and hormonal response to laparoscopy was investigated in 22 patients, in whom nitrous oxide‐oxygen anaesthesia was supplemented with either 150 μg fentanyl or an Althesin infusion. There were significant increases in plasma cortisol (p < 0.05) from 303 to 458 mmol/litre and prolactin from 1869 to 3918 mU/litre (p < 0.01) at the end of laparoscopy in both groups of patients; these were sustained during the first hour of the recovery period. The blood glucose concentration increased significantly (p < 0.05) from 4.48 to 5.28 mmol/litre at the end of laparoscopy in the Althesin patients and remained increased 1 hour postoperatively at 5.54 mmol/litre (p < 0.01). The blood glucose concentration increased significantly (p < 0.05) from 4.43 to 5.36 mmol/litre in the fentanyl patients only during the recovery period. There was no significant difference between the metabolic and hormonal changes observed with the two anaesthetic techniques.
Pre‐operative starvation in children
Authors: ALLISON C. W. , CATER J. I. , GRAY I. G. , STAZIKER ANN C. 
Published: February 2007

SummaryNinety‐two children aged between 8 months and 8 years were fasted overnight prior to surgery. Plasma glucose and alanine concentrations were measured after the induction of anaesthesia.Of 30 children under four years, 23% had plasma glucose concentrations less than 3.3 mmolllitre. Underweight children were particularly at risk.The mean plasma alanine was low (0.17 mmolllitre) indicative of a shortfall in this essential substrate for gluconeogenesis. This probably reflects the greater obligatory glucose need of young children relative to their body protein mass.
Fluorine compounds in anaesthesia (9)
Authors: BURNS T. H. S. , HALL J. M. , BRACKEN A. , GOULDSTONE G. 
Published: February 2007

SummarySix heavily fluorinated aliphatic compounds and four heavily fluorinated derivatives of diethyl ether have been examined as anaesthetics, using mice. Two compounds are felt to be worth further examination. These are 1,1,1,‐trifiuoro‐2,2‐dichIoroethane (halothane with the bromine atom replaced by a second chlorine) and 1,1,2,2,4,5,5‐heptafluoro‐3‐oxapentane (ordinary diethyl ether with seven hydrogen atoms replaced by fluorine).
Liver enzyme studies with disoprofol (ICI 35,868) and midazolam
Authors: KAWAR P. , BRIGGS L. P. , BAHAR M. , McILROY P. D. A. , DUNDEE J. W. , MERRETT J. D. , NESBITT G. S. 
Published: February 2007

SummaryLiver enzyme studies were carried out before and following the use of two new intravenous agents, disoprofol and midazolam. These showed no major abnormal changes attributable to either drug, the findings being similar to those with thiopentone.
Plasma and cerebrospinal fluid barbiturate levels during prolonged continuous thiopentone infusion
Authors: AIREY I. L. , SMITH P. A. , STODDART J. C. 
Published: February 2007

SummaryDuring an infusion of thiopentone to control status epilepticus secondary to hypoxic brain damage, thiopentone and pentobarbitone levels were measured in the serum and cerebrospinal fluid (CSF). Pentobarbitone was found to be present in the serum between 7.8 and 11.1% of the thiopentone levels. There was a prompt response in serum levels of thiopentone to changes in the infusion rate. The CSF thiopentone varied between 15 and 40% of the serum levels. The CSF anticonvulsant threshold for thiopentone for this patient was between 5 and 15 mg/litre.
Pharmacokinetics and pharmacodynamics of thiopentone
Authors: CHRISTENSEN J. H. , ANDREASEN F. , JANSEN J. A. 
Published: February 2007

Summary The induction doses of thiopentone in eight elderly male patients (60–80 years) were significantly lower (p < 0.01) than in eight young male patients (ranges 3.09–5.06 mg/kg body weight in the elderly and 4.88–8.11 mg/kg in the young). The sleep concentrations in venous as well as in arterial blood did not differ between the two groups. In the elderly the arterial concentrations were significantly higher than the venous (p < 0.05). A three compartment open model was used to describe the disappearance of the drug from the venous blood. Significant increases were found in V3(means 145.9 and 51.2 litres) and in T½β(means 781 and427 minutes) in the elderly. The redistribution rate constant, K1,2, was decreased in the elderly (p < 0.05). By impedance cardiography 5 minutes after sleep mean percentages of the pre‐induction value of cardiac output were 94.6% in the young and 87.0% in the elderly (p < 0.05). In the young a correlation was found between cardiac output and induction dose, (r =0.85, p < 0.01).
Temazepam as premedication in elderly patients
Authors: CLARK G. , ERWIN D. , YATE P. , BURT D. , MAJOR E. 
Published: February 2007

SummaryOne hundred and forty‐five men were randomly allocated on a double‐blind basis to receive either temazepam 20 mg, diazepam 10 mg or placebo as premedication. Temazepam produced more sedation than either diazepam or placebo. Postoperative recovery was assessed by a simple visuo‐motor co‐ordination test and was best in the placebo group. Two hours into recovery, temazepam patients could almost match their baseline performance whereas the performance of the diazepam patients was still significantly worse than pre‐operatively. Temazepam is suggested as a suitable premedicant for elderly patients undergoing minor surgery.
Extradural anaesthesia in parturients with severe cardiovascular disease
Authors: McMurray T. J. , Kenny N. T. 
Published: February 2007

SummaryThe use of extradural block (EDB) in healthy parturients for normal delivery and operative procedures is now a widespread and established practice. However, clinical reports of its use in those parturients with severe cardiovascular disease are rare. Here we present two case reports of patients with severe cardiovascular disease delivered under EDB and discuss the merits of this method of anaesthetic management.
Disoprofol and fentanyl for total intravenous anaesthesia
Authors: MAJOR E. , VERNIQUET A. J. W. , YATE P. M. , WADDELL T. K. 
Published: February 2007

SummaryNinety patients undergoing a variety of surgical procedures were anaesthetised with a disoprofol infusion and increments of fentanyl. The first 40 patients constituted a preliminary dose finding study and the subsequent 50 patients a dose comparison study. The second 50 patients were alternately allocated to receive a maintenance infusion of disoprofol 150 or 200 μg/kg/minute. Fentanyl (1 μg/kg) at induction was followed by further small increments when indicated. Maintenance dosage of 200 μg/kg/minute provided good operating conditions and rapid uncomplicated recovery in spontaneously breathing patients, while 150 μg/kg/minute proved inadequate to prevent patient movement.
Horner's syndrome and vocal cord paralysis as a complication of percutaneous internal jugular vein catheterisation in adults
Authors: DAVIS P. , WATSON D. 
Published: February 2007

SummaryCases of neurological deficit following cannulation of the internal jugular vein in adults are reported. From a consideration of the techniques and topography the possibility of damage to the ansa subclavia and recurrent laryngeal nerve is highlighted.
The anaesthetist in the operating theatre
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 of a consultant anaesthetist during the second half of the twentieth century. This essay considers the often unrecognised influence the anaesthetist can have in ensuring that the best possible conditions for the successful surgical treatment of the patient are created in the operating theatre.
A comparative study of enflurane and halothane in children
Authors: O'NEILL MAUREEN P. , SHARKEY A. J. , FEE J. P. H. , BLACK G. W. 
Published: February 2007

SummaryEquipotent concentrations of enflurane and halothane inhaled by children caused substantial hypotension and respiratory depression, these changes being more pronounced with the former agent.Plasma catecholamine levels were unaltered indicating that enflurane, like halothane, elicits little sympatho‐adrenal response.Induction of anaesthesia and recovery times were largely comparable but earlier and more frequent use of narcotic analgesics was required after enflurane anaesthesia.
Is there an optimal P50 of haemoglobin?
Authors: SOLD M. J. 
Published: February 2007

SummaryThe effect a permanent change in the oxygen‐haemoglobin affinity would have on the oxygen transport system is considered theoretically. The calculations were based on Hill's equation and its derivatives. It was demonstrated that in normoxia and at normal oxygen consumption the position of the oxyhaemoglobin dissociation curve of the human adult (P50 3.53 kPa) differs from the optimal position calculated and that a right‐shift (increase in P50) would be favourable. However, the higher the oxygen consumption and therefore the saturation change, and/or the more pronounced the hypoxia, the more the P50 found in vivo coincides with the theoretical optimum.
Minimal haemolytic effects from 0.8% chlormethiazole infusion in volunteer subjects
Authors: SEOW L. T. , RYALL R. G. 
Published: February 2007

SummaryA solution of 0.8% chlormethiazole ethanedisulphonate was infused into the antecubital vein of 14 healthy volunteers for periods ranging from 60 to 120 minutes to examine any haemolytic effects in vivo. Plasma haptoglobin and haemopexin concentrations were measured before, during and after infusion. No evidence of intravascular haemolysis of any clinical significance was found.
The anaesthetist and intensive care
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 of a consultant anaesthetist during the second half of the twentieth century. This essay considers the present and future role of the anaesthetist in intensive care and the need for proper policies of organisation and training in that discipline.
Effect of doxapram on postoperative oxygenation in obese patients
Authors: HOLLWAY T. E. , STANFORD B. J. 
Published: February 2007

SummaryAn infusion of doxapram in 5% dextrose at a rate of 2 mg/kg/hour for 6 hours, or of 5% dextrose alone, was given to 20 grossly obese patients who had undergone upper abdominal surgery. There was no statistically significant difference in the degree of hypoxaemia or the incidence of chest infections between the two groups.
Midazolam/fentanyl. A total intravenous technique for short procedures
Authors: Holmes C. McK. , Galletly D.G. 
Published: February 2007

SummaryMidazolam (RO 21‐3981), a water soluble benzodiazepine, was used in combination with fentanyl as a total intravenous anaesthetic for outpatient cystoscopy. It was compared with a similar technique using Althesin and fentanyl.In both series good conditions were produced, and patient acceptance was high, with absence of pain on injection, no inappropriate muscle movements and no nausea or vomiting. The induction and recovery times were slightly longer in the midazolam series, but not undesirably so. There appeared to be a slight incidence of phlebitis with midazolam, but because the patients were discharged from hospital, the exact incidence could not be ascertained with certainty.
Safer sedation for ventilated patients. A new application for etomidate
Authors: Edbrooke D.L. , Newby D.M. , Mather S.J. , Dixon A.M. , Hebron B.S. 
Published: February 2007

SummaryA technique is described for sedation of ventilated patients. Six patients who underwent major maxillofacial surgery were given low dose infusions of etomidate and fentanyl for postoperative sedation. Measurements of respiratory function were recorded before and during the period of intermittent positive pressure ventilation. Plasma etomidate levels were estimated.After initial stabilisation an almost constant rate of infusion was used to provide a reproducible level of sedation from which the patients were easily aroused. All patients maintained an adequate minute volume when disconnected from the ventilator. All measured and derived respiratory indices remained within normal limits. Patients exhibited amnesia throughout the period of infusion. All patients found this method of sedation pleasant. This technique may be recommended as an alternative to conventional methods of sedation for ventilated patients.
Midazolam and diazepam for gastroscopy
Authors: AL‐KHUDHAIRI D. , WHITWAM J. G. , McCLOY R.F. 
Published: February 2007

SummaryMidazolam 0.1 mg/kg was compared with diazepam 0.15 mg/kg intravenously in patients undergoing gastroscopy. The patients receiving midazolam were more sedated at the end of the procedure. The mean discharge times from the clinic for diazepam and midazolam patients were 85 and 102 minutes, respectively. The principal differences between the two drugs were that midazolam had a faster rate of onset, was virtually free from venous complications, provided much better amnesia (90% compared with 50%), and although the recovery time was longer with midazolam, the rate of recovery during the period of observation was faster. Neither drug caused any significant cardiorespiratory depression.
Premedication with atropine or glycopyrrolate in children Effects on heart rate and rhythm during induction and maintenance of anaesthesia
Authors: Mirakhur R.K. 
Published: February 2007

SummaryAtropine 15 μg/kg and glycopyrrolate 5 or 10 μg/kg were studied as anticholinergic premedicants in groups of 20 children each. A control group of 20 children did not receive anticholinergic premedication. Both atropine and the higher dose of glycopyrrolate produced significant increases in heart rate prior to induction of anaesthesia. The subsequent increase during the process of induction was less than in those who had not received an anticholinergic drug or glycopyrrolate 5 μg/kg. Dysrhythmias during induction of anaesthesia occurred slightly less frequently in the patients given atropine or the higher dose of glycopyrrolate. Although the incidence was similar in these two groups, ventricular ectopic beats occurred less frequently following the use of glycopyrrolate. The control of secretions was also superior with this anticholinergic premedicant.
The anaesthetist and the day‐surgery unit
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 his 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 of a consultant anaesthetist during the second half of the twentieth century. This essay considers the role of the anaesthetist in providing safe anaesthesia, suitable conditions, and speedy recovery in the currently rapidly expanding field of day‐case surgery.
An adverse reaction to the administration of disoprofol (Diprivan)
Authors: BRIGGS L. P. , CLARKE R. S. J. , WATKINS J. 
Published: February 2007

SummaryA case history is reported of an adverse reaction following intravenous injection of ICI 35,868 or disoprofol (Diprivan) resulting in hypotension. flushing and bronchospasm. There was full recovery and investigation confirmed the involvement of complement C3 and C4. The risks with cremophor‐containing anaesthetics are again stressed.
Cockayne's syndrome
Authors: COOK S. 
Published: February 2007

SummaryA case is described of a child with Cockayne's syndrome undergoing anaesthesia for dental extractions. Problems were encountered during intubation; the reasons for the difficulty and the management of the case are described and discussed. This syndrome is rare but presents an unusual combination of abnormalities of particular importance to anaesthetists, especially since anaesthesia in patients with Cockayne's syndrome has not previously been described.
Effect of dantrolene on leg metabolism in porcine malignant hyperthermia
Authors: HALL G. M. , LUCKE J. N. , ORCHARD C. , LOVELL R. , LISTER D. 
Published: February 2007

SummaryThe effect of the intravenous administration of dantrolene 3.5 mg/kg body weight on leg metabolism during porcine malignant hyperthermia (MH) was investigated in six Pietrain pigs. Arterial pH improved only slowly after dantrolene and was associated with the continuing efflux of lactate from the leg. Oxygen uptake by the leg had returned to control values 30 minutes after dantrolene. Glucose production by the leg was observed during malignant hyperthermia but this was rapidly abolished by dantrolene. It is concluded that the most useful indices for assessing the adequacy of the treatment of MH are those which reflect changes in oxidative muscle metabolism.
Pemphigus vulgaris: anaesthesia in the traumatized patient
Authors: VATASHSKY E. , ARONSON H. B. 
Published: February 2007

SummaryThe anaesthetic management of a patient with pemphigus vulgaris who required eight anaesthetics over a 3‐month period, after sustaining closed fractures of both legs and degloving of one leg is described. The slow intravenous infusion of a ketamine/diazepam mixture and steroid therapy provided excellent peri‐operative conditions, without the need for the introduction of an airway or a tracheal tube.
Acute pulmonary oedema due to laryngeal spasm
Authors: COZANITIS D. A. , LEIJALA M. , PESONEN E. , ZAKI H. A. 
Published: February 2007

SummaryPostoperative laryngeal spasm is an emergency which generally responds to ventilation of the lungs without further complication. In the life‐threatening case presented here, severe laryngeal spasm was associated with the development of acute pulmonary oedema.
Respiratory problems and acromegaly
Authors: GOLDHILL D. R. , DALGLEISH J. G. , LAKE R. H. N. 
Published: February 2007

SummaryA case of an acromegalic patient who developed upper airway obstruction and acute pulmonary oedema after removal of a tracheal tube is described. The reasons for this and the significance of his history of hypersomnia and periodic breathing are discussed. Conclusions are reached about the management of acromegalics having general anaesthesia.
Plasma potassium after halothane—suxamethonium induction in children
Authors: HENNING R. D. , BUSH G. H. 
Published: February 2007

SummaryThe changes in plasma potassium following inhalation induction of anaesthesia with halothane followed by suxamethonium were studied in 48 normal children aged 1 to 10 years. Highly significant increases were found in both age groups studied (5 years and under, and 6 to 10 years). The mean percentage increase in plasma potassium and the proportion of children in whom an increase of 0.4 mmol/litre or greater was found, were both greater than in an earlier study on children after thiopentone induction and suxamethonium.
Accidental deep hypothermia due to exposure
Authors: VAAGENES P. , HOLME J. A. 
Published: February 2007

SummaryTwo cases of deep hypothermia due to exposure to cold are described. Although the underlying mechanism and degree of hypothermia were comparable, there was a striking dissimilarity between the observed disturbances of body homeostasis, response to rewarming technique, clinical course and outcome in the two cases. The first case was severely acidotic. She was rewarmed by immersion in warm water, but died from an acute cerebrovascular accident. The second case was moderately intoxicated by alcohol and revealed few disturbing features. She was treated by the use of thermal mattresses and survived without complications.
Uncalibrated anaesthetic scavenging systems with open reservoirs
Authors: JØRGENSEN S. , JACOBSEN F. 
Published: February 2007

SummaryFifty‐three of 114 uncalibrated scavenging systems with open reservoirs had evacuation rates of less than 20 litres/minute. Analysis showed that there was no correlation between the number of hours in use since the date of the last service and the demonstrated change in effectiveness. Calibrated systems which can be continuously monitored have definite advantages.
Nitrous oxide and middle ear pressure
Authors: CASEY W. F. , DRAKE‐LEE A. B. 
Published: February 2007

SummaryThe effects of different methods of induction of anaesthesia on middle ear pressure were investigated in healthy children. An increase in middle ear pressure associated with positive pressure ventilation with a bag and mask was demonstrated. When nitrous oxide was used, middle ear pressure increased by 39 mmH2O/minute in spontaneously breathing patients and 63 mmH2O/minute in those who were ventilated. Maximum pressures, with venting through the Eustachian tube, could be reached within 5 minutes in the latter group.