bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modification of tracheal tube for paediatric bronchography
Authors: VATASHSKY ELIK 
Published: February 2007

SummaryA technique is described for performing bronchography in children using a combined tracheal tube and suction catheter. The catheter is cemented to the shorter (concave) exterior curvature along the length of the tracheal tube and the cross section of the combined tube then conforms to the shape of the open glottis. Ventilation through the tracheal tube is maintained throughout the injection of dye via the suction catheter and its subsequent aspiration after completion of bronchography. The technique has been used successfully in over 30 children.
Evaluation of midazolam as an intravenous induction agent
Authors: GAMBLE J.A.S. , KAWAR P. , DUNDEE J.W. , MOORE J. , BRIGGS L.P. 
Published: February 2007

SummaryMidazolam, a new water‐soluble benzodiazepine, was investigated as an intravenous anaesthetic agent in 260 adult patients in doses ranging from 0.15 to 0.5 mg/kg using a variety of premedications. Its onset of action was generally slow, taking up to 3 minutes to exert its maximum effect. A wide variability in response was found in that some unpremedicated patients were satisfactorily anaesthetised with 0.15 mg/kg while others were only moderately sedated following doses of 0.5 mg/kg. Less variability was found in the elderly who also required smaller doses. Narcotic premedication potentiated the sedative effect of midazolam. Few respiratory or cardiovascular effects were noted apart from hiccough following the larger doses. The incidence of venous sequelae was much lower than that found following diazepam.
Anaesthesia for an unusual carcinoid metastasis
Authors: WARD D.S. , IWAMOTO K. 
Published: February 2007

SummaryThe intra‐operative course of a patient found to have a metastatic serotonin‐secreting carcinoid tumour in the orbit is reported. No prophylactic or intra‐operative therapy was necessary during the administration of enflurane anesthesia. This case demonstrates again the wide spectrum of clinical responses observed among patients with this disease.
Halothane and enflurane in dental anaesthesia
Authors: RYDER W. , WRIGHT P.A. 
Published: February 2007

SummaryA clinical trial was designed to compare the use of halothane and enflurane in outpatient dental anaesthesia. A wholly inhalational technique was chosen. Basal nitrous oxide and oxygen was delivered from a Walton V demand‐flow machine and was supplemented alternately with halothane or enflurane delivered from paired Goldman vaporisers in series. Under these circumstances, enflurane produced significantly fewer dysrhythmias than halothane, but was a more difficult, more expensive and less versatile agent to use. Overall, it was considered inferior to halothane in this context except, perhaps, where repeat anaesthetics might be required at short intervals of time.
The fibrinolytic effects of anaesthesia
Authors: SIMPSON P. J. , RADFORD SHEILA G. , FORSTER S. J. , COOPER GRISELDA M. , HUGHES A. O. 
Published: February 2007

SummaryThe fibrinolytic effects of six different anaesthetic agents were studied in 36 patients undergoing abdominal hysterectomy. Fibrinolytic activity was measured by dilute whole blood and euglobulin clotlysis times. Concentrations of plasminogen, fibrinogen and fibrin degradation products were also determined. Significant enhancement of fibrinolytic activity, measured as a decrease in clotlysis time, was seen during anaesthesia and surgery with all agents studied. Halothane produced the least effect and the greatest increase in fibrinolytic activity was seen during trichloroethylene anaesthesia. Lumbar extradural anaesthesia also consistently produced enhancement of fibrinolysis. The reasons for these results and their clinical implications are discussed.
Cimetidine as an oral antacid before elective Caesarean section
Authors: JOHNSTON J. R. , McCAUGHEY W. , MOORK J. , DUNDEE J. W. 
Published: February 2007

SummaryThe H2‐receptor antagonist cimetidine was used as a pre‐operative antacid in 64 women scheduled for elective Caesarean section. All were given cimetidine 400 mg 90–215 minutes before induction, with 20 of them having an extra 400 mg dose the previous night. The intragastric pH at induction of anaesthesia was reliably above 2.5 if the treatment was given 90 150 minutes beforehand. The volume of gastric contents was reduced when compared with a control series of women receiving either no pre‐operative antacid or 30 ml magnesium trisilicate mixture BPC. No adverse effects on mothers or infants were detected.
Diet induced ketosis in epilepsy and anaesthesia
Authors: HINTON W. , SCHWARTZ RUBY H. , LOACH A. B. 
Published: February 2007

SummaryKetogenic diets have a high fat and low carbohydrate and low protein content to induce ketosis which is monitored by daily urine testing. Lapses in diet are frequently associated with loss of anticonvulsant control. There has, as yet, been no report of children maintained on a ketogenic diet subject to anaesthesia and surgery; this paper records the changes in metabolic variables observed in three patients undergoing simple inhalation anaesthetics for minor surgery.
Anaesthesia and cognitive functioning
Authors: COHEN R. L. , MacKENZIE A. I. 
Published: February 2007

SummaryDay care patients at Law Hospital, who had received either a general or a local anaesthetic in conjunction with minor surgery, were assessed by five tests of mental junction before surgery and before discharge from hospital some hours after surgery. These patients did not perform differently from control patients, who were subjected to the same two testing sessions, without intervening surgery or anaesthesia. It was concluded that the day cases were quite capable of normal cognitive functioning at the time of their discharge and that the procedures followed by the hospital for the discharge of day cases are generally adequate.
Ethylene glycol poisoning
Authors: GORDON H. L. , HUNTER JENNIFER M. 
Published: February 2007

SummaryA case of self‐poisoning with ethylene glycol is presented. The metabolic upset induced by ingestion of this substance is discussed and the principles underlying treatment with ethyl alcohol, sodium bicarbonate and renal dialysis are outlined. The practical problems experienced with this therapy are detailed. The need for immediate instigation of treatment and for intensive care are emphasised.
Ineffective transcutaneous nerve stimulation following epidural anaesthesia
Authors: Davies J. R. 
Published: February 2007

SummaryThirty‐five patients were delivered by elective Caesarean section under general or epidural anaesthesia. For postoperative analgesia they received narcotic analgesics as required and either transcutaneous nerve stimulation or an inactive stimulator. The patients receiving an active stimulator following general anaesthesia had significantly less pain and required significantly less postoperative analgesia than their control group. The epidural patients did not receive any additional benefit from active stimulation, but had the same amount of pain and the same analgesic requirement as patients receiving active stimulation following general anaesthesia. The possible causes for the failure of transcutaneous nerve stimulation after epidural anaesthesia and their implications are discussed.
Effects of nitrous oxide on liver haemodynamics and oxygen consumption in the greyhound
Authors: THOMSON I. A. , HUGHES R. L. , FITCH W. , CAMPBELL D. 
Published: February 2007

SummaryThe effects of increasing concentrations of nitrous oxide 30, 50 and 70% on the hepatic circulation and hepatic oxygen consumption were investigated in seven normocapnic greyhounds. Hepatic arterial and portal venous blood flows were measured continuously using electromagnetic flow probes, and mean arterial pressure and cardiac output monitored. The administration of nitrous oxide caused linear decreases in hepatic arterial, portal venous and total liver blood flows. Increases in mean arterial pressure, hepatic arterial resistance and mesenteric vascular resistance were noted. There were no significant changes in hepatic oxygen consumption. It is suggested that the decrease in liver blood flow may result from alpha‐adrenoceptor stimulation.
Maternal mortality
Authors: BREHENY FRANCIS , McCARTHY J. 
Published: February 2007

SummaryA retrospective study of the causes of maternal mortality over the past 20 years in the National Maternity Hospital, Dublin, was undertaken. Anaesthesia contributed to 4.4% of all maternal deaths and to 5.7% of ‘true’ maternal deaths. In the last 10 years studied it did not contribute to maternal mortality. It was concluded that anaesthesia was not a major cause of maternal mortality in this hospital.
On assisting the anaesthetist
Authors: VENN CHRISTINE 
Published: February 2007

SummaryThe author was born in Leipzig Germany in 1936. She first trained as a children's nurse in West Berlin and, after bringing up three children, qualified as a State Enrolled Nurse at Addenbrooke's Hospital Cambridge in 1976. She has held her present post as an anaesthetic room nurse in the Ear Nose and Throat operating theatre of Addenbrooke's Hospital Cambridge for 3 years. The paper analyses the task of the anaesthetic room nurse in supporting the anaesthetist both physically and psychologically.
Spinal anaesthesia for Caesarean section
Authors: CORKE B. C. , DATTA S. , OSTHEIMER G. W. , WEISS J. B. , ALPER M. H. 
Published: February 2007

SummaryThe effect upon the neonate of a short period of maternal hypotension sustained during the initiation of spinal analgesia for Caesarean section was studied. Babies born to mothers with hypotension were significantly more acidotic than controls although acid‐base levels were still within normal limits. Neuro‐behavioural studies were found to be normal in both groups at 4 and 24 hours. It was concluded that a short period (<2 minutes) of hypotension was not harmful to the neonate.
Diazepam and suxamethonium muscle pain (a dose‐response study)
Authors: Verma R.S. 
Published: February 2007

SummaryPostoperative muscle pain occurred in 17.2% of patients given diazepam intravenously 5 minutes prior to suxamethonium. The incidence of muscle pain was 48% in those patients who were not given diazepam before suxamethonium. The difference is statistically significant (p < 0.01). Five mg diazepam reduced the incidence of pain but not significantly (p = 0.30); 10 mg diazepam significantly reduced the incidence (p < 0.05); while 15 and 20 mg diazepam showed belter effects (p < 0.01). Diazepam pretreatment also reduced the severity, frequency and duration of muscle pain. The incidence of fasciculations was significantly reduced hut there was no correlation between the incidence of fasciculations and the occurrence of muscle pains.
Status asthmaticus
Authors: MATHER S. J. , EDBROOKE D. L. , NEWBY D. M. 
Published: February 2007

SummaryThe management of a case of status asthmaticus complicated by surgical emphysema is described. In view of voice changes, intubation was necessary but intermittent positive pressure ventilation was considered unwise, because of the surgical emphysema. A means of maintaining adequate sedation in an intubated patient whilst allowing spontaneous respiration is outlined.
Carbon dioxide response after epidural morphine
Authors: Holland R. B. , Levitt M. W. D. , Whitton L. A. , Shadbolt N. 
Published: February 2007

SummaryThe change in minute volume in response to a rising inspired carbon dioxide concentration was compared in 20 patients who received epidural morphine for postoperative analgesia (the test group), and 18 patients who did not (the control group). The minute volume increase in the test group was depressed at 6 hours but not at 12 hours postoperatively, but the degree of depression was not statistically significant. Control patients had no significant respiratory depression at any time. When the test and control groups were compared with each other, no statistically significant difference between groups was found. Two patients in the test group demonstrated a markedly depressed response to carbon dioxide challenge postoperatively. The incidence of nausea and vomiting was similar in both groups, while the presence and severity of pain was reduced in the test group.
Undergraduate teaching: a developing country experience
Authors: Ene E.E. , Akpan Sylvia G. 
Published: February 2007

SummaryThe objectives and programme of instruction for medical students in the University of Lagos are described.The reactions of 144 students to the course were assessed by a detailed questionnaire. AH the students expressed a preference for instructional simulation to teaching in an operating theatre. Twenty per cent indicated that they would consider anaesthesia as a career.
Naloxone reversal of meptazinol‐induced respiratory depression
Authors: SLATTERY P. J. , HARMER M. , ROSEN M. , VICKERS M. D. 
Published: February 2007

SummaryThe effects of intravenous meptazinol on respiratory rate and end‐tidal CO2 concentrations were investigated in a group of 20 anaesthetised subjects. In clinically effective doses, meptazinol produced a dose‐related fall in respiratory rate and elevation in end‐tidal CO2 concentration. Naloxone reversed these effects.
Anaesthesia in first degree atrioventricular block
Authors: HAYWARD R. , DOMANIC N. , ENDERBY G. E. H. , McDONALD L. 
Published: February 2007

SummaryA patient with an intracardiac conduction defect characterised by first degree atrioventricular block due to slowed transmission through the atrioventricular node with increased refractoriness of the node, is described. Asymptomatic first degree block, rarely progressing to transient Wenckebach (type 1 second degree) block had been present for a period of 32 years until general anaesthesia was required, when profound bradycardia attributable to complete atrioventricular block developed abruptly. Subsequent investigations located delayed intracardiac conduction through the atrioventricular node, and indicated excess vagal activity rather than structural disease as the cause.The significance of first degree heart block is discussed in relation to other forms of atrioventricular conduction defect and the current recommendations for temporary pacing for elective general anaesthesia.
Anaesthesia for pharyngolaryngectomy with extrathoracic oesophagectomy and gastric transposition
Authors: Plant Mary 
Published: February 2007

SummaryPharyngolaryngectomy with extrathoracic oesophagectomy and gastric transposition has become a standard operation for laryngopharyngeal cancer. The anaesthetic management of patients undergoing this procedure is described, with reference to a personal series of 10 cases.
The anaesthetic management of a patient with familial dysautonomia
Authors: STENQVIST O. , SIGURDSSON J. 
Published: February 2007

SummaryFamilial dysautonomia is a rare inherited disease of the nervous system, involving mainly peripheral sensory and sympathetic nerves. The autonomic instability is of greatest importance for the anaesthetist although the sensory defect is the most dramatic symptom of the disease. A case report of a 15‐year‐old girl undergoing two operations for severe scoliosis is presented with a discussion of the anaesthetic problems encountered in this disease.
Transcutaneous Pco2 in adults
Authors: GOLDMAN M. D. , GRIBBIN H. R. , MARTIN R. J. , LOH L. 
Published: February 2007

Summary Using a transcutaneous Pco2 (PtcCO2) electrode, arterial Pco2 (Paco2) was compared with PtcCO2in eight adults (seven patients, one normal subject) over a wide range of values of PaCO2(2.4 to 7.87 kPa). At an electrode temperature of 43°C, PtcCO2=1.25 Paco2kPa (95% confidence limits: 0.60 kPa). Change in PtcCO2accurately reflected change in Paco2.
Anaesthetic manpower in the future in the UK
Authors: VICKERS M. D. 
Published: February 2007

SummaryThe short‐term objective of the DHSS of a 1:1 consultant: junior ratio by 1988 is compatible with current trends in consultant expansion and implies no reduction in registrars before then.The target of doubling the number of consultants in 15 years cannot be met in anaesthesia without a fairly sharp, and relatively short‐lived increase in senior registrar numbers. This has implications for planning in other specialties, particularly surgery. It seems prudent to assume the target will take longer than 15 years to achieve. Between 1988 and 2004 there would need to be a reduction of between one and two registrar posts per region per annum if the DHSS target of a consultant:junior ratio of 1.8: 1 is to be met. Lesser reductions would be necessary if there were to be expansion of Hospital Practitioners in anaesthesia. No change in the number of senior registrar posts need be envisaged. If entry were properly controlled, the current number of registrar posts would be compatible with a viable career structure for British graduates.
Doxapram and postoperative chest complications
Authors: DRUMMOND G. B. , PARK G. R. 
Published: February 2007

SummaryIn a double‐blind study, an infusion of doxapram, 1 mg/kg/hour, for 4 hours after upper abdominal surgery reduced the incidence of spontaneous cough but did not influence the incidence of other chest complications, such as increased expectoration of sputum or abnormal physical signs.
Extradural versus intramuscular diamorphine
Authors: JACOBSON L. , PHILLIPS P. D. , HULL C. J. , CONACHER I. D. 
Published: February 2007

SummaryThe effects of diamorphine hydrochloride 0.1 mg/kg, given either extradurally or intramuscularly for postoperative analgesia were compared in two randomised double‐blind studies involving 39 patients undergoing thoracotomy and major gynaecological surgery. Assessments were made at fixed intervals after the administration of diamorphine and consisted of the measurement of pain or analgesic effect. Segmental, sympathetic and any adverse effects were sought. There was no significant difference in the quality of analgesia between the two groups in either trial. Extradural diamorphine provided safe and effective analgesia of rapid onset, with no specific undesirable side‐effects. In both studies, analgesia was more prolonged following extradural administration. The relative proportion of spinal binding may be increased after extradural administration and this may be reflected in the prolonged analgesia observed.
On‐demand analgesia
Authors: WELCHEW E. A. 
Published: February 2007

SummaryA double‐blind study comparing a totally patient‐controlled on‐demand intravenous regime delivering fentanyl and a simple, regular, 4‐hourly intramuscular regime delivering morphine is described. It was demonstrated that mean pain scores in the two groups were almost identical whilst sedation scores were not significantly different. Nausea scores were significantly lower in the regular morphine group. Postoperative respiratory function tests were not significantly different in the two groups.
Experience with self‐administered pethidine with special reference to the general practitioner obstetric unit
Authors: Harper N.J.N. , Thomson J. , Brayshaw S.A. 
Published: February 2007

SummaryWe describe our experience with on‐demand self‐administered intravenous pethidine when used to provide analgesia on a general practitioner obstetric unit. The Cardiff Palliator was used by 42 patients at or near term. Analgesia was satisfactory in a high proportion of case i and this method of analgesia was generally preferred to intramuscular pethidine. Apgar scores were unsatisfactory in three instances but obstetric considerations were thought to have contributed. The problems of incorporating this form of analgesia into the practice of a general practitioner unit are discussed.
Anaesthesia for myringotomy
Authors: DRAKE‐LEE A. B. , CASEY W. F. , OGG T. W. 
Published: February 2007

SummaryThe effect of two methods of anaesthesia on the findings at myringotomy in children with secretory otitis media was studied. One group of patients spontaneously breathed a mixture of nitrous oxide. oxygen and halothane whereas a second group had assisted ventilation, tracheal intubation and breathed a mixture of halothane and oxygen. Nitrous oxide diffused significantly into middle ears which had gas under reduced pressure (with or without fluid present) when compared with normal ears (p <0.05). Assisted ventilation prior to tracheal intubation did not introduce gas into the middle ear. It is concluded that impedance audiometry is a reliable method of assessing the middle ear prior to surgery.
Effects of intermittent 0.5% nitrous oxide/air (v/v) on the fertility of male rats and the post‐natal growth of their offspring
Authors: VIEIRA ERICA , CLEATON‐JONES P. , MOYES D. 
Published: February 2007

SummaryIn a study of male rat fertility male Wistar albino rats were exposed to 0.5% nitrous oxide/air mixtures (v/v) for 30 days and control rats were exposed to oil‐free air for the same time period. Thereafter each male was mated with three nulliparous female rats and mated again with three more nulliparous rats after a 6‐month recovery period. The offspring were weighed and measured for 8 weeks postnatally. There was a significant reduction in mean litter size of the female rats mated with the male rats directly after the nitrous oxide exposure period. The offspring from the female rats mated with the males directly after the exposure period were significantly smaller in size than the control group. These results show a reversible reduction in male Wistar rat fertility, after exposure to 0.5% nitrous oxide in air (v/v), as well as a postnatal growth depression.
Failed intubation in congenital tracheal stenosis
Authors: GODDARD R. H. , HUGHES D. G. 
Published: February 2007

SummaryA girl aged 16 years was found to have tracheal obstruction which prevented satisfactory intubation at induction of anaesthesia for surgical correction of an idiopathic scoliosis. Subsequent radiological investigations revealed a tracheal stenosis, and an anaesthetic assessment of her upper airway was carried out before major surgery.
Bicornuate uterus and aortocaval compression
Authors: MAGEE D. A. 
Published: February 2007

SummaryA severe case of supine hypotensive syndrome associated with a bicornuate uterus is presented. It is suggested that failure of left lateral tilt to prevent the syndrome was associated with anatomical displacement of the uterus to the right. The importance of trying right lateral tilt, if response to left tilt is poor, is noted.
Internal jugular catheterisation in small children. The use of a posterior approach
Authors: Chatrath R.R. , Stock J.G.L. , Jones O.D.H. 
Published: February 2007

SummaryInternal jugular catheterisation, using a posterior approach, was attempted in 50 infants and children aged from 1 day to 12 years, weighing 1.25 to 30 kg. Thirty‐five of the patients weighed less than 10 kg. Catheterisation was successful in 49 cases. Initial catheter position was satisfactory in 48 of the 49 cases and satisfactory pressure waveform and flow characteristics were achieved in all 49 cases. There were no complications attributable to the technique. The technique proved reliable and easily learnt and is recommended as a particularly suitable approach to central venous catheterisation in small children.
An evaluation of Org NC 45 (vecuronium) in paediatric anaesthesia
Authors: FERRES C. J. , CREAN P. M. , MIRAKHUR R. K. 
Published: February 2007

SummaryVecuronium (Org NC 45) was evaluated as a neuromuscular blocking agent in chidren and compared with pancuronium in a double‐blind study. Satisfactory intubating conditions were present 90 seconds after 0.1 mg/kg of either drug. The onset of complete block was quicker after vecuronium but the greatest difference was found in the duration to 25% recovery which was significantly shorter with vecuronium (20 min) compared with pancuronium (48 min). The use of vecuronium was associated with cardiovascular stability and no clinical evidence of histamine release. Antagonism of the block was readily achieved with neostigmine.