bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of oral slow release morphine (MST) with intramuscular morphine for premedication
Authors: PINNOCK C. A. , DERBYSHIRE D. R. , ELLING A. E. , SMITH G. 
Published: February 2007

SummaryOral morphine sulphate slow‐release (MST) 40 mg and intramuscular morphine sulphate 10 mg, each administered with intramuscular atropine 0.6 mg, were compared in a randomised double‐blind trial as premedication agents in 30 patients undergoing abdominal hysterectomy. Both formulations produced sedation but no anxiolysis in the anaesthetic room, as measured by 10 cm, horizontal linear analogue scales. There was no significant difference between the preparations in terms of postoperative pain, recorded either by the linear analogue scales or using a patient questionnaire. The usage of analgesics and anti‐emetics postoperatively was comparable in both groups.
Patient‐controlled postoperative analgesia with alfentanil
Authors: WELCHEW E. A. , HOSKING JANE 
Published: February 2007

SummaryA double‐blind study comparing aventanil and pethidine given intravenously by an adaptive, patient‐controlled on‐demand analgesic system is described. It was demonstrated that, despite its well‐known rapid onset of effect, alfentanil took several hours to achieve good quality analgesia. Nevertheless, it had a much more predictable consumption pattern than pethidine. Alfentanil was associated with significantly less sedation during the postoperative period than pethidine, and was also associated with a significantly greater urine output during the 24–hour period of study. There was no evidence of tolerance or accumulation with either of the two drugs.
The ‘Mini O2’ and ‘Healthdyne’ oxygen concentrators
Authors: HARRIS C. E. , SIMPSON P. J. 
Published: February 2007

SummaryTwo oxygen concentrators designed for home use, the ‘Healthdyne’ and the ‘Mini O2’, have been assessed with particular reference to their possible role in anaesthesia. Both were found to be a reliable source of oxygen enriched gas. Neither was fully capable of driving a gas powered ventilator satisfactorily, but both could potentially be very useful in normal and field anaesthetic practice.
Induction and recovery characteristics of isoflurane and halothane anaesthesia for short outpatient operations in children
Authors: Pandit Uma A. , Steude Georgine M. , Leach A.B. 
Published: February 2007

SummaryInduction and recovery characteristics of isoflurane anaesthesia were compared with halothane anaesthesia during outpatient myringotomy and placement of Sheely ventilation tubes in 101 unpremedicated children. Compared with halothane, isoflurane resulted in prolonged induction times and inferior induction scores due to increased salivation, coughing, breathholding and laryngospasm. However, when modified by halothane induction, isoflurane anaesthesia decreased induction time and improved induction scores. Induction with thiamylal 4 mg/kg did not improve induction scores significantly. Recovery times from halothane plus isoflurane and pure isoflurane anaesthesia were quicker than pure halothane and thiamylal plus isoflurane, although this was not statistically significant. Compared to halothane, anaesthetic induction using isoflurane is associated with an increased incidence of respiratory problems in unpremedicated children.
Volume‐controlled high frequency positive pressure ventilation for upper abdominal surgery
Authors: BABINSKI M. F. , SMITH R. B. , SJÖSTRAND U. H. 
Published: February 2007

SummaryVolume‐controlled high‐frequency positive pressure ventilation was evaluated and compared to intermittent positive pressure ventilation during anesthesia in 74 patients undergoing biliary tract surgery. There were no statistically significant differences in oxygenation or ventilation. Significantly lower airway pressures and lower tidal volumes were recorded during high frequency positive pressure ventilation. This technique was also used in eight morbidly obese patients during gastric stapling surgery, and provided adequate oxygenation and ventilation. Used intra‐operatively, it also produced a quiet operative field, which the surgeons appreciated during cannulation of the biliary duct and stapling of the stomach. At the end of the anaesthesia, high frequency positive pressure ventilation was superimposed on spontaneous breathing and operated as a new mode of intermittent mandatory ventilation. This reduced the risk of hypoxia at the time of emergence from anaesthesia and at tracheal suctioning.
The armlift test
Authors: BAR Z. G. 
Published: February 2007

SummaryThe armlift test was assessed as an alternative to the headlift test for recovery from neuromuscular blockade. Forty comparisons of inspiratory force, duration of arm‐lift and duration of headlift were performed in 27 intubated patients after anaesthesia, which included the use of non‐depolarising neuromuscular blockade. Patients' ability to keep one arm raised (with the elbow clear of the bed) correlated well with inspiratory force (r = 0.67). All patients capable of an armlift duration of 45 seconds or more were also found to have an inspiratory force of at least – 2.5 kPa and were safely extubated. The headlift test was found to be less discerning (r = 0.34) and of 40 determinations of headlift and inspiratory force there were 18 false negatives and two false positives.
Depression and anxiety in pain clinic patients, Rapid assessment by microcomputer
Authors: Hanks G.W. , Lloyd J.W. , Evans P.J.D. , Ancill R.J. 
Published: February 2007

SummaryComputer administered depression and anxiety rating scales were used in a pilot study to screen patients attending a regional pain relief unit. Patients found the procedure acceptable and helpful. There was a poor correlation between the computer assessments and doctors' ratings, with in general a much greater degree of morbid depression and anxiety revealed by the computer. Computer administered rating scales may be useful as a screening tool in pain clinic patients to identify those at risk of signficant psychiatric morbidity.
Analgesia following femoral neck surgery. Lateral cutaneous nerve block as an alternative to narcotics in the elderly
Authors: Jones S.F. , White A. 
Published: February 2007

SummaryIn a prospective controlled randomised trial on patients undergoing operative repair of fractured neck of femur via a lateral incision, the postoperative analgesic requirements of one group of patients who received a lateral cutaneous nerve block were compared with a second group who received no block. The former group were found to need significantly less intramuscular pethidine in the first 24 hours, and 44% required no supplementary analgesia whatsoever during this period. The time to first dose of opioid in ihe remainder was greatly increased. No untoward sequelae associated with the nerve block were seen.
Epidural meptazinol for pain relief after lower abdominal surgery
Authors: RAO U. , CAMPBELL I. T. , CATLEY D. M. , SUTHERST J. R. 
Published: February 2007

SummaryA preliminary investigation is reported into the use of epidural meptazinol for pain relief in 20 patients after major lower abdominal (gynaecological) surgery. Analgesia was rapid in onset (15 minutes), had a median duration of 124 minutes (interquartile range 85‐212 minutes) after a single dose of 30 mg and a median duration of 122.5 minutes (interquartile range 70–127 minutes) after a single dose of 60 mg. Overall pain relief, as judged by the patients themselves, was satisfactory in 19 out of the 20 cases. At 30 minutes and 45 minutes pain relief was significantly better with the 60 mg than the 30 mg dose (p < 0.02). No drug‐related adverse events were observed during the study.
Influence of plasma proteins on the onset of hypnotic action of intravenous midazolam
Authors: HALLIDAY N. J. , DUNDEE J. W. , COLLIER P. S. , LOUGHRAN P. G. , HARPER K. W. 
Published: February 2007

SummaryThe action of midazolam is influenced by serum protein binding as seen in the relationship between the time of onset of action of a fixed dose of the drug and the plasma albumin. Pretreatment with intravenous aspirin produces a decrease in the in vitro binding of midazolam. In vivo this is manifest as an increase in the rapidity of action of the benzodiazepines. Probenecid pretreatment will also cause a decrease in the onset time of midazolam. However this is not due to altered plasma protein binding of the sedative.
Extracranial surgery—intracerebral tumour
Authors: MILLAR S. W. , HENSHER R. 
Published: February 2007

SummaryA case is described in which localising neurological signs developed on the first day following general anaesthesia for insertion of a silastic implant over a frontal fracture. Despite prompt appropriate investigation seven weeks elapsed before the correct diagnosis was made. Aspects of the management of patients who develop a neurological deficit soon after general anaesthesia are discussed.
Severe hypertension during anaesthesia for dacryocystorhinostomy
Authors: EL‐DIN A. S. M. A. K. , MOSTAFA S. M. 
Published: February 2007

SummaryA healthy 82‐year‐old woman presented for dacryocystorhinostomy under general anaesthesia. Following the application of intranasal cocaine and subcutaneous injection of felypressin she developed severe hypertension. multiple ventricular ectopic beats and depression of the ST segment on the electrocardiogram. A drug interaction is suspected.
The Penlon Bromsgrove high frequency jet ventilator for adult and paediatric use
Authors: SMITH B. E. 
Published: February 2007

SummaryThe Penlon Bromsgrove is a new high frequency jet ventilator, suitable for use in both adults and children. The jet stream is humidified by means of an integral in‐line Bernoulli nebuliser. The self‐recharging nebuliser can also convey drugs directly to the airways in the form of an aerosol. Alarms and fail‐safe systems are incorporated. A pressure gauge continuously displays the jet drive pressure. There are two digital LED displays; one shows jet frequency in breaths per minute; the other, the jet drive pressure, minimum, maximum and mean patient airway pressures. Two fail‐safe systems ensure that these pressures do not become excessive. Both audible and visual alarms are provided. The prototype has proved to be quiet and completely reliable over more than 4000 hours use, with no bronchoscopic or histological evidence of ineffective humidification.
Variability of fentanyl pharmacokinetics in man
Authors: REILLY C. S. , WOOD A. J. J. , WOOD M. 
Published: February 2007

SummaryThe derived pharmacokinetic data for the intravenous administration of fentanyl obtained from seven previous studies were compared using computer simulation of predicted plasma concentrations following three intravenous dosage regimens. There was wide discrepancy between the reported calculated pharmacokinetic constants from the various studies, such that the volume of distribution ranged from 4.4 to 59.7 litres, estimates of terminal elimination half‐life ranged from 141 to 853 minutes while total body clearance values ranged from 160 to 1530 ml/minute. The differences in predicted plasma concentrations were marked. The peak concentration following a bolus of 500 pg ranged from 8.4–113.6 ng/ml and took from 2.9 to 18.9 hours to fall to 0.5 ng/ml. The steady state plasma concentration reached with an infusion of 0.3 μg/kg/minute varied from 12.2–119.9 ng/ml and the plateau level attained with a two‐rate infusion (2.7 μg/kg/minute for 20 minutes then 0.3 μg/kg/minute) ranged from 10.6–50.8 ng/ml. The aim of descriptive pharmacokinetics is to allow the clinician to predict the plasma concentration achieved by a given dose and to facilitate dosage choice and adjustment. Recent interest has centred on the use of pharmacokinetics to calculate continuous intravenous infusion dosage regimens. The clinical application of current pharmacokinetic data for fentanyl is questionable.
The potencies of edrophonium and neostigmine as antagonists of pancuronium
Authors: BREEN P. J. , DOHERTY W. G. , DONATI F. , BEVAN D. R. 
Published: February 2007

SummaryDose response curves were constructed for edrophonium and neostigmine when used to antagonise pancuronium, 0.07 mg/kg during thiopentone‐nitrous oxide‐halothane anaesthesia. The antagonist was given when 10% twitch height had been restored and the effect was measured 10 minutes later. Recoveries to 50% and 90% twitch height were achieved with 167 and 828 μg/kg of edrophonium, and 10.5 and 51 μg/kg of neostigmine. The dose response curves were parallel and neostigmine was 16 times more potent than edrophonium. Combinations of equipotent doses of edrophonium and neostigmine were also administered and produced additive but not synergistic effects. It is concluded that either edrophonium or neostigmine may be used for the reversal of pancuronium neuromuscular blockade, but the combination of the two offers no advantage.
Biochemical changes following suxamethonium
Authors: LAURENCE A. S. 
Published: February 2007

SummaryForty patients were investigated for serum myoglobin changes following induction of anaesthesia but before the commencement of surgery. Blood was drawn for potassium, creatinine kinase and serum myoglobin immediately prior to and 5, 10 and 20 minutes after administration of thiopentone 4 mg/kg and suxamethonium 1.2 mg/kg. Twenty patients were given either 2 mg alcuronium or 20 mg gallamine as pretreatment 2 to 3 minutes before the suxamethonium to reduce the fasciculations. Anaesthesia was maintained with artificial ventilation and alcuronium, or spontaneous ventilation with halothane. Serum myoglobin was assayed by radioimmunoassay.All pre‐induction rnyoglobin levels were within the normal range. Of the 20 patients who were not pretreated, six showed a marked rise of serum myoglobin within 5 minutes, increasing to 150–200 μg/litre at 20 minutes. The remaining 14 patients had no such rise. No patients in the pretreatment group had any significant rise in serum myoglobin, suggesting that although the fasciculations were not completely abolished, there was protection against one of the effects of suxamethonium on the muscle. Although there was no clear relationship between intensity of fasciculations and increase in serum myoglobin, there was no marked rise in serum myoglobin values in any patient who did not have muscle fasciculations. There were no consistent changes in potassium or creatinine kinase in any group during the period of study.
A new site for the adjustable pressure limiting valve on a circle absorber
Authors: PURI G. D. , VARMA Y. S. 
Published: February 2007

SummaryA new site for the adjustable pressure limiting valve has been suggested which will result in the most efficient utilisation of soda lime using typical flows with a circle absorber system. It will permit economy of fresh gases using old models of circle absorbers in which the adjustable pressure limiting valve and fresh gas inlet are both situated upstream of the inspiratory unidirectional valve. The cost of the new attachment is small
C‐reactive protein in patients undergoing cardiac surgery
Authors: BORALESSA H. , DE BEER F. C. , MANCHIE A. , WHITWAM J. G. , PEPYS M. B. 
Published: February 2007

SummaryAmong 25 patients undergoing cardiac surgery with the aid of cardiopulmonary bypass, 13 who recovered uneventfully all had normal (< 2 mg/litre) levels of serum C‐reactive protein pre‐operatively. In contrast, 10 of the 12 patients who suffered from various postoperative complications, including two who died, had abnormally raised levels of C‐reactive protein pre‐operatively. AN patients showed a major acute phase response to surgery with peak C‐reactive protein levels at about 46 hours but, whereas the uncomplicated cases showed a characteristic smooth biphasic pattern of declining levels thereafter, the complicated cases all exhibited significant alterations of this pattern. The occurrence during the postoperative period of a secondary rise in C‐reactive protein or the failure of the level to continue falling, generally preceded clinical evidence of intercurrent infection. Pre‐operative measurement of serum C‐reactive protein may thus make a valuable contribution to the assessment of patients requiring elective cardiac surgery; regular postoperative monitoring can provide early warning of serious complications.
Intramuscular midazolam premedication in small children
Authors: TAYLOR M. B. , VINE P. R. , HATCH D. J. 
Published: February 2007

SummaryMidazolam 0.2 mg/kg was compared as an intramuscular premedication in small children with papaveretum and hyoscine 0.4 and 0.008 mg/kg. Midazolam produced satisfactory sedation and anxiolysis and in the early postoperative period patients were significantly more awake 0,<0.05).
Detection of neurological damage during cardiopulmonary bypass
Authors: BOLSIN S. N. C. 
Published: February 2007

SummaryThree cases of neurological damage, which occurred during cardiopulmonary bypass, and which were detected by the cerebra1, function analysing monitor, are reported. A fourth case, which had similar changes on the cerebral function analysing monitor but no neurological damage, is also described. The importance of changes in frequency of the cerebral electrical activity in the early detection and accurate prediction of severity of neurological damage is emphasised. The advantages of this instrument over other displays of the electroencephalogram are discussed.
Intubating conditions following pre‐induction priming with alcuronium
Authors: HARROP‐GRIFFITHS A. W. , GROUNDS R. M. , MOORE M. 
Published: February 2007

SummaryThree priming doses of alcuronium have been investigated and, using a logistic transformation technique, the priming dose required to produce adequate intubating conditions in 99% of patients at 60 seconds following the second dose of alcuronium has been deduced. This dose, 106.5 μg/kg is extremely high and may be unsafe if used, since 30% of our patients complained of side effects when given a priming dose of only 50 μg/kg.
Anaesthesia for Friedreich's ataxia
Authors: BELL C. F. , KELLY J. M. , JONES R. S. 
Published: February 2007

SummaryA patient with Friedreich's ataxia was anaesthetised on two occasions. The neuromuscular blocking agent was atracurium 0.5 mg/kg on the first occasion and tubocurarine 0.5 mg/kg on the second. The effect of each was monitored using the train‐ofifour twitch technique. Friedreich's ataxia has been reported to cause a marked sensitivity to non‐depolarising muscle relaxants and hyperkalaemia, with resulting cardiac dysrhythmias after suxamethonium. This patient did not demonstrate an abnormal response to either relaxant; the operating conditions were satisfactory and recovery was not delayed. These drugs may be safely used in this condition provided that monitoring is adequate.
Halothane and trichloroethylene
Authors: HOLLIS N. 
Published: February 2007

SummaryThe vapour pressures of static mixtures of halothane and trichloroethylene and the output of the two vapours from an Oxford Miniature Vaporizer filled with mixtures of the two liquids have been studied. In a small pilot study, a mixture of halothane and trichloroethylene was used for drawover anaesthesia in patients having minor surgery; this seems to work satisfactorily and may have some limited applications.
Respiratory depression after morphine in the elderly
Authors: DAYKIN A. P. , BOWEN D. J. , SAUNDERS D. A. , NORMAN J. 
Published: February 2007

SummaryThe effects of intravenous morphine (10 mg/70 kg) on the ventilatory response to CO2 were studied in two groups of subjects, young (18‐29 years) and old (66‐85 years), prior to elective surgery. In both groups morphine caused a signijcant depression of respiration as judged by a reduction in the slope of the CO2 response curve. a reduction in the calculated ventilation at an end tidal CO2 tension of 7.3 kPa, a rise in resting end tidal CO2 and a rise in the CO2 threshold. There were no significant differences between the two groups in the changes produced by the drug, suggesting that acute respiratory depression after a single intravenous injection of morphine is similar in old and young people.
Acute poisoning with gold cyanide
Authors: Wright I. H. , Vesey C. J. 
Published: February 2007

SummaryA case of deliberate ingest ion of an electroplating solution containing gold cyanide is described. Despite the use of an antidote, and supportive treatment for cyanide poisoning, the patient died after 13 hours. Sublethal cyanide and high red blood cell gold levels suggest acute gold toxicity as the most likely cause of death. Evidence for this is discussed and recommendations are made for the treatment of cyanide poisoning.
Distribution of evoked paraesthesiae and effectiveness of brachial plexus block
Authors: Smith B. E. 
Published: February 2007

SummaryThe distribution of paraesthesiae evoked by a low power nerve stimulator during performance of supraclavicular brachial plexus block was studied in 120 patients. Evoked paraesthesiae in the distribution of the median nerve was associated with a significant improvement in effectiveness of the block when compared with evoked paraesthesiae in the ulnar and radial distributions. A possible explanation for this funding is proposed.
Potentiation of epidural opioids with epidural droperidol
Authors: Bach V. , Carl P. , Ravlo O. , Crawford M. E. , Werner M. 
Published: February 2007

SummaryDuring a period of one year, 119 patients with chronic pain received injections of opioids via a catheter inserted in the lumbar epidural space. Twenty‐three patients (19%) showed evidence of tolerance and were given droperidol 1.25–5.0 mg epidurally. In 20 patients in this study, there was a significant reduction in the number of epidural opioid injections. Six patients complained of excessive sedation, which disappeared when the dose of droperidol was reduced, although this did not affect the analgesia. One patient given an accidental overdose of droperidol developed reversible Parkinsonism. It is concluded that epidural administration of the dopamine antagonist droperidol may be beneficial as supplementary medication to epidural opioids when tolerance develops.
Intravenous regional anaesthesia below the knee
Authors: Valli H. , Rosenberg P. H. 
Published: February 2007

SummaryThe quality of anaesthesia provided by three dosages of prilocaine. 40 ml 0.5%. 20 ml 1%, or 40 ml 1%. administered in random order, for intravenous regional anaesthesia of the lower extremity below the knee was compared in six volunteers. Limited sensory blockade was achieved in the groups with 40 ml 0.5% and 20 ml I% during the 30‐minute test period. One subject was not fully anaesthetised with any of the dosages used. Recovery was rapid (mean 12–13 minutes) in these two groups. In two subjects given 40 ml of 1%. complete recovery took 90 minutes. At 30 minutes, the degree of flexion remaining in the great toe (control 100%) was 4% in the groups who received 40 ml Of 0.5% and 1 %, but 34% in those who received 20 ml of I% respectively. Full motor recovery was achieved in 8–9 minutes. Five of six volunteers who received the 400‐mg dose experienced subjective signs of central nervous system side effects when the cuff was released. In this group, the mean plasma level of prilocaine at 2 minutes was 1.22 μg/ml. maximum 2.12 μg/ml. In a radiological examination, no leak of contrast medium under the tourniquet cuff (300 mmHg) was detected. The development of anaesthesia was fastest following the largest dose, but the large number of central side effects makes that dosage less suitable for clinical work.