bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with survival and eventual cerebral status following cardiac arrest
Authors: SOWDEN G. R. , ROBINS D. W. , BASKETT P. J. F. 
Published: February 2007

SummaryCardiac arrests at two acute hospitals were investigated over a 5‐month period. The outcome expressed as short‐term and long‐term survival was correlated with diagnosis, age, sex and technical details of the resuscitation. Survivors were followed up for 3 months to detect any remaining cerebral deficit.Of 108 patients who suffered cardiac arrest, 23 (21.3%) survived to be discharged from hospital, 58 (53.7%) died immediately and 27 (25%) survived for periods ranging from I hour to 30 days following cardiac arrest, before eventual death. Evidence of cerebral impairment was present initially in three patients (2.7%) at discharge from hospital. After 3 months however cerebral impairment was present in only one patient (0.9%). Survival was highest in patients suffering ventricular fibrillation following myocardial infarction where 16 out of 35 (47%) survived.Certain groups of patients were identified where the ultimate survival was predictably nil. Although some survived for short periods it was concluded that the attempted resuscitation in these patients was inappropriate and unjustified.
Anaesthesia for a patient with Down's syndrome and Eisenmenger's complex
Authors: BIRD T. M. , STRUNIN L. 
Published: February 2007

SummaryA patient with Down's syndrome and Eisenmenger's complex presented for orthopaedic surgery on the elbow under general anaesthesia. During pre‐oxygenation, in order to prevent a subsequent fall in systemic vascular resistance, metaraminol 1 mg was administered intravenously. The patient immediately developed bradycardia, mild hypertension and became deeply cyanosed. His condition rapidly improved after atropine 0.6 mg was given intravenously. Following induction of anaesthesia with thiopentone and tracheal intubation facilitated by suxamethonium, anaesthesia was maintained by mechanical ventilation of the lungs with nitrous oxide and oxgen (40%) with intravenous increments of fentanyl for analgesia and pancuronium for muscle relaxation; residual neuromuscular blockade was reversed with neostigmine. The patient made an eventful recovery. Although general anaesthesia is tolerated by patients with Eisenmenger's complex, powerful vasoactive drugs should not be administered unless specifically indicated.
Venous pressures during simulated Bier's block
Authors: LAWES E. G. , JOHNSON T. , PRITCHARD P. , ROBBINS P. 
Published: February 2007

SummaryVenous pressures in the forearm veins during the simulated performance of intravenous regional analgesia were measured. Pressures obtained equalled or exceeded the recommended occluding pressure of the tourniquet. This finding is proposed as one of the possible reasons for the occasional observation that convulsions may occur during Bier's block despite the presence of an intact tourniquet system.
Controlled ventilation in dental outpatients
Authors: SALE J. P. , POOBALASINGAM N. , DALAL S. D. 
Published: February 2007

SummaryThis study compares anaesthesia with controlled ventilation of the lungs with atracurium and alfentanil analgesia with halothane anaesthesia. Recovery time, the incidence of dysrhythmias and postoperative morbidity were evaluated. Anaesthesia with controlled ventilation was found to reduce significantly the incidence of cardiac dysrhythmias during dental surgery, and to produce a significantly more rapid recovery than halothane anaesthesia. The incidence of subjective postoperative complications is similar. It is concluded that controlled ventilation with atracurium and aljentanil is a suitable outpatient dental technique.
Paraplegia following epidural potassium chloride
Authors: SHANKER K. B. , PALKAR N. V. , NISHKALA R. 
Published: February 2007

SummaryA patient is presented in whom 15 ml of 15% potassium chloride (30 mM) mixed with bupivacaine was injected epidurally for relief of pain resulting from widespread pelvic malignancy. Within minutes the patient complained of severe pain in both the lower limbs and rapidly became paraplegic with bladder and bowel incontinence. The paraplegia was permanent. The transient symptoms of pain may have been partly due to the irritant effects of a hyperosmolar solution of potassium chloride in the epidural space, while the permanent neurological damage might have been due to the very high extracellular concentration of potassium leading on to a depolarising phenomenon initially followed by nerve tissue necrosis.
Neuromuscular transmission and its blockade
Authors: JONES R. M. 
Published: February 2007

SummaryThe role of two recently introduced muscle relaxants—atracurium and vecuronium—in contemporary anaesthetic practice is assessed. Recent advances in the physiology of neuromuscular transmission, particularly the roles of calcium and calmodulin, are reviewed, and new ideas concerning the reversal and monitoring of neuromuscular blockade are discussed.
Control of spinal blockade. A volume expansion technique with hyperbaric cinchocaine
Authors: Attygalle D. 
Published: February 2007

SummarySubarachnoid anaesthesia was performed using 2 ml of hyperbaric cinchocaine diluted with cerebrospinal fluid in 83 patients. When different volumes of the diluted cinchocaine (6 ml or 8 ml) were injected in the same manner into two comparable groups of patients in the height range of 150–180 cm, there was a statistically significant (p.<0.001) difference in the mean levels of the analgesia obtained. Individual values had a narrow range of spread for a given volume of injectate. There was no significant correlation between maximum analgesic levels and age and height in this group. When the smaller volume of 6 ml was given to 21 patients under 150 cm in height, there was a statistically significant correlation (r =− 0.74) between height and levels obtained. It is possible to obtain the required analgesic levels by varying the volume of dilution without altering the drug dosage, but height is an important consideration in patients of less than 150 cm.
Uptake of volatile anaesthetics in children
Authors: GALLAGHER THERESA M. , BLACK G. W. 
Published: February 2007

SummaryThe uptake of halothane is known to be more rapid in children than in adults, but comparable clinical data regarding other inhalational anaesthetics are not available. In this study, the rates of uptake of halothane, enflurane, isoflurane and methoxyflurane were compared in children of different ages. Expired (FE′) and inspired (FI) vapour concentrations were measured with an infrared analyser, and FE′/FI ratios were used to determine rates of uptake. Uptake rates of halothane, enflurane and methoxyflurane were more rapid in the younger than in the older children, but age had no effect on the uptake of isoflurane which was uniformly rapid in all the children studied.
Bronchial intubation. A comparison between polyvinyl chloride and red rubber double lumen tubes
Authors: Clapharn M.C.C. , Vaughan R.S. 
Published: February 2007

SummaryRid rubber and polyvnyl chloride bronchial double lumen tubes were compared. Polyvinyl chloride rubes are easier to puss, quicker to position und cause less damage to the mucosa of the respiratory tract than the red rubber equivalents.
Pentobarbitone formation during thiopentone infusion
Authors: Chan H. N. J. , MORGAN D. J. , CRANKSHAW D. P. , BOYD M. D. 
Published: February 2007

SummaryThe plasma concentrations and elimination half‐life of pentobarbitone were determined in 14 surgical patients receiving a continuous, exponentially decreasing, influsion of thiopentone (mean total dose, 1.05 g; SD 0.34; mean duration of infusion 2.4 hours, SD 0.7) as the primary anaesthetic agent. The plasma pentobarbitone concentration increased gradually, to reach a maximum of 1.49 μ/ml (SD 0.61) at the end of the thiopentone infusion, which was 15.5 per cent (SD 6.04) of the plasma thiopentone concentration. The elimination half‐life of pentobarbitone measured over the following 70 hours in nine of the patients was 34.3 hours (SD 8.2), which is within the range of values reported previously in several studies in which pentobarbitone was administered directly to volunteers. It was concluded that the formation of this active metaholite during 2–3 hour thiopentone infusions was unlikely to be of clinical relevance, but that significant concentrations may occur with longer thiopentone infusions.
A comparison between isoflurane and alfentanil supplemented anaesthesia for short procedures
Authors: SHORT S. M. , RUTHERFOORD CLARE F. , SEBEL P. S. 
Published: February 2007

SummarySixty unpremedicated patients undergoing short urological and gynaecological procedures were randomly allocated to three groups to receive either methohexitone, alfentanil, nitrous oxide and oxygen, methohexitone, isoflurane and oxygen or methohexitone, isojurane, nitrous oxide and oxygen. The group receiving methohexitone, isoflurane and oxygen was abandoned after 11 patients had been studied, due to poor conditions during induction of anaesthesia. Therefore, data from only 51 patients are presented. Early recovery was assessed by time to opening eyes, giving correct name and date of birth; later, recovery was assessed by using the postbox test and deletion of‘p's. During anaesthesia and surgery, there was a high incidence of coughing and laryngospasm in the isoflurane groups. The patients in the alfentanil group opened their eyes and gave their names and dates of birth significantly faster post‐operatively (p < 0.01) than those in the isofurane groups. However, there were no significant differences between the three groups regarding the later tests of recovery. The late recovery after isofurane was equal to that obtained using an intravenous technique with alfentanil, although the peroperative complication rate was higher.
Plasma magnesium during epidural anaesthesia
Authors: KANCIR C. B. , PETERSEN P. H. , WANDRUP J. 
Published: February 2007

SummaryThe variations of plasma magnesium concentration in relation to protein concentration and plasma volume were studied in 12 patients during epidural anaesthesia for transurethral prostatectomy. The most significant changes in plasma magnesium concentration were observed during the onset of anaesthesia. From the arrival in the operating theatre to the start of operation, the concentration of plasma magnesium decreased from 0.88 (SD 0.10) mmol/l to 0.82 (SD 0.10) mmol/l. At the same time, the increase of 16 per cent in plasma volume was associated with a rise of 8.4 per cent in the total amount of magnesium in plasma. After commencement of surgery, the plasma magnesium concentration was unchanged throughout the remainder of the study period. The total plasma protein concentration and the erythrocyte volume fraction decreased during the onset of anaesthesia, remained stable during surgery and returned to initial values one hour postoperatively.The pre‐operative changes in the plasma magnesium concentration may have been the result of haemodilution and mobilisation of magnesium ion from its bone stores. Postoperatively, an increased urinary loss of magnesium must have followed the injection offrusemide at the end of surgery. The consequences of these variations in plasma magnesium concentration are unlikely to be of clinical significance, except in patients with pre‐existing subclinical magnesium deficiency.
Athletic dysrhythmias
Authors: BULLOCK R. E. , HALL R. J. C. 
Published: February 2007

SummaryA 36‐year‐old athlete was anaesthetised for a minor surgical procedure. His heart rate fell to 30 beats/minute during the operation, the electrocardiogram showed A‐V junctional rhythm. Sinus rhythm of 58 beats/minute was restored by atropine 1.2 mg. His resting 12‐lead electrocardiogram showed sinus bradycardia and features consistent with a diagnosis of ‘athlete's heart’. A review is presented of the physiological and electrocardiographical features of this phenomenon. The current popularity of running as a leisure pursuit makes it important that anaesthetists recognise the peculiarities of the trained athletic heart.
Epidural diamorphine and the metabolic response to upper abdominal surgery
Authors: NORMANDALE J. P. , SCHMULIAN C. , PATERSON J. L. , BURRIN J. , MORGAN M. , HALL G. M. 
Published: February 2007

SummaryThe effect of the administration of diamorphine 10 mg epidurally on the metabolic response to cholecystectomy was investigated and compared with a control group of patients given intravenous papaveretum. There were no significant differences in blood glucose, lactate and pyruvate, and plasma nonesterified fatty acid values between the epidural diamorphine group and the control group. Plasma cortisol concentrations were significantly lower in the epidural diamorphine group postoperatively and this was associated with a marked improvement in pain relief. We conclude that epidural opiates do not directly influence the metabolic response to surgery, but decrease the cortisol response postoperatively secondary to improved analgesia.
Anaesthesia in dysautonomia: further complications
Authors: SWEENEY B. P. , JONES S. , LANGFORD R. M. 
Published: February 2007

SummaryA case is described of a patient, known to be suffering from idiopathic autonomic neuropathy, who underwent general anaesthesia for repair of a fractured neck of femur. In addition to profound hypotension, unexpected respiratory depression occurred which has not previously been described in this condition. Other unusua1, features of this patient's condition are also discussed.
The effect of atracurium or fazadinium on intra‐ocular pressure. A comparative study during induction of general anaesthesia
Authors: Tattersall M.P. , Manus N. J. , Jackson D.M. 
Published: February 2007

SummaryThe effect of atracurium 0.6 mg/kg (group A; n= 11) and fazadinium 1 mg/kg (group F; n= 11) on intraocular pressure (IOP) was investigated in 22 patienis during induction of anaesthesia with thiopentone 4 mg/kg and fentanyl 0.015 mg/kg. IOP was significantly reduced (p <0.01) in all patients following induction of anaesthesia. Intubation produced a rise in IOP in all patients hut this was not statistically significant and remained below pre‐induction values. The changes were similar in each group. Both of these neuromuscular blockers appear suitable relaxants to use for intraoculur surgery.
A comparison of alfentanil, halothane and enflurane for day‐case gynaecological surgery
Authors: Jellicoe J.A. 
Published: February 2007

SummarySixty patients received either alfentanil, halothane or enflurane for maintenance of anaesthesia during short day‐case gynaecological procedures. The alfentanil group recovered more rapidly but there was no difference between halothane und enflurane in terms of recovery time. Apnoea and movement during surgery only occurred in the patients who received alfentanil. The incidence of other side effects was the same in each group, including late subjective feelings of drowsiness and unsteadiness.
Excision of giant haemangioma in the newborn using hypothermia and cardiopulmonary bypass
Authors: MILLIGAN N. S. , EDWARDS J. C. , MONRO J. L. , ATWELL J. D. 
Published: February 2007

SummaryThe use of cardiopulmonary bypass with deep hypothermia and circulatory arrest to provide suitable operating conditions for removal of a giant haemungioma in u newborn infant is described.
AIDS and anaesthesia
Authors: LEE K. G. , Soni N. 
Published: February 2007

SummaryThe Acquired Immune Deficiency Syndrome (AIDS) is a group of conditions which is reaching epidemic proportions. It is caused by a virus new to man, with an as yet poorly understood natural history, ominous prognosis and no known cure. Anaesthetists should be aware of the implications of dealing with increasing numbers of both diagnosed and undiagnosed AIDS patients and asymptomatic carriers in the fields of resuscitation, intensive therapy and theatre anaesthesia. The misunderstanding of AIDS is as extensive as the literature on the subject and a review of the current knowledge of the disease relevant to the anaesthetist is pertinent.
Some aspects of epidural block provided for elective Caesarean section
Authors: CRAWFORD J. S. , DAVIES P. , LEWIS M. 
Published: February 2007

SummaryWe present here clinical data from 993 patients who were destined to undergo elective Caesarean section under epidural analgesia. In 29 cases the attempt to provide an epidural was abandoned before the operation started. In regard to this, the importance of monitoring the fetal heart rate during initiation of the epidural is emphasised. In 10 cases general anaesthesia was induced after delivery, and in a further 108 cases supplemental analgesia was administered, either systemically, by inhalation or by an additional epidural top‐up, after delivery. Satisfactory analgesia throughout the operation was achieved in 87.8%. In an appreciable proportion of cases the recommended maximum dose of bupivacaine, and the recommended maximum rate of bupivacaine administration, were exceeded without apparent complication. There was a tendency for the volume of Hartmann's solution infused intravenously before and during initiation of the epidural to he increased throughout the period under review (1971–85). The prevalence of hypotension diminished during that period. Characteristics of the data did not permit a close analysis of the main factors which could have led to an episode of maternal hypotension. However, it did appear that such an episode could he ascribed to too brief an interval between the first and second, or the second and third top‐up doses. The frequency with which blood was transfused during operation was markedly lower than that noted in a concurrent series of elective sections conducted under general anaesthesia. Brief reports of six unusual complications are included and attention is drawn to the prominence of the use of 0.75% bupivacaine in these, and also to the frequency with which use of that solution was associated with unsatisfactory analgesia.
Anaesthesia for transoral craniocervical surgery
Authors: Marks R.J. , Forrester P.C. , Calder I. , Crockard H.A. 
Published: February 2007

SummaryTransoral surgery on lesions in the craniocervical region has been performed on 25 patients in this unit. The anaesthetic management is presented. Tracheostomy and nasotracheal intubation have both been used. Peroperative monitoring of cord compression remains an important and only partly solved problem. There were two deaths as a result of anaesthesia and surgery, and these are discussed.
Anxiety levels in junior anaesthetists during early training
Authors: Pinnock C. A. , Elling A. E. , Eastley R. J. , Smith G. 
Published: February 2007

SummaryTrait anxiety levels (predisposition to anxiety) and personality profiles were recorded in four novice anaesthetists prior to the start of their training in anaesthesia. State anxiety (the extent of anxiety at the moment of testing) was also assessed before and afer the transition from accompanied to solo anaesthetic practice. There was no demonstrable difference in anxiety scores as a result of ‘going solo’ in any subject.
Blood glucose in anaesthetised children
Authors: REDFERN NANCY , ADDISON G. M. , MEAKIN G. 
Published: February 2007

SummaryBlood glucose levels were measured immediately after induction of anaesthesia and again intra‐operatively in 26 children fasted overnight for operations in the morning and 28 children fasted from 8.00 a.m. for afternoon surgery. The mean post‐induction glucose concentration of the afternoon surgery group was significantly lower than that of the morning group. However, no child in either group was hypoglycaemic. Anaesthesia and surgery caused significant increases in blood glucose levels. It is concluded that pre‐operative fasting is well tolerated in healthy pre‐school children. regardless of the timing of surgery.
Bedford Square
Authors: FUGE C. A. 
Published: February 2007

SummaryNine Bedford Square has now been established as a Centre for Anaesthesia. It is a town house of considerable merit in the first square to have been planned on the London estate of the fifth Duke of Bedford. Built between 1775 and 1780, it is now the last complete Georgian square in Bloomsbury. This brief note on the history of Bedford Square shows that this part of London was prominent in nineteenth century medicine and, in particular, was involved in the early practice of mesmerism in this country. The place of mesmerism in the evolution of anaesthesia is restated and attention is drawn to the extraordinary coincidence that the new home that has been chosen for the Association of Anaesthetists of Great Britain and Ireland should be in an area which already has connexions with anaesthesia through mesmerism.
Repeated deep accidental hypothermia
Authors: DRENCK N. E. , STAFFELDT H. v. 
Published: February 2007

SummaryDeep accidental hypothermia after self‐poisoning with drugs occurred twice in the same patient within 25 days. Initial rectal temperatures were 22.0°C and 23.3°C, respectively; the clinical conditions were otherwise identical. In the first instance, active rewarming by means of peritoneal irrigation was performed, while spontaneous rewarming was allowed on the second occasion. Normothermia was attained within 24 hours in both cases, and the patient was discharged in her habitual state of well‐being.The course of these nearly identical cases illustrates the possibility of a passive treatment for deep hypothermia.
Buccal morphine premedication
Authors: Fisher A. P. , Vine P. , Whitlock J. , Hanna M. 
Published: February 2007

SummaryFifty patients were admitted to a double‐blind, double‐dummy study comparing buccal morphine 10 mg tablets and intramuscular morphine sulphate 13.5 mg as premedication. This investigation was performed on the basis of favourable results obtained in an earlier 25 patient pilot study designed to examine the efficacy, safety and patient acceptability of buccal morphine 10 mg tablets as pre‐anaesthetic medication, Both studies and sets of results are presented and show that, whilst buccal morphine is a safe alternative means of delivering opioid premedication, which is acceptable to the majority of patients, an equivalent intramuscular morphine dose is nevertheless a more effective premedicant in terms of anxiolysis and wakefulness, as assessed by linear analogue scores. Pharmacokinetic considerations are advanced both to explain the differing clinical efficacies of the two means of morphine administration and to indicate that improved per‐ and immediate postoperative analgesia might be obtainable in patients premedicated with buccal morphine.
Sleep and comfort after Caesarean section
Authors: Webster N.R. , Lyons G. , Macdonald Rosemary 
Published: February 2007

SummaryTo compare postoperative well‐being after general and epidural anaesthesia. 58 women undergoing Caesarean section were divided into a general anaesthetic group receiving intramuscular opioid postoperatively (26). and an epidural group receiving morphine via the epidural route (32). The epidural group required less analgesia (p < 0.01 at 0.5 and 8 hours, p < 0.001 at 4 hours). There was no difference in the use of oral analgesics. At 1,4 and 24 hours after delivery more patients in the general anaesthesia group described themselves as very comfortable (p < 0.05). More in the epidural group had a very good night's sleep during each night studied. Patients in the epidural group were slower to use the ward toilet (p < 0.01) and had more itching (p < 0.001). Our conclusion is that patients progressed well in both groups.
Respiratory disturbance and posterior fossa surgery
Authors: YATES A. P. , SUMNER E. , LINDAHL S. G. E. 
Published: February 2007

SummaryThis report, of a 16‐month‐old child recovering from surgery for a posterior fossa tumour, illustrates how pneumotachography, capnography and occlusion testing before and during CO2 challenge can be of clinical value in the analysis of a difficult respiratory disturbance in the early postoperative period. The application of these techniques to assist decisions regarding timing of extubation as well as for assessment of the influence of remaining tumour on respiratory competence is discussed.