bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasal CPAP after coronary artery surgery
Authors: THOMAS A. N. , RYAN J. P. , DORAN B. R. H. , POLLARD B. J. 
Published: February 2007

SummaryTwo groups of 14 patients were compared after coronary artery bypass surgery where the left internal mammary artery had been used as a conduit. One group received nasal continuous positive airway pressure for 1 h, the other group acted as a control. Mean pulmonary shunt fraction was 16.3% before, 12.6% during and 15.7% after continuous positive airways pressure. In the control group the shunt fraction fell from 17.3% to 16.8%. The reduction in shunt fraction was significantly greater with nasal continuous positive airways pressure than in the control group (p = 0.016). There was a significant reduction (p = 0.025) in respiratory rate from 18.3 to 16.7 breath.min–1 during continuous positive airway pressure. Other measured cardiorespiratory variables did not differ significantly between the groups. Visual analogue scores showed no significant difference in chest pain or mask comfort between the groups. The ease of breathing score was, however, significantly better in the continuous positive airways pressure group, 7.5 (SD 1.8) cm and control 5.6 (SD 2.6) cm.
Nosocomial sinusitis in ventilated patients
Authors: BACH A. , BOEHRER H. , SCHMIDT H. , GEISS H. K. 
Published: February 2007

SummaryA total of 68 postoperative patients whose lungs were ventilated for more than 4 days were studied prospectively during a one‐year study period to investigate the effect of the mode of intubation on the paranasal sinuses. After an initial X ray of the skull showing no pathological findings, patients were assigned randomly to one of the study groups; the lungs of patients in group A were ventilated via an orotracheal tube (n = 32), and patients in group B via a nasotracheal tube (n = 36). X ray examinations of the sinuses were performed at regular intervals. Diagnosis of sinusitis was confirmed by transantral needle puncture and culture of fluids obtained. Antibiotic regimens were altered according to laboratory testing. Two patients in group A developed signs of sinusitis in comparison to 15 patients in group B (p < 0.01). However, there were significantly more airway complications in the orotracheal group, particularly during the period of weaning from ventilation. We conclude that orotracheal intubation should be preferred as the routine route of intubation.
Measurement of forces during laryngoscopy
Authors: BUCX M. J. L. , SCHECK P. A. E. , VAN GEEL R. T. M. , DEN OUDEN A. H. , NIESING R. 
Published: February 2007

SummaryThe forces transmitted by the laryngoscope blade onto the base of the tongue are assumed to be a major cardiovascular stimulus. This study investigates the various forces applied onto a Macintosh laryngoscope during laryngoscopy. The forces acting along the axis of the handle are described, as well as the forces exerted by the anaesthetist to prevent the laryngoscope from turning. Based on a relatively simple technique, a modified laryngoscope has been designed to measure these forces. Four different laryngoscopic parameters are determined: (1) the duration of laryngoscopy, (2) the maximally applied force, (3) the mean force and (4) the integral of the force over the time (area under the curve). The force measurements of 49 anatomically normal patients undergoing uncomplicated intubation are included in the study. The duration of laryngoscopy was 16.3s (SD 11.8), the applied peak force was 35N (SD 12) and mean force necessary was 20N (SD 6) while the force‐time integral was 324N (SD 194).
A comparison of the filtration properties of heat and moisture exchangers
Authors: HEDLEY R. M. , ALLT‐GRAHAM J. 
Published: February 2007

SummaryHeat and Moisture Exchangers are used increasingly as filters to prevent the contamination of breathing apparatus and to limit cross‐infection. A series of laboratory tests has been developed to evaluate the microbial filtration and air flow resistance properties of these devices. The tests were designed to simulate the clinical situation and therefore evaluated devices in both dry and wet conditions. The devices tested (Engstrom Edith, Pall BB50T, Dar Hygrobac, Intersurgical Filtatherm and Intersurgical Filtaguard) were each representative of a particular type of construction. The simple hygroscopic device (Engstrom Edith) showed poor airborne and liquid‐borne filtration efficiency, but its resistance to air flow remained low in all conditions. The composite devices (Dar Hygrobac, Intersurgical Filtatherm and Intersurgical Filtaguard), which all possessed relatively large pores, performed well in terms of dry airborne filtration efficiency, but showed substantial increases in airflow resistance and poor filtration efficiency in the presence of liquid. The pleated membrane filter (Pall BB50T), which possessed small pores, showed good airborne filtration efficiency and prevented the passage of liquid. The latter property enabled this device to prevent the passage of liquid‐borne contamination and to maintain a low resistance to airflow in wet conditions. It would appear that in terms of contamination control and air flow resistance the pleated membrane filter provides a wider margin of safety than either the hygroscopic or composite devices.
Recovery characteristics using isoflurane or propofol for maintenance of anaesthesia: a double‐blind controlled trial
Authors: MARSHALL C. A. , JONES R. M. , BAJOREK P. K. , CASHMAN J. N. 
Published: February 2007

SummaryWe studied 114 female patients (ASA 1 or 2) who were within 20% of ideal body weight and who were scheduled to undergo gynaecological laparoscopy which required supplementation with an opiold (groups I A and PA), or dental procedures which did not require opioid supplementation (groups IO and PO). A computerised package of psychomotor tests was performed before surgery. Anaesthesia was induced with propofol 2.5 mg.kg−1 and all patients received atracurium 0.3 mg.kg−1 and 67% nitrous oxide in oxygen. Patients in group I A received isoflurane 1% (inspired), and alfentanil 10 μg.kg−1 as a bolus and 10 μg.kg−1.h−1 as an infusion. Patients in group PA received propofol 9 mg.kg−1.h−1 as an infusion, decreasing to 6 mg.kg−1.h−1 after 15 min, together with alfentanil 10 μg.kg−1.h−1. Patients in groups IO and PO received isoflurane and propofol in the regimens described for groups 1A and PA, but without alfentanil. Recovery was assessed by a blinded observer who recorded times to awakening (eye opening) and orientation (giving date of birth), and who repeated the psychomotor tests at 1,3 and 5 h. Linear analogue scales of mood, nausea and pain were obtained and other side effects were noted in the succeeding 48 h. A matched control group of 25 females (who were not anaesthetised) underwent psychomotor testing on four occasions in order to assess the ‘learning effect’ of repeated recovery testing. The analysis of recovery tests did not assume a normal distribution. There were no significant differences in awakening or orientation times among the groups (median values IO: 4.92 and 6.06 min; PO: 3.88 and 5.11 min; IA: 6.90 and 7.98 min; PA: 6.24 and 7.30 min). There were also no differences among groups in respect of the results of psychomotor testing during recovery. There was significantly less nausea in group PO (6132 patients) than in group IO (13/32 patients). There was also a significant difference between the performance of the control group compared with those of the study groups in most of the tests, and this emphasises the importance of including a control group in studies which involve recovery testing. We conclude that, after induction of anaesthesia with propofol in unpremedicated outpatients, maintenance of anaesthesia with nitrous oxide and either isoflurane or propofol, with or without alfentanil, provides reasonably rapid and reliable recovery and are equally acceptable to the patient.
Admixture of propofol and alfentanil
Authors: SHERRY E. 
Published: February 2007

SummaryAn admixture of propofol and alfentanil provides adequate sedation and analgesia during transvaginal oocyte retrieval in the absence of a paracervical block. In 100 patients the technique provided haemodynamic stability, sedation which was easily controlled, rapid recovery and universal patient acceptance.
Anaesthesia for bullectomy
Authors: KAN A. F. , OH T. E. 
Published: February 2007

SummaryA patient with a single large bulla occupying 50% of the right hemithorax was anaesthetised successfully with a combination of techniques not previously described. The technique consisted of extradural analgesia and intravenous infusion of propofol, while ventilation was maintained with high frequency jet ventilation through a single lumen tracheal tube. The advantages of this technique are a reduced risk of barotrauma, good operating conditions and good analgesia.
Functionally crossed pipelines
Authors: WEIGHTMAN W. M. , FENTON‐MAY V. , SAUNDERS R. , LEWIS A. , WISE C. C. 
Published: February 2007

SummaryUnexpectedly high blood oxygen tension in intensive care patients occurring over a 5‐year period were found to have been caused by an apparently normally functioning ventilator which was intermittently acting as a conduit between the oxygen and air pipelines. Responses to a circular letter sent to Quality Control Pharmacists in England and Wales suggest that similar faults may have occurred at least five times in the past 10 years. Recommendations are given for the prevention of this problem, including monitoring of gas pipeline composition.
Spinal epidural anaesthesia
Authors: LIFSCHITZ R. , JEDEIKIN R. 
Published: February 2007

SummaryWe present our experience with a new combined spinal epidural system through which regional anaesthesia was performed in 30 male patients undergoing suprapubic prostatectomy. The technique consists of two needles, a 17 G Tuohy needle with a hole in its distal curve (back eye) and a 29 G spinal needle which is passed through the back eye before being introduced into the subarachnoid space. We found the back eye combined spinal‐epidural system effective and simple to use. The Tuohy needle with its back eye did not impede insertion of the epidural catheter and was a suitable introducer for the thin 29 G spinal needle.
Modification to the Sprotte spinal needle
Authors: AGLAN M. Y. , STANSBY P. K. 
Published: February 2007

SummaryThe large lateral hole of the Sprotte needle is claimed to aid cerebrospinal fluid efflux during the performance of spinal anaesthesia. Using theoretical calculations and practical measurement we have shown that reducing the area of the lateral hole to that of the cross sectional area of the needle does not affect the flow rate. We suggest this modified Sprotte needle is an improved design which has the potential advantages of reducing the incidence of inadequate spinal anaesthesia and strengthening the needle tip.
Induction of anaesthesia with propofol using a target‐controlled infusion system
Authors: CHAUDHRI S. , WHITE M. , KENNY G. N. C. 
Published: February 2007

SummarySixty patients premedicated with temazepam were allocated randomly to receive an infusion of propofol designed to achieve and maintain a target blood concentration of 3, 4 or 5 μg.ml−1. Induction time was measured from the start of infusion to loss of verbal contact. The success rate of inducing anaesthesia within 3 min of achieving the target concentration was 40% when the predicted target concentration was 3 μg.ml−1, 75% when the predicted target was 4 μg.ml−1 and 90% when the target was 5 μg.ml−1. There were no significant differences between the three groups for time to loss of verbal contact in patients who were induced successfully within 3 min. There were significant reductions in arterial pressure 3 min after achieving the target concentrations within the groups but not between them. The frequency of apnoea and pain on injection was small in all groups. Selecting a target concentration of 5 μg.ml−1 would successfully induce anaesthesia in the majority of patients premedicated with temazepam without major haemodynamic or respiratory side effects.
A pressure regulator for the cuff of a tracheal tube
Authors: MILLER D. M. 
Published: February 2007

SummaryA regulator is described for the maintenance of a constant pressure difference above airway pressure during positive pressure ventilation in a cuffed tracheal tube. It comprises a tubular threshold valve which is powered by the anaesthetic gas supply source to a breathing system. The valve is interposed between the anaesthetic gas supply machine and the breathing system creating a pressure differential. The upstream pressure is transmitted to the pilot tube supplying the cuff of a tracheal tube via an upstream connection. The valve is suitable only for breathing systems that require a constant gas supply. The regulator was evaluated during anaesthesia, using a modified Mallinkrodt Hi‐Lojet ventilation tube to obtain simultaneous pressure measurements within the cuff and the lumen of the tracheal tube. A greater pressure was demonstrated in the cuff than in the airway and the two traces were approximately parallel throughout the respiratory cycle. The device should prevent excessive cuff inflation pressure and solves the problem of forgetting to let the cuff down before extubation.
The minimum effective dose of lignocaine to prevent injection pain due to propofol in children
Authors: Cameron E. , Johnston G. , Crofts S. , Morton N. S. 
Published: February 2007

SummaryIn a single‐blind study of 100 children aged 1 to 10 years, the minimum effective dose of lignocaine required to prevent injection pain due to propofol was 0.2mg.kg−1 when veins on the dorsum of the hand were used. This is more than twice the adult value. We concluded that injection pain should not limit the use of propofol in children if an adequate amount of lignocaine is mixed immediately prior to injection.
Continuous paravertebral block in children
Authors: Lönnqvist P.‐A. 
Published: February 2007

SummaryContinuous paravertebral block has not previously been described for use in children. This study reports the use of this technique in five patients (aged 7 months to 8 years) scheduled for renal surgery or cholecystectomy. The block was not difficult to perform and provided good intra‐ and postoperative analgesia. Continuous paravertebral block appears to be a promising technique for pain management in children and might prove a valuable addition in the field of paediatric regional anaesthesia.
Low dose amitriptyline in the treatment of chronic pain
Authors: MCQUAY H. J. , CARROLL D. , GLYNN C. J. 
Published: February 2007

SummaryThe analgesic efficacy of amitriptyline 25 mg was compared with placebo in 41 patients with chronic (more than 3 months) nonmalignant pain, using a double‐blind randomised multiple‐dose 3‐week treatment period crossover design. Amitriptyline 25 mg provided significantly greater efficacy than placebo, with significant differences evident within the first week. There was no significant difference on mood scores between amitriptyline and placebo. The results suggest that surprisingly low doses of amitriptyline may be effective without substantial adverse effects, that the effect is evident early, and that the effect is distinguishable from any effect of the amitriptyline on mood.
Phenytoin reduces suxamethonium‐induced myalgia
Authors: HATTA V. , SAXENA A. , KAUL H. L. 
Published: February 2007

SummaryA prospective, randomised trial was undertaken in 60 healthy adults to determine the efficacy of intravenously administered phenytoin in doses of 5 mg.kg−1 for the prevention of suxamethonium‐induced fasciculations, a rise in serum K+ and myalgia. This was compared with tubocurarine pretreatment and no pretreatment (control group). Phenytoin pretreatment significantly reduced myalgia from 45% (nine patients) in the control group to 10% (two patients) (p < 0.05). It also decreased the duration and mean intensity of fasciculations. Incidentally, phenytoin was also found to decrease significantly mean serum Na+ levels (p < 0.001) both at 5 and 20 min after administration. Tubocurarine pretreatment (3 mg) resulted in a significant decrease in fasciculations, but myalgia, which occurred in five patients, remained the same. No significant correlation was found between muscle fasciculations, postoperative myalgia and K+ changes, but patients with myalgia had a significant decrease in mean serum Na + levels at 5 and 20 min after suxamethonium (p < 0.01).
Light anaesthesia with propofol for paediatric MRI
Authors: Vangerven M. , Van Hemelrijck J. , Wouters P. , Vandermeersch E. , Van Aken H. 
Published: February 2007

SummaryAnaesthetic techniques and monitoring equipment may interfere with the technical demands of magnetic resonance imaging. The purpose of this study was to evaluate the safety and efficacy of a light anaesthetic technique with intravenous propofol in nonintubated children. In 20 neuropaediatric patients sedation was induced with propofol 1 mg.kg−1, followed by a continuous infusion titrated to produce adequate immobilisation. Oxygen, 4 l.min−1, was administrated by paediatric face mask. Respiratory rate, end‐tidal carbon dioxide tension and oxygen saturation were continuously monitored. In 10 patients capillary blood gas tensions were determined 3 and 20 min after the procedure. Data are reported as mean (SD) and the mean (SD) total propofol dose was 5 (2) mg.kg−1.h−1. Oxygen saturation remained constantly higher than 96% in all patients. End‐tidal carbon dioxide tension varied between 35 (7) mmHg 3 min after induction, and 41 (6) mmHg 30 min after the start of the procedure. End‐tidal to capillary PCO2 difference was 4 (3) mmHg. Within 20 min after the end of the procedure all patients were fit for dismissal to the ward. One imaging sequence out of 49 was repeated because of movement artefacts. In conclusion, intravenous propofol sedation appears to be a safe and reliable technique for paediatric sedation during magnetic resonance imaging.
Unconscious learning during anaesthesia
Authors: JELICIC M. , DE ROODE A. , BOVILL J. G. , BONKE B. 
Published: February 2007

SummaryForty‐three surgical patients were, during general anaesthesia, presented (via headphones) with either statements about common facts of some years ago (group A), or new verbal associations, i.e. the names of fictitious, nonfamous people (group B). None had any recall of intra‐operative events. In a postoperative test of indirect memory, patients in group A answered more questions about the ‘common facts’ correctly than those in group B (p < 0.005), which reflects the activation of pre‐existing knowledge. Furthermore, patients in group B designated more ‘nonfamous names’ as famous (thus falsely attributing fame) than patients in group A (p < 0.001), which demonstrates that information‐processing during anaesthesia can also take place as unconscious learning.
Spinal anaesthesia for urological surgery
Authors: Harrison D. A. , Langham B. T. 
Published: February 2007

SummaryA survey was conducted on 100 consecutive patients who underwent spinal anaesthesia in our urology operating theatres. Details of the spinal technique were recorded in the operating theatre. In 25% of patients, more than one attempt at subarachnoid puncture was required and 16% of this group went on to require general anaesthesia. The patients were visited between 24 and 48 h postoperatively by one of the authors. On questioning, 24% of patients reported a headache, which had the characteristics associated with dural puncture; 62% of these headaches were described as moderate or severe and lasted between 12 and 24 h. Patients were significantly (p < 0.05) more likely to develop a postdural puncture headache if more than one attempt at subarachoid puncture was made.
Peri‐operative liver graft function: monitoring using the relationship between blood glucose and oxygen consumption during anaesthesia
Authors: Steltzer H. , Tuchy G. , Hiesmayr M. , Muller C. , Germann P. , Zimpfer M. 
Published: February 2007

SummaryThe purpose of our study was to test the hypothesis that the quotient between plasma glucose and whole body oxygen consumption (V̇o2) as a ‘metabolic index’ is a sensitive indicator of early graft function. Arterial levels of glucose and oxygen consumption were determined in 100 consecutive patients during orthotopic liver transplantation performed without anhepatic veno‐venous bypass. Patients were divided into survivors with no obvious problems related to graft function and those with primary nonfunction of the graft. The neohepatic increase in V̇o2 was significantly higher in survivors (112 + 4 vs 88 + 11 ml.min−1.m2; p < 0.05), whereas blood glucose levels after reperfusion were higher (352 + 18 vs. 287+36 mg dl−1) in those with primary non‐function of the graft. The calculated metabolic index was also higher (4.02 + 0.93 vs 2.67+ 0.45, p < 0.05) in patients with primary nonfunction of the graft. Our principal conclusion was that 92% of normal functioning liver grafts could be classified correctly by the metabolic index immediately after reperfusion, whereas glucose levels and V̇o2 alone classified only 67% and 70% of normal functioning liver grafts correctly.
Cimetidine‐dobutamine interaction?
Authors: Baraka A. , Nauphal M. , Arab W. 
Published: February 2007

SummaryThe report describes a patient during induction of anaesthesia for coronary artery by‐pass grafting, in whom the infusion of dohutamine at a rate of 5 fig.kg−1.min−1 resulted in unanticipated severe hypertension. The exaggerated response may be attributed to cimetidine‐dobutamine interaction.
Acute isoniazid poisoning
Authors: GURNANI A. , CHAWLA R. , KUNDRA P. , Bhattacharya A. 
Published: February 2007

SummaryWe present two cases of acute isoniazid poisoning in patients who ingested 7.5 g and 5.0 g of isoniazid respectively, with the intention of committing suicide. Both were admitted unconscious, with ventilatory insufficiency and convulsions. Hepatic dysfunction and peripheral neuropathy were notable complications.
Prolonged resuscitation in acute deep hypothermia
Authors: STONEHAM M. D. , SQUIRES S. J. 
Published: February 2007

SummaryA case report is described with successful outcome of prolonged cardiopulmonary resuscitation in a 30‐year‐old man suffering from acute deep hypothermia. His lowest temperature recorded was 23°C. Continuous external cardiac massage was required for a total of 4,5 h whilst rewarming was instituted. The patient eventually left hospital with no permanent sequelae. A review of hypothermia follows, emphasising some important management principals and pitfalls.
Managing the airway in cervical spine injury
Authors: WOOD P. R. , LAWLER P. G. P. 
Published: February 2007

SummaryThe American College of Surgeons' Advanced Trauma Life Support protocol for managing the airway in patients with a cervical spine injury is reviewed. The relative risks and benefits of oral and nasotracheal intubation are discussed and the potential hazards of alternative methods of airway control are considered with particular respect to British practice.