bluuebunny/crossref_metadata_2025_split huggingface dataset:
An investigation of the local anaesthetic effects of pethidine in volunteers
Authors: OLDROYD G. J. , THAM E. J. , POWER I. 
Published: February 2007

SummaryWe have investigated the local anaesthetic effects of 0.1% and 0.2% pethidine compared with 0.5% prilocaine using an intravenous regional anaesthetic technique, in a randomised, double‐blind study in volunteers. Both pethidine and prilocaine produced a sensory and motor blockade, although the latter had a more profound effect, with a faster onset and slower recovery. Pethidine in low concentration clearly has a local anaesthetic action on peripheral nerves.
Latex allergy: an unfamiliar cause of intra‐operative cardiovascular collapse
Authors: HODGSON C. A. , ANDERSEN B. D. 
Published: February 2007

SummaryWe describe severe latex allergy in an 8‐year‐old girl undergoing elective orthopaedic surgery and anaesthesia. Sudden, profound cardiorespiratory collapse occurred 40 min after induction. During the 1 h period of resuscitation the child required a total of 14.5 ml adrenaline 1 in 10 000. A subsequent latex radioallergosorbent test was very strongly positive. Two weeks later the child presented again for surgery. Neoprene surgical gloves were used and all latex products eliminated from the anaesthetic equipment. Latex contact was strictly avoided during drug preparation and administration. This time the intra‐operative course was uneventful.
Large cervical osteophyte—another cause of difficult flexible fibreoptic intubation
Authors: RANASINGHE D. N. , CALDER I. 
Published: February 2007

SummaryA patient suffering from ankylosing spondylitis required surgical excision of a large anterior osteophyte of the cervical spine. Fibreoptic nasal intubation was difficult due to distortion of the airway by the osteophyte. This cause of difficult flexible fibreoptic intubation has not been described previously.
Ondansetron, clinical development for postoperative nausea and vomiting: current studies and future directions
Authors: JOSLYN A. F. 
Published: February 2007

SummaryThe clinical development of ondansetron for the prevention and treatment of postoperative nausea and vomiting has been progressing for 5 years, and continues as new directions of research are being addressed. Large multicentre studies have demonstrated the efficacy of ondansetron in the prevention and treatment of postoperative nausea and vomiting, but no large comparator studies have been reported. Several studies are now being undertaken to compare ondansetron with other currently used antiemetics such as droperidol and metoclopramide; assessing efficacy, safety, pharmacoeconomic, and quality of life parameters. The majority of studies to date have been performed in gynaecological surgery patients receiving general anaesthesia—a population that experiences a high incidence of postoperative nausea and vomiting. Clinical development of ondansetron is therefore progressing to establish its efficacy in a wider surgical population, including paediatrics, the elderly, non‐gynaecological surgery, and as re treatment in patients with failed prophylactic antiemetic therapy.
Dexmedetomidine as intramuscular premedication for day‐case cataract surgery
Authors: VIRKKILÄ M. , ALI‐MELKKILÄ T. , KANTO J. , TURUNEN J. , SCHEININ H. 
Published: February 2007

SummaryThe effects of dexmedetomidine 1.0 μg.kg‐1, midazolam 20 μg.kg‐1 and saline placebo were assessed in a double‐blind, randomised study in 90 patients undergoing day‐case cataract surgery under regional anaesthesia. The trial drug was injected into the deltoid muscle 45 min before the peri‐ocular block. Dexmedetomidine 1.0 μg.kg‐1 decreased intra‐ocular pressure before, during and after surgery. The maximum reduction in mean (SD) intra‐ocular pressure occurred in the dexmedetomine group just before discharge from hospital (17.7 (2.8) mmHg to 11.5 (2.9) mmHg) (p < 0.001 compared with midazolam and placebo). In contrast, midazolam did not differ from saline placebo. Dexmedetomidine and midazolam produced a similar sedative effect of short duration. Dexmedetomidine induced a moderate decrease in blood pressure (p < 0.001 compared with placebo) and a slight but statistically significant decrease in heart rate throughout the study period (p < 0.001 compared with placebo). Dexmedetomidine 1.0 μg.kg‐1 intramuscularly, effectively reduced intra‐ocular pressure and produced short‐acting sedation with marginal cardiovascular effects; it may be a useful premedicant drug for elderly patients undergoing day‐case cataract surgery under regional anaesthesia.
Myocardial infarction in a parturient
Authors: SÖDERLIN M. K. , PURHONEN S. , HARING P. , HIETAKORPI S. , KOSKI E. , NUUTINEN L. S. 
Published: February 2007

SummaryMyocardial infarction is rare in pregnancy. We report a 38‐year‐old woman with a history of smoking and pre‐eclampsia in her previous pregnancy, who suffered a non‐Q infarction at 18 weeks of gestation. Stenoses in the left coronary artery were verified angiographically. She delivered a healthy child vaginally under epidural anaesthesia.
A rare and fatal complication of oesophagoscopy
Authors: ZUBAIR N. A. , PATIL D. R. , ALGHAMDI A. H. 
Published: February 2007

SummaryA 3.5‐year‐old child developed a tight oesophageal stricture following ingestion of caustic soda. At the end of the fourth anaesthetic for oesophageal dilatation, laryngospasm and difficulty in mask ventilation was followed by cyanosis, bradycardia, and cardiac arrest. Chest X ray showed a large pneumopericardium, which was immediately aspirated, but unfortunately resuscitation was unsuccessful. It was presumed that during attempted manual ventilation of the lungs in the presence of a closed glottis, air had been accidentally forced into the pericardium through a small tear in the fragile oesophagus.
Can a drawover vaporizer be a pushover?
Authors: TAYLOR J. C. , RESTALL J. 
Published: February 2007

SummaryBench testing was carried out to establish whether the vapour output from an OMV50 vaporizer, as used in the Triservice apparatus, differs according to whether the carrier gas is either drawn or pushed through the vaporizer. Results show that the differences in output concentration between the two modes were clinically insignificant.
Emergency airway management in patients with cervical spine injuries
Authors: Criswell J. C. , Parr M. J. A. , Nolan J. P. 
Published: February 2007

SummaryA retrospective study of admissions to a Level 1 Trauma Centre, revealed 393 patients with traumatic cervical spine injuries. All 36 patients intubated urgently and 37 and 68 patients intubated between 30min and 24 h of admission, were intubated orally, following a rapid sequence induction with the application of cricoid pressure and manual in‐line stabilisation of the head and neck. There were no neurological sequelae in these 73 patients (95% confidence interval 0–4%). This technique for airway management is described in detail. It is a safe, familiar, and effective method for securing the airway in patients with cervical spine injury.
Validation of a croup score and its use in triaging children with croup
Authors: Jacobs S. , Shortland G. , Warner J. , Dearden A. , Gataure P. Singh , Tarpey J. 
Published: February 2007

SummaryThe Syracuse croup scoring system was validated in 165 children with croup who were admitted to an intensive therapy unit for assessment over a one year period. The unit served as a croup triage point for Cardiff and its environs. A score of > 5 was taken as an indication that a patient was at risk of upper airway obstruction and was used to support a triage decision by the junior hospital doctor to admit a patient to the intensive therapy unit. All patients with an initial score ≤ 5 were considered safe for transfer to a general paediatric ward and none of these required subsequent admission to intensive care. This score was then tested on a further 134 children with croup, in order to identify those patients who required specialised monitoring, observation or treatment in intensive care. A score of > 5 gave a specificity of 100% and a sensitivity of 80%. Croup scoring continued after admission on the general paediatric wards. Two patients who were originally admitted to the intensive therapy unit with a score > 5 improved within 6 h and were transferred to the general ward with a score ≤ 5. These children subsequently required readmission to the intensive therapy unit. Our tracheal intubation rate of 2% was low and may relate to the routine use of regular adrenaline nebulisation. We recommend this scoring system to other paediatric departments for initial triaging decisions and for documenting progress on the wards.
The effect of hyaluronidase on peribulbar block
Authors: Crawford M. , Kerr W. J. 
Published: February 2007

SummaryThe effect of supplementing a standardised local anaesthetic mixture with hyaluronidase was studied in 60 patients undergoing peribulbar block for intra‐ocular surgery. All the patients had the block performed with a 2: 1 mixture of lignocaine 2% and bupivacaine 0.75%, but in half of the cases hyaluronidase 50u.ml‐1 was added to the solution by random allocation. The mean volumes of solution injected were 8.9 and 9.0 ml in the control and hyaluronidase groups respectively. Five minutes after injection the block was deemed unsuccessful in one third of the patients in each group and these patients required supplementary injections. At 15 min all but one patient in each group had satisfactory block and these two patients subsequently required retrobulbar block. There were no statistically significant differences between the two solutions in rate of onset of block, requirement for supplementation, block failure, or surgical conditions. There were no significant complications. We conclude that the addition of hyaluronidase 50u.ml‐1 to the local anaesthetic mixture described confers no advantage at the volumes of local anaesthetic used.
Recovery of mivacurium block with or without anticholinesterases following administration by continuous infusion
Authors: MADDINENI V. R. , MIRAKHUR R. K. , McCOY E. P. 
Published: February 2007

SummaryThirty patients received a bolus dose of 0.2mg.kg‐1 of mivacurium followed by an infusion during anaesthesia with thiopentone, fentanyl and halothane. Neuromuscular block was monitored using train‐of‐four stimulation and mechanomyography and the block maintained to keep the first response in the train‐of‐four (T1) at 10% of control. At the end of surgery the patients were randomly allocated to reversal with neostigmine or edrophonium or to spontaneous recovery. The mean dosage of mivacurium for maintaining the T1 at 10% was 5.7 μg.kg‐1.min‐1. There was a significant (r =–0.81, p < 0.001) negative correlation between time to recovery of T1 to 10% after the bolus dose and infusion rate. The times taken for T1 to reach 25, 75 and 90% of control and for the train‐of‐four ratio to reach 0.7 were significantly shorter (p < 0.05 to 0.001) with neostigmine and edrophonium compared to the spontaneously recovering group. The average (SD) times for attaining the train‐of‐four ratio of 0.7 were 7.0 (1.2), 6.8 (1.4) and 13.5 (2.3) min respectively for neostigmine, edrophonium and spontaneously recovering groups. There were no differences between endrophonium and neostigmine in any of the recovery times.
Factors important in determining trainee anaesthetists’quality of life
Authors: Masterson G. R. , Ashcroft G. S. , Shah R. 
Published: February 2007

SummaryA postal survey of all trainee anaesthetists in the North West Region of England was conducted to investigate areas important in determining the trainee's quality of life. The questionnaire enquired about life on‐call, hospital facilities available to doctors and trainees’morale. The results suggest that changes are urgently required to improve trainees’lifestyles and therefore help raise morale within the profession.
Single medial injection peribulbar anaesthesia using prilocaine
Authors: Brahma A. K. , Pemberton C. J. , Ayeko M. , Morgan L. H. 
Published: February 2007

SummaryA prospective randomised study is reported comparing a single peribulbar injection into the medial compartment of the orbit and the standard two injection peribulbar technique. One hundred and seven patients undergoing elective intra‐ocular surgery were randomly allocated to receive either a single medial injection, or two injections, using prilocaine 3% with felypressin. Akinesia and pain during surgery were assessed following the injection(s). There was no significant difference in pain during surgery and globe akinesia between the two groups. The single medial peribulbar injection is as effective as two injections using prilocaine 3%.
The effect of epidural administration of alfentanil on intra‐operative intravenous alfentanil requirements during nitrous oxide‐oxygen‐alfentanil anaesthesia for lower abdominal surgery
Authors: DER LELY F. HAAK‐VAN , BURM A. G. L. , VAN KLEEF J. W. , VAN DEN NIEUWENHUYZEN M. C. O. , SIEMENS T. J. , MULDER S. M. , BOVILL J. G. , VLETTER A. A. 
Published: February 2007

SummaryThe effects of epidural administration of alfentanil on the intravenous alfentanil dose requirements and the plasma concentrations required to suppress responses to surgical stimulation during nitrous oxide‐oxygen‐alfentanil anaesthesia in 20 patients undergoing lower abdominal surgery were studied. Before induction of anaesthesia, patients in one group (E) received an epidural injection of 1mg alfentanil, followed by an epidural infusion of alfentanil 0.2mg.h‐1 until skin closure, whilst patients in the other group (C, control) received a continuous infusion of sodium chloride via a sham catheter in order to blind the main investigator to the treatment. Anaesthesia was induced and maintained with nitrous oxide (66%) in oxygen and a‘target’‐controlled intravenous infusion of alfentanil. During surgery, the‘target’alfentanil concentration was increased or decreased according to patients’responses. The number of responses to surgical stimulation was smaller in patients from group E (median 1, range 0‐3) than in patients from group C (median 4, range 1–15; p < 0.005), even though the alfentanil intravenous infusion rates were smaller in group E [mean (SD): 1.6(0.5)μg.kg‐1min‐1] than in group C [2.9(1.2)μg.kg‐1min‐1, p < 0.02]. Both the lowest concentrations associated with no response [133(40)ng.ml‐1]and the highest concentrations associated with a response [155(65)ng.ml‐1] in group E were lower than those in group C [238(100) ng.ml‐1, p < 0.01 and 334(163) ng.ml‐1, p < 0.05, respectively]. We concluded that epidural administration of alfentanil reduces intravenous alfentanil requirements during nitrous oxide‐oxygen‐alfentanil anaesthesia for lower abdominal surgery. The results indicate a spinal mechanism of action of epidural alfentanil.
Right ventricular function and oxygen transport patterns in patients with acute respiratory distress syndrome
Authors: STELTZER H. , KRAFFT P. , FRIDRICH P. , HIESMAYR M. , HAMMERLE A. F. 
Published: February 2007

SummaryWe investigated the impact of right ventricular performance on oxygen kinetics in 15 consecutive patients with acute respiratory distress syndrome. Six hundred and twenty‐two complete assessments of haemodynamics, right ventricular function and oxygenation were used for evaluation. Patients were grouped as survivors (n = 8) and nonsurvivors (n = 7) and studied during four phases of lung failure. Oxygen delivery and consumption were significantly higher in survivors compared to nonsurvivors despite comparable arterial oxygen saturation. Right ventricular end‐diastolic volumes were similar for both groups, while end‐systolic volumes were significantly higher in nonsurvivors due to depressed ejection fraction (40.5 (SD 1.2) versus 34.4 (SD 2.8)%) during all phases of lung failure. No clinically relevant differences in right ventricular function or oxygenation were observed between periods of moderate or severe pulmonary hypertension. Nonsurvivors have depressed cardiac function caused by reduced contractility and not by inadequate right ventricular end‐diastolic volume (preload) or increased pulmonary artery pressure (afterload). Maintenance of oxygen delivery in ARDS is predominantly a function of cardiac performance and not of pulmonary gas exchange.
The effect of propofol sedation in pregnancy on neonatal condition
Authors: BACON R. C. , RAZIS P. A. 
Published: February 2007

SummaryA woman who suffered an intracerebral haemorrhage secondary to Moyamoya disease in her 33rd week of pregnancy was sedated for ventilation with propofol for 48 h until she underwent emergency Caesarean section. There appeared to be no adverse metabolic effects on the neonate from the use of propofol in the mother although sedation was prolonged.
Anaesthesia and mucopolysaccharidoses
Authors: WALKER R. W. M. , DAROWSKI M. , MORRIS P. , WRAITH J. E. 
Published: February 2007

SummaryThe airway problems encountered during anaesthesia in all children with mucopolysaccharidoses presenting for a surgical procedure from 1988 to September 1991 are reviewed. Thirty‐four patients underwent 89 anaesthetics for 110 procedures. The results reveal a high incidence of airway problems. The overall incidence of difficult intubation was 25% and failed intubation 8%. In those children with Hurler's syndrome, the difficult intubation incidence was 54% and failed intubation incidence 23%. Other potential anaesthetic problems such as cardiac anomalies and obstructive sleep apnoea are also reviewed.
Comparison of the addition of three different doses of sufentanil to 0.125% bupivacaine given epidurally during labour
Authors: VERTOMMEN J. D. , LEMMENS E. , VAN AKEN H. 
Published: February 2007

SummaryIn a double‐blind, randomised, prospective study 150 women in labour received intermittent epidural injections of 10 ml 0.125% bupivacaine with adrenaline (1: 800000) with 5, 7.5 or 10 μg of sufentanil added. The onset, duration, and quality of analgesia were compared. Motor block, type of delivery and neonatal Apgar scores were noted. The onset, duration, and quality of analgesia were generally similar in the three groups, except following the second injection when the quality of analgesia was significantly superior in the sufentanil 7.5 and 10 μg groups. Motor blockade and type of delivery did not differ between the groups and there were no differences in neonatal Apgar scores. No patient required more than three injections. We conclude that 7.5 μg sufentanil is the optimal dose to add to intermittent epidural injections of 10 ml 0.125% bupivacaine with adrenaline (1: 800000) for pain relief in labour.
Prolonged epidural anaesthesia in a patient with Dupuytren's diathesis
Authors: DE LA CALLE J. L. , LA VILLA M. , VALLE J. , PLIEGO M. 
Published: February 2007

SummaryA patient with Dupuytren 's diathesis experienced a prolonged sensory and motor block following epidural anaesthesia. It was postulated that this occurred secondary to fibrous changes within the epidural space.
The oesophageal and precordial stethoscope transducer as a monitoring and teaching aid
Authors: BARTHRAM C. N. , TAYLOR L. 
Published: February 2007

SummaryWe describe a low cost, easy to construct monitoring and teaching aid for the oesophageal and precordial stethoscopes. It is constructed from two readily available 'state of the art’integrated circuits. The aid allows more than one observer simultaneously to hear heart and breath sounds, without being acoustically isolated from the other monitoring. In addition it is possible to record from the device to audiotape.
Patient knowledge of anaesthesia and peri‐operative care
Authors: Hume M. A. , Kennedy B. , Asbury A. J. 
Published: February 2007

SummaryOne hundred and sixty six patients were questioned by means of a multiple choice questionnaire, to determine their knowledge of peri‐operative care, anaesthesia and the role of anaesthetists. In general, knowledge was good, but there were some important misconceptions; in particular, 28.3% of respondents thought that fasting referred to food only, and not to fluid intake. In addition, 47.6% of respondents considered pain to be a necessary part of the healing process and 38.6% believed that it was something that just had to be endured. When forthcoming anaesthesia is discussed, anaesthetists need to ascertain that patients really do understand the language used.
Difficulties in spinal needle use
Authors: Tarkkila P. , Huhtala J. , Salminen U. 
Published: February 2007

SummaryThe effect of different size (25‐, 27‐ and 29‐gauge) Quincke‐type spinal needles on the incidence of insertion difficulties and failure rates was investigated in a randomised, prospective study with 300 patients. The needle size was randomised but the insertion procedure was standardised. The time to achieve dural puncture was significantly longer with the 29‐gauge spinal needle compared with the larger bore needles and was due to the greater flexibility of the thin needle. However, the difference was less than 1 min and cannot be considered clinically significant. There were no significant differences between groups in the number of insertion attempts or failures and the same sensory level of analgesia was reached with all the needle sizes studied. Postoperatively, no postdural puncture headaches occurred in the 29‐gauge spinal needle group, whilst in the 25‐ and 27‐gauge needle groups, the postdural puncture headache rates were 7.4% and 2.1% respectively. The incidence of backache was similar in all study groups. We conclude that dural puncture with a 29‐gauge spinal needle is clinically as easy as with larger bore needles and its use is indicated in patients who have a high risk of postdural puncture headache.
Intra‐operative patient‐controlled sedation and patient attitude to control
Authors: OSBORNE G. A. , RUDKIN G. E. , JARVIS D. A. , YOUNG I. G. , BARLOW J. , LEPPARD P. I. 
Published: February 2007

SummaryIntra‐operative patient controlled sedation with propofol (bolus dose 18 mg over 5.4 s; lockout period 1 min) has been compared 10 continuous propofol infusion (3.6 nig.kg−1.h−1) in a randoniised crossover study of 38 ASA 1 or 2 day surgery patients mdergoing two‐stage bilateral extraction of third molar teeth under local anaesthesia (76 procedures). Mean (SD) propofol used (mg.kg−1) was less with patient‐controlled sedation (2.39 (1.28)) than with the infusion (2.58 (0.84)) but the difference was not statistically signifcant. There were only minor differences between the methods in postoperative recovery of cognitive tirnction and no differences for patient cooperation and surgeon's satisfaction with sedation. Patient‐controlled sedation was preferred by 19 patients, continuous infusion by 10, with nine indifferent. Preferences, expressed as mild, moderate or strong, were significantly stronger for patient‐controlled sedation (p < 0.05). Sedation was no deeper than eyelid closure with response ro command in all 76 procedures. This level was reached in all 38 infusion cases but in only 26 cases with patient‐controlled sedation, where 12 patients remained less sedated (p < 0.01). Patient‐controlled sedation with propofol provided safe sedation and was strongly preferred over the infusion by a large proportion of patients.