bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of the flow‐resistive properties of double‐lumen bronchial tubes in vitro
Authors: CHIARANDA M. , ROSSI A. , MANANI G. , PINAMONTI O. , BRASCHI A. 
Published: February 2007

SummaryThis study measures the resistance to gas flow of different double‐lumen bronchial tubes used for separate ventilation of each lung in critically ill patients. Different‐sized Robertshaw and Carlens' tubes were studied, as well as a new device that consisted of a cuffed bronchial catheter introduced through a standard tracheal tube. The pressure‐flow relationship was curvilinear in all cases. Robertshaw and Carlens' tubes were generally found to have bronchial and tracheal channels with almost similar resistance and offered total resistances similar to those of 7.0–8.0 mm internal diameter tracheal tubes. The new device had a higher resistance than others of equal external diameter. This must be taken into account when its use is recommended for prolonged respiratory support.
Bed rest and postlumbar puncture headache
Authors: COOK P. T. , DAVIES M. J. , BEAVIS R. E. 
Published: February 2007

SummaryA prospective, blind, randomised trial was undertaken to determine if the incidence of postlumbar puncture headache is significantly altered by 24 hours’ recumbency. One hundred and two patients were allocated randomly to rest supine in bed for either 4 or 24 hours after spinal anaesthesia for urological or gynaecological surgery. A standardised spinal anaesthetic technique was applied that incorporated the use of a 22‐gauge needle. All patients were followed‐up prospectively to determine if there was a difference in the incidence of postlumbar puncture headache between the two groups. Five patients (11.6%) who were recumbent for 4 hours developed postlumbar puncture headache, a result which was not statistically significantly different from the seven patients (11.9%) in the other group who complained of postlumbar puncture headache.
Gelling of urea‐linked gelatin with fresh frozen plasma
Authors: MURRAY F. , HUTTON P. 
Published: February 2007

SummaryUrea‐linked gelatin and succinylated gelatin were mixed with fresh frozen plasma and human albumin solutions in vitro, in varying concentrations and at different temperatures. Gelling was only seen in those mixtures that contained fresh frozen plasma and urea‐linked gelatin. It occurred at both room temperature and 37°C when the mixture contained more than 40% by volume of urea‐linked gelatin. Further tests confirmed that this was the result of calcium ions in the urea‐linked gelatin allowing coagulation to occur in the fresh frozen plasma.
Effect of buprenorphine on the cardiovascular response to tracheal intubation
Authors: KHAN F. A. , KAMAL R. S. 
Published: February 2007

SummaryThe effects of buprenorphine on the haemodynamic responses to tracheal intubation were studied in a placebo‐controlled double‐blind trial in 40 patients who had elective surgery. In one group saline was administered intravenously 8 minutes before induction, whereas the others received buprenorphine 2.5 μg/kg intravenously. Anaesthesia was induced in both groups with thiopentone 4 mg/kg followed by suxamethonium 1.5 mg/kg after 90 seconds. In the buprenorphine group, the maximum increase in systolic and diastolic arterial blood pressures, heart rate and rate pressure product were significantly lower compared to the control group. It is concluded that buprenorphine is partially effective in attenuating the cardiovascular response to laryngoscopy and intubation, but does not obliterate it.
Stellate ganglion block with bupivacaine
Authors: HARDY P. A. J. 
Published: February 2007

SummarySympathetic blockade after stellate ganglion block with bupivacaine was assessed by liquid crystal thermography. The minimum concentration of bupivacaine required for successful block was between 325 and 406 μmol/litre. Further study of bupivacaine in a solution that contained potassium 5 mmol/litre showed that this reduced the minimum concentration of bupivacaine required for successful block to between 81 and 162 μmol/litre. We conclude that potassium has a major effect on the minimum concentration of bupivacaine required for sympathetic blockade.
Fluid flow through dural puncture sites
Authors: CRUICKSHANK R. H. , HOPKINSON J. M. 
Published: February 2007

SummaryLeakage of artificial cerebrospinal fluid through human dura was measured in vitro after puncture by spinal needles. Fluid loss tailed off in all cases and ceased within 5 minutes in 10% of punctures made with a 22‐gauge needle, 28% made with a 26‐gauge and 65% made with a 29‐gauge needle (p < 0.05). The fluid loss was not reduced by alignment of the bevel of the needle parallel to the longitudinal direction of the fibres. Whitacre point needles of 22 gauge produced lower fluid loss than a 22‐gauge Quincke point needle inserted across the fibres (p < 0.05). Leakage rate was related to needle size, but not related to the alignment of a Quincke point. Little or no leakage occurred with 29‐gauge needles.
Crystalloid versus colloid for circulatory preload for epidural Caesarean section
Authors: MURRAY A. M. , MORGAN M. , WHITWAM J. G. 
Published: February 2007

SummarySixty mothers were randomly allocated to receive either 2 litres of crystalloid or 1 litre of colloid solution (hydroxyethyl starch) in order to preload the circulation prior to elective Caesarean section under epidural anaesthesia. There were no differences in the incidence of hypotension, degree of haemodilution, umbilical cord blood gas tensions or umbilical blood osmolalities between the two groups.
Gastric emptying after head injury
Authors: POWER I. , EASTON J C. , TODD J. G. , NIMMO W. S. 
Published: February 2007

SummaryGastric emptying was measured in patients after head injury and compared with that of healthy volunteers using the rate of paracetamol absorption as an indicator of gastric emptying rate. There was a trend towards slower gastric emptying in the head injured patients, but the dyerences were not statistically significant.
Recurrent anaphylactoid reaction during Caesarean section
Authors: JACKSON I. J. B. , BRYSON M. R. , McPHAIL S. , BHALA B. B. 
Published: February 2007

SummaryA 28‐year‐old woman presented for emergency Caesarean section at 31 weeks’gestation with deranged liver junction and a history of recurrent anaphylactoid reactions during previous pregnancy‐related anaesthetics. The anaesthetic management and outcome of this case is presented.
The effect of H2 antagonists on duration of action of suxamethonium in the parturient
Authors: Bogod D. G. , Oh T. E. 
Published: February 2007

SummaryFifteen patients who underwent elective Caesarean section were given sodium citrate, either alone or combined with oral cimetidine or ranitidine, as antacid premedication. No significant diflerences in time to 25 or 50% recovery of the first twitch of a train‐of‐four after administration of suxamethonium were found between any of the groups. It is concluded that H2‐antagonists do not significantly affect the duration of action of suxamethonium in parturients, in contrast to the findings of a study in nonpregnant patients.
Assessing collateral circulation in the hand—four methods compared
Authors: Glavin R. J. , Jones H. M. 
Published: February 2007

SummaryFour ways to assess the collateral circulation in the hand were compared. No correlation was shown between the Doppler ultrasound method and those that used either the pulse monitor or the Ohmeda Biox 3700 pulse oximeter. The study was unable to confirm suggested benejits of these methods in assessing adequacy of collateral flow in the hands of unconscious patients.
Reversal of prolonged sedation using flumazenil in critically ill patients
Authors: Bodenham A. , Park G. R. 
Published: February 2007

SummaryThirteen critically ill patients received flumazenil after multiple doses, or an infusion, of midazolam was used as part of a sedation regimen to facilitate intensive care. All patients remained excessively sedated after the midazolam was stopped for 6 hours or longer. An improvement in conscious level occurred in eight patients (61%). In four of these eight patients, the duration of action of flumazenil necessitated its continued administration by an infusion to maintain the improvement in conscious level. The dose of flumazenil required each hour was less than estimated previously; this indicates that it may be subjected to similar alterations of elimination as those described for midazolam. Flumazenil appears to be a useful drug for the reversal of prolonged benzodiazepine sedation but repeated bolus doses or an infusion are needed if significant accumulation of benzodiazepines has occurred.
The effects of hypocapnic ventilation on mental function in elderly patients undergoing cataract surgery
Authors: JHAVERI R. M. 
Published: February 2007

SummaryMental function was studied using the Rivermead Behavioural Memory Test and the Unprepared Simple Reaction Time test in 83 elderly patients for cataract surgery. Three groups of patients were studied: Group N (n = 40) whose lungs were ventilated to a mean Paco2 of 4.9 kPa, Group H (n = 30) who were hyperventilated to a mean Paco2 of 2.9 kPa, and Group L (n = 13) who received local anaesthesia for surgery. The psychometric tests were administered on the day before the operation, and 4 days and 4 weeks after the operation. Statistically significant changes in the performance of hyperventilated patients could not be demonstrated using these tests.
The attitudes of junior anaesthetists to research A survey
Authors: Gaylard D. G. , Lamberty J. M. 
Published: February 2007

SummaryA survey was undertaken to investigate aspects of research work undertaken by junior anaesthetists. Two hundred and ninety‐five junior anaesthetists were surveyed. Forty‐seven percent of respondents were involved actively in research activities at the time of the survey, although 57% of senior house officers and registrars and 30% of senior registrars would not attempt to acquire publications except to improve their curriculum vitae. Few had received any formal training in research methods. The significance of these findings is discussed with regard to current training opportunities.
Lytic cocktail in children Rectal versus intramuscular administration
Authors: LAUB M. , SJØGREN P. , HOLM‐KNUDSEN R. , FLACHS H. , CHRISTIANSEN E. 
Published: February 2007

SummaryThe efficacy of the lytic cocktail (1 ml contains pethidine 28 mg, promethazine 7 mg, chlorpromazine 7 mg) administered intramuscularly or rectally as premedication was studied in 51 children aged 1–12 years who had minor elective otological surgery. One group received 0.05 ml/kg intramuscularly (maximum dose 2.0 ml) and the other 0.07 ml/kg per rectum (maximum dose 2.8 ml). Most were satisfactorily sedated before operation, but after operation the rectally premedicated children were less sedated, which was in agreement with lower plasma pethidine concentrations in this group. The rectal dose should be increased if prolonged postoperative sedation is desireable.
Monitoring of curarisation in patients with tetraparesis
Authors: FIACCHINO F. , BRICCHI M. , LASIO G. 
Published: February 2007

SummaryNeuromuscular blockade induced by pancuronium was monitored on the trapezius and abductor digiti minimi muscles in three patients with upper motor neurone lesions: one patient was hemiparetic and two were tetraparetic. A greater sensitivity to pancuronium was always observed on the trapezius muscle. It is suggested that the assessment of curarisation is more reliable on proximal than on distal muscles if the patient's sensitivity to relaxants is expected to be generally low.
Hypotension due to unexpected cardiac tamponade
Authors: CYNA A. M. , RODGERS R. C. , McFARLANE H. 
Published: February 2007

SummaryWe report a case of profound hypotension, after induction of general anaesthesia, that resulted from unexpected cardiac tamponade. The differential diagnosis was complicated by the absence of any evidence to indicate that there was significant direct chest injury. Many of the recognised clinical signs of cardiac tamponade were absent, in particular, there was no compensatory tachycardia, and heart rate remained stable despite severe hypotension before surgical drainage of the pericardium. The possible aetiology and pathophysiology is discussed. It is suggested that after major trauma, cardiac tamponade should be considered as a possibility even in the absence of significantly abnormal cardiovascular signs, evidence of direct chest injury, or an abnormal chest X ray.
Pain on injection of propofol: the effect of injectate temperature
Authors: McCRIRRICK A. , HUNTER S. 
Published: February 2007

SummaryA double‐blind, randomised clinical study was undertaken to compare the effect of temperature on the incidence and severity of the pain experienced on injection of propofol. The number of patients who experienced pain and the severity of the pain were reduced significantly when propofol was administered at a temperature of 4°C. The efficacy of propofol as an induction agent appeared to remain unaltered.
Inhaled fentanyl as a method of analgesia
Authors: WORSLEY M. H. , MACLEOD A. D. , BRODIE M. J. , ASBURY A. J. , CLARK C. 
Published: February 2007

SummaryA study was undertaken to investigate the use of fentanyl by aerosol for postoperative analgesia. Seven patients had placebo, six received fentanyl 100 μg and seven were given fentanyl 300 μg. A significant improvement in postoperative pain, as assessed by linear visual analogue scale, was achieved in the higher dose group, and in both fentanyl groups the time to alternative analgesia was significantly longer than in the control group. Serum fentanyl levels after inhalation of 100 μg reached a plateau around 0.04 ng/ml and after 300 μg at around 0.1 ng/ml after 15 minutes. Inhaled fentanyl may have a useful analgesic effect despite these low serum levels; this supports the hypothesis that the mode of analgesia from inhaled opioids may be different from that after other routes of administration. There were no adverse effects such as respiratory depression, bronchospasm, nausea or drowsiness.
A comparison of the effects of alfentanil/droperidol or fentanyl/droperidol on intra‐ocular pressure
Authors: Coley S. , Jones G. W. , Lassey D. , May A. E. , Fell D. 
Published: February 2007

SummaryThe influence of two intravenous sedative regimens on intra‐ocular pressure was investigated in conjunction with retrobulbar local anaesthesia. Forty patients were allocated randomly to either group A (alfentanil and droperidol) or group F (fentanyl and droperidol). Measurements of intra‐ocular pressure, arterial pressure and oxygen saturation were made before operation, after premedication, after intravenous sedation and after surgery. Paco2 was also measured before and after operation. Each sedation technique caused a similar reduction in intra‐ocular pressure. There was less effect on Paco2 and oxygenation in group A.
Comparison of propofol and thiopentone as anaesthetic agents for electroconvulsive therapy
Authors: BOEY W. K. , LAI F. O. 
Published: February 2007

SummaryPropofol and thiopentone were compared as anaesthetic agents for electroconvulsive therapy in 31 patients on four occasions in a repeated measure crossover study. Discomfort on injection was significantly more common with propofol (51.6% of anaesthetics) compared to thiopentone (1.6% of anaesthetics). The duration of seizure was shorter with propofol in both treatments but there was significant drug‐time interaction. Propofol gave a milder tonus and clonus during seizure when both treatments were considered together. The increase in systolic and diastolic arterial pressures and heart rate after treatment were significantly higher with thiopentone. Apnoea was significantly longer with propofol. The times to sitting up unaided and opening the eyes on command were the same for both drugs. The ability to walk 10 m 20 minutes after anaesthesia was significantly better with propofol (p < 0.0001).
The end‐tidal carbon dioxide detector Assessment of a new method to distinguish oesophageal from tracheal intubation
Authors: O'FLAHERTY D. , ADAMS A. P. 
Published: February 2007

SummaryA new method to distinguish oesophageal from tracheal intubation using an end‐tidal carbon dioxide detector was evaluated. In a prospective study on 50 healthy adult patients, the end‐tidal carbon dioxide detector was reliably used to detect initial oesophageal intubation in 22 cases, and then to confirm tracheal intubation in all 50 patients. We conclude from this study that the end‐tidal carbon dioxide detector is a reliable, rapid and easy method for the detection of oesophageal intubation.
A disposable blood pressure cuff. An assessment of its accuracy
Authors: DODD F. M. , ARMSTRONG P. , RAY D. C. , SCOTT D. H. T. 
Published: February 2007

SummaryAn empty 500‐ml infusion bag was used as the cuff for a Lifestat 100 oscillotonometer. The systolic and mean blood pressures obtained in 40 subjects were not significantly different from those measured with a standard cuff. The diastolic pressure was unrelated between the two cuffs. The empty bag is a cheap and hygienic option in patients who present a high infection risk.
Management of donors for heart and heart–lung transplantation
Authors: Ghosh S. , Bethune D. W. , Hardy I. , Kneeshaw J. , Latimer R. D. , Oduro A. 
Published: February 2007

SummaryThe quality of donor organs will determine the quality of life for the recipient and the importance of optimal management of the multi‐organ donor is that the organs may benefit up to five, critically ill, patients. The basic principle is to maintain sufficient preload to minimise the need for inotropic support and it is recommended that all multiple organ donors should have central venous and arterial pressure monitoring in addition to adequate venous access. The importance of the choice of fluid for volume expansion and the management of the hormonal disturbances which follow brain death are considered.
Needlestick injuries in anaesthetists
Authors: Maz S. , Lyons G. 
Published: February 2007

SummaryA survey of needlestick injuries among 42 anaesthetists at this university hospital was carried out over a 3‐month period to ascertain the rate of occurrence and the extent to which a revised protocol for the management of such injuries was followed. There were nine reported incidents, of which six were with contaminated needles. Three were reported. Eight anaesthetists had not taken up immunisation against hepatitis B. The rationale behind the revised protocol, and possible reasons for poor compliance are discussed.
A postoperative analysis of the patient's view of anaesthesia in a Netherlands’ teaching hospital
Authors: van Wijk M. G. F. , Smalhout B. 
Published: February 2007

SummaryA postoperative questionnaire was used in 129 patients who had undergone a wide range of surgical procedures in order to investigate their personal experience of anaesthesia. The most frequent complaints were of feeling cold on waking up, sore throat, vomiting and muscle pains, all of which are capable of reduction by a change in anaesthetic technique. The total number of patients who had one or more complaints was 107 (82.9%). More than a third of the patients were afraid of the anaesthetic, as distinct from the operation. Most had received a pre‐operative visit from the anaesthetist which was greatly appreciated. A few patients believed they could have been better informed of possible sequelae. More than 30% were not visited by the surgeon before the operation. A routine postoperative interview, using a preformulated questionnaire, is a good way to assess and maintain a high quality of anaesthesia.
Autonomic dysfunction and Guillain‐Barré syndrome The use of esmolol in its management
Authors: CALLEJA M. A. 
Published: February 2007

SummaryA 17‐year‐old girl with Guillain‐Barrè syndrome and autonomic dysfunction was treated successfully with esmolol. Esmolol may be an appropriate drug for the rapid assessment and control of tachyarrhythmias in critically ill patients.
The Engström Elsa anaesthetic machine An electronic system for anaesthesia
Authors: ALEXANDER J. P. , WATTERS C. H. , DODDS W. J. C. , McNEILL W. E. 
Published: February 2007

SummarySix Engström Elsa anaesthetic machines have been in regular use for 18–24 months. The machine incorporates a number of new concepts for anaesthetic delivery and monitoring. At flows below 1000 ml/minute, each machine delivered 20% more than the indicated value; at higher flows, the indicated value was within 10% of the flow delivered. Minute volume, tidal volumes and oxygen concentrations were within the manufacturer's specifications. However, vaporizer and vapour monitor performance was outside the (SD) 5% accuracy claimed by the manufacturers. It was noted that the bistable valve requires user familiarity for the change from controlled to spontaneous ventilation to be accomplished with ease. It was also possible to misconnect the breathing system and so isolate the excess pressure escape valve and high‐pressure alarm. Nevertheless, once familiarisation was achieved, the machines have proved easy to operate and are particularly satisfactory when used with low fresh gas flows.
Successful difficult intubation Tracheal tube placement over a gum‐elastic bougie
Authors: Dogra S. , Falconer R. , Latto I. P. 
Published: February 2007

SummaryA randomised study was carried out to assess the effect of tracheal tube rotation on the passage of a tube over a gum‐elastic bougie into the trachea in 100 patients. The effect of the presence or absence of a laryngoscope on successful tube placement was also assessed. A grade 3 difficult intubation was simulated in patients with a laryngoscope. There was a significant difference in the rates for successful first‐time intubation in those patients with tube orientation of ‐90° (with the bevel facing posteriorly) as compared with a tube orientation of 0° (the normal orientation with the bevel facing left). The unsuccessful first‐time intubations with a 0° orientation were frequently converted to successful intubations with the ‐90° position at a second attempt. The presence of a laryngoscope in the mouth while rail‐roading a tube over the bougie also made a significant difference to the rate of successful first‐time intubations. The most successful method was to leave the laryngoscope in the mouth and rotate the tube to ‐90°.
Comparison of conventional and rapid inhalational induction of anaesthesia with enflurane
Authors: Rowbottom S. J. , Yukioka H. , Fujimori M. 
Published: February 2007

SummaryInhalational induction of anaesthesia using either a conventional method or a vital capacity breath of 4% enflurane in 67% nitrous oxide was compared in 30 adult surgical patients. Induction time was significantly faster in patients who took a vital capacity breath (71. SD 22 versus 132. SD 18 seconds, p < 0.01). There were no significant differences between groups in respect of systolic blood pressure, heart rate, arterial oxygen saturation or incidences of excitement or coughing. The vital capacity breath method was acceptable to 87% of patients.
Goldenhar's syndrome: an analysis of anaesthetic management A retrospective study of seventeen cases
Authors: Madan R. , Trikha A. , Venkataraman R. K. , Batra R. , Kalia P. 
Published: February 2007

SummarySeventeen patients with Goldenhar's syndrome who had surgery 28 times are presented. Various authors have reported problems in the anaesthetic management of these patients, but we encountered significant difficulties in only one. Three anaesthetic techniques were used. A thorough pre‐operative assessment with back‐up facilities for difficult intubation are important. Additional cardiorespiratory and craniovertebral anomalies may necessitate modifications in the basic techniques.