bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dose‐response relationship for disoprofol (ICI 35868; Diprivan)
Authors: KAY B. , STEPHENSON D.K. 
Published: February 2007

SummaryThe duration of sleep following intravenous administration of three doses of disoprofol (1, 2 and 3 mg/kg) was compared with that following methohexitone 1 or 2 mg/kg. Disoprofol and methohexitone were shown to be approximately equipotent. Side‐effects were dose‐related for both drugs, but the incidence was significantly less following disoprofol than methohexitone 2 mg/kg. The most frequent side‐effects were pain on injection, myoclonia and hiccup. Studies of blood concentrations of disoprofol show that the profile is dose‐independent and conforms to a two‐compartment model with a very short distribution phase (about 2 minutes) and short elimination phase (about 70 minutes). Waking blood levels gave no indication of acute tolerance. Disoprofol would appear to be particularly useful for induction of a short period of sleep using a small dose given quickly, or for maintenance of sleep by continuous infusion.
High dose buprenorphine for postoperative analgesia
Authors: Budd Keith 
Published: February 2007

SummaryBuprenorphine was given intravenously to produce analgesia in the immediate postoperative period, the dose being titrated against the response of each patient in order to obtain complete freedom from pain. In 50 patients following lower segment Caesarean section under general anaesthesia, buprenorphine in the dose range 0.4–7.0 mg was found to be a potent, long lasting and safe analgesic. Serial blood gas estimations performed on ten of the patients confkmed the clinically observed lack of respiratory depression.
Inadvertent intra‐arterial injection of flucloxacillin
Authors: ZIDEMAN D.A. , MORGAN M. 
Published: February 2007

SummaryFlucloxacillin 500 mg in 5 ml water was accidentally injected into a radial artery. This resulted in gangrene of parts of the thumb, index and middle fingers, necessitating amputation. Gangrenous areas requiring skin grafting also occurred on the forearm.
Epidural block during labour in a patient with spina bifida cystica
Authors: VAAGENES P. , FJÆRESTAD I. 
Published: February 2007

SummaryA case report is presented of a patient in whom a lumbosacral meningocele had been successfully removed in the neonatal period and who later received a lumbar epidural block for pain relief during labour. Although a high level was chosen for the puncture, deficiency of the dorsal interspinous layer of ligaments complicated the localisation of the epidural space when the ‘loss of resistance’ technique was applied. Analgesia was achieved more rapidly and with a lower dose of analgesic drug than is normally necessary for satisfactory relief of pain in labour.
Induced hypotension with a mixture of sodium nitroprusside and trimetaphan camsylate
Authors: MacRae W.R. , Wildsmith J.A.W. , Dale B.A.B. 
Published: February 2007

SummaryThirty patients undergoing induced hypotension were given a 10:1 mixture of trimetaphan camsylate and sodium nitroprusside by intravenous infusion. A readily controllable hypotension was produced with considerable reduction in the dosage of these drugs compared to their use individually. There were no cases of prolonged hypotension.
The placental transfer of cimetidine
Authors: HOWE J.P. , MCGOWAN W.A.W. , MOORE J. , MCCAUGHEY W. , DUNDEE J.W. 
Published: February 2007

SummaryThe placental transfer of cimetidine 200 mg intravenously was investigated in 16 patients in normal labour and 40 patients undergoing elective Caesarean section. Cimetidine crosses the placental barrier, blood levels at delivery in mothers and infants being lower with increasing time from injection. Umbilical cord blood cimetidine levels are markedly lower than those of the mother during the first hour following administration but thereafter levels are similar. The mean fetal–maternal ratio at delivery was highest (0.84) at 1 1/2–2 hours following administration. Postdelivery infant and maternal blood samples showed that cimetidine could not be detected, in most cases, 19 hours following administration. The relevance of these findings is discussed.
Protection against pulmonary acid aspiration with ranitidine
Authors: ANDREWS A. D. , BROCK‐UTNE J. G. , DOWNING J. W. 
Published: February 2007

SummaryNinety patients presenting for elective surgery were randomly divided into three groups A, B and C and studied on a double‐blind basis to assess the effects of ranitidine, a new histamine H2‐receptor antagonist and placebo on gastric secretion. Group A received 150 mg ranitidine orally at 2200 hours on the evening before surgery and a further 150 mg 1–2 hours before operation. Group B received 150 mg ranitidine with premeditation only, while Group C received a placebo at 2200 hours and again with premedication on the day of surgery. Gastric fluid was aspirated immediately after induction of anaesthesia and the volume and pH of the aspirate measured. Gastric volumes were significantly greater in the placebo group when compared to Group B. but not to Group A. The proportion of patients with pH > 2.5 at induction of anaesthesia was 100. 82.3 and 67.9% in Groups A, B and C, respectively. The percentage of patients who had measured gastric volume < 25 ml or pH > 2.5 were Group A—90%. Group B–75.9% and Group C—57%. Thus ranitidine 150 mg orally on the evening before surgery and on the morning prior to anaesthetic induction lowered the mean volume and raised the average pH of gastric content to safe levels in all cases.
Delayed respiratory arrest after bupivacaine
Authors: HOLMBOE J. , KONGSRUD F. 
Published: February 2007

SummaryA case history is reported in which a 55‐year‐old man developed respiratory arrest nearly 3 hours after administration of an epidural anaesthetic with bupivacaine 135 mg. Some of the possible explanations are discussed, but none of them fully accounts for the complication.
Transoesophageal cardiac pacing
Authors: HARTLEY J. M. F. 
Published: February 2007

SummaryAn elderly patient, whilst undergoing anaesthesia for a total hip replacement, developed a marked bradydysrhythmia suggestive of sick sinus syndrome. The heart rate was unaffected by atropine 1.2 mg administered intravenously. Cardiac pacing was achieved by means of a non‐invasive transoesophageal pacemaking catheter. The simplicity of this technique although temporary, is ideal for emergencies.
Paralysis of the right hemidiaphragm
Authors: POLLARD B. J. , HAIN W. R. , SMALL P. G. 
Published: February 2007

SummaryA case is described of a baby born with a combination of a paralysed hemidiaphragm and congenital hypothyroidism which led to the need for artificial ventilation. Difficulties were encountered in discontinuing the ventilatory support. The problems involved in timing extubation of infants are discussed together with consideration of the diagnosis and treatment of neonatal hypothyroidism.
Drug recognition by nurses and anaesthetists
Authors: Smellie Gavin D. , Lees Norman W. , Smith Elizabeth M. 
Published: February 2007

SummaryA survey of nurses and anaesthetists in a 500‐bed teaching hospital set out to discover how they located a drug container in order to read its label and verify its contents. Members of each group assessed the value of seven factors thought to help in this location and answered questions on personal errors in drug administration. The nurses found the expected position of the drug container in the trolley or cupboard to be the most important factor, followed by the size of the container. The anaesthetists placed the colour of the container as most important, followed by the manufacturer's distinctive container as their second best guide to drug location. This preference for colour and a distinctive container can be used to reduce the chance of confusing drugs locally. A scheme for colour‐coding ampoules in broad groups to reduce gross mistakes in the future is presented.
Cardiac output changes during Caesarean section
Authors: NEWMAN B. 
Published: February 2007

SummaryA non‐invasive technique of measuring cardiac output changes is described and studies of its accuracy and reproducibility are reviewed. Cardiac output changes in 11 patients undergoing Caesarean section under general anaesthesia were measured with this technique. Increases in cardiac output after induction and commencement of surgery (mean 19%, p < 0.05), and after delivery (mean 19%, p < 0.05) were found.
Outpatient sedation for oral surgery
Authors: WARD M. E. , ROSE N. M. 
Published: February 2007

SummaryIn an attempt to exploit the benefits and to reduce the incidence of side‐effects of etomidate during intravenous sedation for nervous patients undergoing oral surgery under local analgesia, a series of four clinical trials were undertaken: a pilot study in which etomidate was preceded by a combination of pentazocine and diazepam; a double‐blind study in which saline was randomly substituted for the etomidate, and two further studies in which the administration of etomidate was preceded by that of either pentazocine or diazepam alone. The combination of a small dose of diazepam (0.1 mg/kg) with an initial does of etomidate (0.1 mg/kg) followed by increments of the latter as necessary proved to be most successful in reducing the severity of unwanted reactions while retaining the unique advantages of etomidate.
Continuous intravenous infusion of disoprofol (ICI 35868, Diprivan)
Authors: O'CALLAGHAN A. C. , NORMANDALE J. P. , GRUNDY E. M. , LUMLEY JEAN , MORGAN M. 
Published: February 2007

SummaryDisoprofol has been used to induce and, by continuous infusion, to maintain a light level of general anaesthesia in 100 patients undergoing surgery with the aid of a regional block. Its effects have been compared with 100 patients anaesthetised in a similar manner with Althesin. Disoprofol proved to be a very satisfactory agent for use by this method and apart from an appreciable incidence of pain on injection the number of complications‘was small and comparable to those found with Althesin, which caused more involuntary movements. Recovery was particularly rapid and clear‐headed following disoprofol, and occurred highly significantly more quickly than after Althesin. Disoprofol, however, will not be marketed in the present formulation which has Cremophor EL as the solubilising agent.
Open heart surgery in a patient with homozygous sickle cell disease
Authors: RIETHMULLER R. , GRUNDY E. M. , RADLEY‐SMITH R. 
Published: February 2007

SummaryA child in heart failure with homozygous sickle cell disease underwent corrective surgery on cardiopulmonary bypass. The use of early intra‐operative exchange transfusion produced a rapid fall in the level of HbS. Postoperatively she developed falciparum malaria which responded to treatment. She was eventually discharged home to Nigeria 8 weeks after her operation.
Intra‐ocular pressure and premedication with oral diazepam
Authors: Trew C.T. , Manus N.J. , Jackson D.M. 
Published: February 2007

SummaryThirty patients scheduled for routine eye surgery were randomly allocated to receive either diazepam 0.2 mg/kg or ascorbic acid 100 mg orally 90 minutes pre‐operatively in a double‐blind fashion. Diazepam caused no significant change in intra‐ocular pressure.
Plasma levels of methylprednisolone following administration during cardiac surgery
Authors: THOMPSON M. A. , BROADBENT M. P. , ENGLISH JUDIE 
Published: February 2007

Summary Methylprednisolone was given to patients undergoing open‐heart surgery in a dose of 30 mg/kg administered following induction of anaesthesia and repeated with the start of cardiopulmonary bypass. The effects of this treatment on 2,3‐DPG, P50 and cardiac index were compared with a control group who did not receive steroids. In addition plasma levels of methylprednisolone were assayed throughout the operations and up to 24 hours postoperatively. There was no significant difference between the two groups despite apparently adequate plasma levels of methylprednisolone, and it is concluded that steriods do not affect the P50 or 2,3‐DPG in patients undergoing cardiopulmonary bypass.
Subclavian venous catheterisation in small children using the Seldinger technique
Authors: Pybus D.A. , Poole J.L. , Crawford M.C. 
Published: February 2007

SummarySubclavian venous catheterisation, using a Seldinger technique, was attempted in 25 children weighing less than 10 kg (mean 6.4 kg). Catheterisation was successful in 24 cases. Initial catheter position was satisfactory in 19 of the 24 cases (79%) and with repositioning it was possible to obtain satisfactory flow and pressure‐wave recordings in all 24 patients. The technique is simple and provides reliable access to the central circulation in small infants. There was no serious morbidity attributable to the technique.
The anaesthetist and industrial action by ancillary workers
Authors: LODER R. E. 
Published: February 2007

Introduction and SummaryThe author retired from active practice as a consultant anaesthetist in the British National Health Service during 1980 at the age of 60. He kept a detailed diary for the last full year as consultant. One of the Editors suggested that the diary could form the basis of a series of essays on various aspects of the life and practice of a consultant anaesthetist during the second half of the twentieth century, with his considered views culled from the experiences of a professional lifetime. The first essay deals with the effects of the industrial action by hospital ancillary‐workers in 1979 and considers the special role of the hospital anaesthetist during such disputes.
Laboratory data on ICU admission
Authors: BATCHELOR G. N. , ASBURY A. J. , GREENFIELD A. A. 
Published: February 2007

SummaryOne hundred and seventeen patients admitted to an intensive care unit were studied, to determine whether there is any relationship between laboratory data taken on admission to the unit and the final outcome (survival or non‐survival) of the stay within the intensive care unit.Discriminant analysis of the data shows that patients could be allocated to one of two groups (survival or non‐survival) using the two parameters of age and serum phosphate, and that this allocation proves correct in 70% of cases, irrespective of the admitting disease and treatment.The validity of this discriminant function was tested in a further 53 cases and the allocation of patients to survival or non‐survival groups was found to be correct in 70% of cases, supporting the first estimate of the discriminant function.
High frequency venturi jet ventilation
Authors: DAVEY A. J. , LEIGH J. M. 
Published: February 2007

SummaryA Penlon Nuffield Series 200 Ventilator, adapted for use as a high frequency jet ventilator, was used to treat a patient with adult respiratory distress syndrome. Adequate alveolar ventilation with this method was achieved with lower mean intrapulmonary pressure (5.4 cmH2O) than with conventional intermittent positive pressure ventilation (IPPV) (6 cmH2O). An improved cardiac output was also apparent, as judged by a better systemic blood pressure [105/50 mmHg for high frequency jet ventilation (HFJV) compared to 90/40 mmHg for IPPV] and a lower central venous pressure 6 cmH2O for HFJV as compared to 9.5 cmH2O with conventional IPPV.During HFJV, the patient's need for sedatives and narcotics was reduced. This allowed an assessment to be made of any potential neurological damage caused by the cervical fracture. An assessment had not been possible during conventional ventilation due to the heavy narcotic and sedative regime required to settle the patient.This case report provides further evidence that HFJV is a useful adjunct in the management of patients requiring mechanical ventilation and also that the Penlon Nuffield Series 200 Ventilator is capable of high frequency jet ventilation.
High frequency venturi jet ventilation
Authors: DAVEY A. J. , LAY G. R. , LEIGH J. M. 
Published: February 2007

SummaryThe functional characteristics of the Penlon Nuffield Series 200 Ventilator used for high frequency venturi jet ventilation are investigated.The results show that the ventilator is capable of ventilating lungs with low compliance with large minute volumes and should prove to be effective in clinical practice.
Pneumocephalus as a complication of posterior fossa surgery in the sitting position
Authors: MacGillivray R. G. 
Published: February 2007

SummaryA case of pneumocephalus complicating posterior fossa surgery in the sitting position is presented. Rapid diagnosis was obtained by computerised tomography. This condition should be suspected whenever a patient demonstrates delayed recovery or neurological deficit after craniotomy and nitrous oxide anaesthesia. The literature on the subject is reviewed.
Pneumocephalus after posterior fossa exploration in the sitting position
Authors: PANDIT UMA A. , MUDGE BARBARA J. , KELLER T. S. , SAMRA S. K. , KILARU P. , PANDIT S. K. , COHEN P. J. 
Published: February 2007

SummaryEntrainment of air following exploration of posterior cranial fossa in the sitting position was studied in five patients. Intracranial pressure was monitored through a ventriculostomy catheter after closure of the dura. In three patients nitrous oxide was added to the breathing mixture only after the baseline intracranial pressure had stabilised following closure of the dura. A marked rise in intracranial pressure was observed immediately. A rapid decrease in intracranial pressure occurred when nitrous oxide administration was stopped. Two patients were given nitrous oxide from the beginning. No change in intracranial pressure was noted.Computerised tomogram on the first postoperative day revealed a significant amount of air in eight cases.
Recalled apprehension after premedication with lorazepam
Authors: Burton A. J. 
Published: February 2007

SummarySeventy patients undergoing minor gynaecological surgery were allocated to four groups. Patients received intramuscular diazepam or papaveretum in combination with hyoscine, oral lorazepam in combination with hyoscine, or no premedication at all. Visual analogue scales were used to assess apprehension and postoperative recall of apprehension. From this study only patients given lorazepam and hyoscine can be said to recall less pre‐operative apprehension than patients not premedicated.
Caudal block for postoperative analgesia in children
Authors: Bramwell R.G.B. , Bullen Catherine , Radford P. 
Published: February 2007

SummaryA clinical trial was performed to compare the effects of intramuscular dihydrocodeine with caudal bupivacaine on postoperative pain and recovery in 181 children who had undergone either circumcision, inguinal herniotomy or orchidopexy performed under general anaesthesia. Linear analogues were used to assess level of consciousness and apparent pain. Recovery of consciousness was slower after caudal analgesia. For 90 minutes following circumcision there was significantly less pain with caudal analgesia, but better pain relief could not be demonstrated following inguinal herniotomy and orchidopexy.
Unusual dissemination of pseudomonads by ventilators
Authors: IM S. W. K. , FUNG J. P. H. , SO S. Y. , YU D. Y. C. 
Published: February 2007

SummaryThree patients acquired Pseudomonas pneumonia while they received mechanical ventilation. Detailed microbiological studies on these cases showed direct surface spread of pseudomonads from ventilator tubing into the airways. The ventilator tubing was not sterilised properly by liquid disinfectant due to air‐trapping and inadequate drying. Proper cold sterilisation not only of nebulisers and humidifiers, but also of ventilator tubings, is emphasised.
Acebutolol and coronary artery surgery
Authors: THOMS G. M. M. , REECE I. J. , ODOM N. J. , KAYE C. M. , SANKEY M. G. 
Published: February 2007

SummaryPlasma levels of acebutolol and its major human metabolite, diacetolol, were determined before, during and after aortocoronary bypass grafting in 10 patients who had received a chronic oral regimen of acebutolol 200 mg t.d.s. for at least 6 days before surgery, a 200 mg dose with the premedication and 5–10 mg intravenously immediately before intubation. It was found that this regimen produced beta‐adrenoceplor antagonist levels which were within the range in which attenuation of hypertension and tachydysrhythmiu occurs. These effective plasma levels were sustained throughout surgery and persisted into the early recovery period.
Early documentation of disaster victims
Authors: FINCH P. M. , HAMILTON T. 
Published: February 2007

SummaryEarly documentation is important in the process of sorting disaster victims. To provide a basis for this documentation, a four category card has been designed that can be rapidly used with little previous training. Once folded, the card displays the category of urgency on one side and basic medical details on the reverse. Later changes of category can easily be effected by refolding the card.
The alcoholic patient and surgical stress
Authors: HAXHOLDT OLGA ST. , JOHANSSON G. 
Published: February 2007

SummaryIn order to find out how the response to operative trauma is influenced by chronic alcohol consumption, 53 patients (28 alcoholics and 25 non‐alcoholics) were investigated. The chronic alcoholic was defined as a person having a regular, daily alcohol consumption of over 70 g pure alcohol for at least 3 years. The mean annual consumption in the patients studied was 52 litres pure alcohol (143 ml/day). The investigation was also designed to determine whether the pre‐operative infusion of alcohol could prevent the withdrawal syndrome and in that way alter the stress response.The results clearly showed a diminished adrenocortical response to surgical stress in alcoholic patients. While it was possible to suppress some catecholamine‐mediated withdrawal symptoms by pre‐operative alcohol infusion this did not influence the stress response, in any way. It is concluded that complications under anaesthesia and in convalescence in alcoholic patients are not only the consequence of the withdrawal but rather of the general toxic effects of alcohol especially on the endocrine and metabolic functions.
Aspirin in the prevention of painful intravenous injection of disoprofol (ICI 35,868) and diazepam (Valium)
Authors: Bahar M. , McAteer E. , Dundee J. W. , Briggs L. P. 
Published: February 2007

SummaryPain caused by intravenous injection in the dorsum of the hand of ICI 35,868 and diazepam (Valium) was studied. The effect of pretreatment with intravenous aspirin was compared with two groups—one pretreated with fentanyl and an untreated group. In the case of diazepam neither analgesic drug prevented pain on injection whereas with ICI 35,868 pain was significantly reduced by both drugs.
The anaesthetist and the obstetric department
Authors: LODER R. E. 
Published: February 2007

SummaryThe author retired from active practice as a consultant anaesthetist in the British National Health Service during 1980 at the age of 60. He kept a detailed diary for the last full year as a consultant. One of the editors suggested that the diary, augmented by his considered views culled from the experiences of a professional lifetime, could form the basis of a series of essays on various aspects of the life and practice of a consultant anaesthetist during the second half of the twentieth century. This essay considers the special and increasing responsibility of the anaesthetist in the obstetric department, both for the provision of analgesia in the labour ward and anaesthesia for operative obstetrics, and as a link between others who are vitally concerned in the provision of safe perinatal care for both mother and child.