bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart rate and arterial pressure changes during fibreoptic tracheal intubation under general anaesthesia
Authors: SMITH J. E. 
Published: February 2007

SummaryThe cardiovascular responses to fibreoptic orotracheal intubation under general anaesthesia were compared with those in a control group in whom tracheal intubation was effected with a Macintosh laryngoscope. The patients received a standard anaesthetic and were allocated randomly to either group immediately before intubation. Fibreoptic intubation took significantly longer to perform. There were significant increases in heart rate and arterial pressure in both groups compared with pre‐induction values. The tachycardia in the fibreoptic group was significantly greater than that in the control group during the second minute after intubation, and the increase in systolic pressure was sustained for a longer period in the fibreoptic group. The maximum increases in systolic and diastolic pressures above pre‐intubation values were significantly greater in the fibreoptic group. The cardiovascular responses associated with fibreoptic intubation under general anaesthesia appear to be more severe than those which follow intubation effected with a Macintosh laryngoscope.
Low volume intercostal injection. A comparative study in patients and cadavers
Authors: MOWBRAY A. , WONG K. K. S. 
Published: February 2007

SummaryThis study compared the spread of 3 ml of a solution of bupivacaine‐methylene blue in the intercostal space of patients and cadavers. There were 51 successful injections in each group which demonstrated in 86% of patient injections and 84% of cadaver injections that spread was confined to one intercostal space. Spread was more extensive in cadavers, probably as a result of autolysis. It would therefore still appear necessary, when low volumes of local anaesthetic are used, to block each intercostal nerve individually.
Tracheal stenosis or agenesis in association with tracheo‐oesophageal fistula and oesophageal atresia
Authors: BRAY R. J. , LAMB W. H. 
Published: February 2007

SummaryTwo babies are described with oesophageal atresia, a tracheo‐oesophageal fistula and severe subglottic tracheal stenosis. A third baby, who did not survive, had a tracheal agenesis associated with bronchi arising from the oesophagus. A review of the types of tracheal stenosis and agenesis associated with various forms of tracheo‐oesophageal fistula is included.
Hyponatraemia and mental symptoms following vesical ultrasonic lithotripsy
Authors: BATRA Y. K. , KAPOOR R. , HEMAL A. K. , VAIDYANATHAN S. 
Published: February 2007

SummaryA patient became confused and restless after vesical ultrasonic lithotripsy performed with distilled water as the irrigant. Serum sodium decreased to 120 mmol/litre from the pre‐operative value of 138 mmol/litre. A cystogram revealed intraperitoneal extravasation of contrast. She recovered promptly after intravenous infusion of normal saline and emergency surgery for repair of the damaged bladder wall. This case illustrates that hyponatraemia and mental symptoms similar to those following transurethral resection syndrome also occur with ultrasonic lithotripsy when distilled water is used as the irrigant.
Tracheal tubes in cold stress
Authors: DAHLGREN B.‐E. , NILSSON H. G. , VIKLUND B. 
Published: February 2007

SummaryDuring rescues in cold climates, plastic tracheal tubes have fractured because of cold stress or mishandling. Susceptibility of rubber and plastic tracheal tubes to cold stress was tested in a climate chamber. Plastic tubes became stiffer when chilled, had greater resistance to reshaping and were more sensitive to shock and manipulation. They also need protection against cold and shock during transport. Rubber tubes were more tolerant of cold stress. Very cold rubber and plastic tubes may induce tissue damage. Rewarming to a nondangerous temperature was shown to be a quick procedure. It is suggested that the rescuer's own body heat be used.
Evaluation of a new tracheal tube with a movable bronchus blocker
Authors: MacGILLIVRAY R. G. 
Published: February 2007

SummaryA new tracheal tube which incorporates: a movable bronchus blocker (the Univent tube), was evaluated in eight patients who underwent thoracic surgery. Difficulties encountered with accurate placement suggest that routine use should be made of a fibreoptic bronchoscope to confirm the position of the blocker.
Plasma concentrations of bupivacaine during extradural anaesthesia for Caesarean section
Authors: WILSON C. M. , MOORE J. , GHALY R. G. , FLYNN R. , McCLEAN E. , DUNDEE J. W. 
Published: February 2007

SummaryThe clinical effects and plasma levels associated with the use of 0.5% bupivacaine with and without the addition of 1:200 000 adrenaline (5 μg/ml) were studied in 30 patients who underwent extradural anaesthesia for elective Caesarean section. The addition of adrenaline to bupivacaine prolongs analgesia, reduces the degree of hypotension and delays its onset. Plasma bupivacaine levels were consistently lower when adrenaline was added, but this difference was significant only at 10 minutes after the initial dose. Prolonging the interval between increments seems to be a more reliable way to reduce plasma concentration than the addition of the catecholamine.
Survey of the practice of epidural analgesia in a regional sample of obstetric units
Authors: Frank M. , Heywood A. , MacLeod D. M. 
Published: February 2007

SummaryAn investigation into practices of the epidural services in a regional sample of obstetric units was undertaken following recent reported disasters associated with epidural analgesia for labour pain. A questionnaire was completed by all 22 obstetric units in the region, which included six teaching, 14 district and two independent centres. In three units the epidural service was shared with the obstetricians. A continuous anaesthetic presence was provided in 16 of 22 units. There was considerable variation in the attendance upon epidural patients by the anaesthetists. Instructions to midwives for top‐ups and subsequent care of patients followed no uniform pattern. Midwife in‐service training in the initial management of serious epidural complications and in cardiopulmonary resuscitation was inconsistent. In some units, the avoidance of aortocaval compression was not emphasised in the management of serious complications such as severe maternal hypotension, total spinal blockade or cardiac arrest of the parturient. The results obtained in this survey suggest that there is a need to review the requirements in the provision of obstetric epidural services and consideration should be given to the establishment of a generally accepted standard of practice.
Anaesthesia and angiotensin‐converting enzyme inhibitors
Authors: YATES A. P. , HUNTER D. N. 
Published: February 2007

SummaryThe effect of enalapril pretreatment on the haemodynamic response to tracheal intubation and surgical stimulation has been studied in 22 patients. Enalapril 5 mg given 4 hours before operation was associated with a significant reduction in the pressor response associated with intubation (p < 0.05) and surgical stimulation (p < 0.005) compared with control. Heart rate changes were similar in the two groups. The role of the renin‐angiotensin system in relation to the pressor response to sympathetic stimulation is discussed and it is concluded that angiotensin‐converting enzyme inhibitors may help improve peri‐operative cardiovascular stabiity.
Pulmonary oedema following carbamazepine overdose
Authors: KITSON G. E. , WAUCHOB T. D. 
Published: February 2007

SummaryThe successful management of a case of pulmonary oedema is described after the late recognition of an overdose of carbamazepine which complicated recognised benzodiazepine overdosage. The presentation and management are described and the possible mechanism of this rare complication discussed.
The control of post‐thoracotomy pain. A comparative evaluation of thoracic epidural fentanyl infusions and cryo‐analgesia
Authors: Gough J. D. , Williams A. B. , Vaughan R. S. , Khalil J. F. , Butchart E. G. 
Published: February 2007

SummaryThis is a comparative study of two methods to relieve postoperative thoracotomy pain. Continuous thoracic epidural infusion of fentanyl produced superior analgesia when compared with cryo‐analgesia of the relevant thoracic nerves. Linear analogue pain scores were consistently lower in the epidural group reaching significance (p < 0.05) at 32 and 40 hours after operation. All 36 patients in the cryo‐analgesia group required additional analgesia, while 12 out of the 32 patients in the epidural group did not. This difference was significant at p < 0.001. Respiratory and cardiovascular measurements were similar in both groups and the only side effect attributable to the epidural fentanyl was itching but this was not a problem.
Epidural fentanyl for shaking in obstetrics
Authors: Matthews N. C. , Corser G. 
Published: February 2007

SummaryThis study assesses the efficacy of epidural fentanyl in the relief of shaking associated with epidural analgesia. Fifty mothers whose shaking was sufficient to cause distress were divided randomly to receive either fentanyl 25 μg in 5 ml sterile normal saline or 5 ml of saline through their in‐situ epidural. Shaking stopped within 15 minutes in 18 out of 25 (72%) of those given fentanyl but in only 4 out of 25 (16%) of the saline group and this is statistically significant (p < 0.01). Fentanyl can be recommended in this context.
Successful difficult intubation
Authors: KIDD J. F. , DYSON A. , LATTO I. P. 
Published: February 2007

SummaryThe reliability of two signs of tracheal placement of a gum elastic bougie was studied. These signs were clicks (produced as the tip of the bougie runs over the trachea! cartilages) and hold up of the bougie as it is advanced (when the tip reaches the small bronchi). Ninety‐eight simulated and two genuine Grade 3 difficult intubations were attempted with the aid of a gum elastic bougie. Seventy‐eight trachea/ and 22 oesophageal placements of the bougie resulted. No clicks or hold up occurred with the bougie in the oesophagus. Clicks were recorded in 89.7% of tracheal placements of the bougie. Hold up at between 24–40 cm occurred in all tracheal placements. We conclude that these signs are reliable and that they should be taught as part of any difficult intubation drill in which the gum elastic bougie is used.
Anaesthetic management in patients with epidermolysis bullosa dystrophica
Authors: HAGEN R. , LANGENBERG C. 
Published: February 2007

SummarySuccessful anaesthetic management of two patients with severe epidermolysis bullosa dystrophica was accomplished with the use of ketamine—diazepam dissociative anaesthesia in one and brachial plexus block in the other. The classification and pathology of epidermolysis bullosa is considered, and the problems associated with anaesthesia in patients with this disease are discussed.
Nifedipine prevents the pressor response to laryngoscopy and tracheal intubation in patients with coronary artery disease
Authors: Kale S.C. , Mahajan R.P. , Jayalakshami T.S. , Raghavan V. , Das B. 
Published: February 2007

SummaryThe efficacy of sublingual nifedipine, administered one minute before anaesthetic induction, in order to minimise the pressor response to laryngoscopy and tracheal intubation was studied in a group of 15 patients who underwent coronary artery bypass surgery. Another group of 15 similar patients served as control. Premedication consisted of oral diazepam 5–10 mg, intramuscular morphine 0.2 mg/kg and promethazine 0.4 mg/kg. Anaesthesia was induced with morphine. 0.1–0.15 mg/kg and thiopentone 3–5 mg/kg. Laryngoscopy and tracheal intubation were facilitated with suxamethonium 1.5 mg/kg. A significant increase in blood pressure occurred during and after laryngoscopy and tracheal intubation in the control group. This increase was absent in the patients pretreated with nifedipine. The nifedipine group also maintained a lower rate‐pressure‐product than the control group during the period of study. It is concluded that nifedipine 10 mg is a useful pretreatment to prevent the pressor response to laryngoscopy and tracheal intubation in patients with coronary artery disease.
Peri‐operative dreaming and awareness in children
Authors: HOBBS A. J. , BUSH G. H. , DOWNHAM D. Y. 
Published: February 2007

SummaryDreaming under anaesthesia was investigated in a prospective study of 120 day case paediatric patients, aged 5–17 years, who underwent a variety of surgical procedures. Patients were anaesthetised using the ‘Liverpool technique’ of paediatric anaesthesia (nitrous oxide‐oxygen‐relaxant). No patient reported awareness, but 23 of 120 patients (19%) reported dreams. Analysis of the data revealed that the choice of muscle relaxant, (nondepolarising or depolarising) had a statistically significant effect on the incidence of dreaming (p < 0.05). It is suggested that the technique of intermittent intravenous suxamethonium may result in increased muscle spindle discharge and cause cerebral arousal and an increased incidence of dreaming.
Clinical relevance of the B12/N2O interaction A report of a seminar
Authors: NUNN J. F. 
Published: February 2007

SummaryThe interaction of nitrous oxide and vitamin B12 and its implications are not the exclusive territory of any one discipline. The initial discovery was by a chemist but it is of obvious relevance to anaesthetists and intensivists; some complications are neurological others haematological. The interaction provides an extremely important research tool as the first easily available B12‐deficient animal model. Finally there are implications for exposure to contaminated atmospheres in hospitals and in industry.
Edrophonium–hyoscine butylbromide mixture for reversal of neuromuscular blockade: heart rate changes in infants and children
Authors: Yamashita M. , Tajima K. 
Published: February 2007

SummaryThe effectiveness of hyoscine butylbromide in the prevention of edrophonium‐induced bradycardia was assessed in 50 infants and children. A mixture of edrophonium (1.0 mg/kg) and either atropine (0.01 mg/kg) or hyoscine butylbromide (0.4 mg/kg) was administered to reverse the effects of tubocurarine. An initial bradycardia followed the injection of the edrophonium‐atropine mixture. In contrast there was no initial decrease in heart rate after the administration of the edrophonium‐hyoscine butylbromide mixture. Hyoscine butylbromide can be used with advantage as a substitute for atropine in edrophonium reversal in infants and children.
Resuscitation in late pregnancy
Authors: REES G. A. D. , WILLIS B. A. 
Published: February 2007

SummaryThis paper considers cardiopulmonary resuscitation in obstetric patients at term and the influence of aortocaval compression on the outcome. The maximum chest compression force produced by eight physicians was measured as a function of angle of inclination using an inclined plane. The compression force at an angle of 27° is 80% of that in the supine position and the Cardiff resuscitation wedge, designed to prevent aortocaval compression, is described with this inclination. Midwives' expertise in basic life support 6 months after instruction was assessed using a manikin simulator. The majority had acquired errors in external chest compression and mouth to mouth ventilation. These were corrected by additional tuition. Resuscitation of the manikin on the Cardiff wedge was found to be as efficient as in the supine position.
Which intravenous induction agent for day surgery?
Authors: HEATH P. J. , KENNEDY D. J. , OGG T. W. , DUNLING C. , GILKS W. R. 
Published: February 2007

SummaryEighty day patients for the vaginal termination of pregnancy were randomly allocated to receive thiopentone, propofol, methohexitone or etomidate as intravenous induction agents. The same anaesthetist administered the anaesthesia and all the observers were blind to the agents used. The results show that thiopentone and propofol produced the least sequelae at induction and in recovery. Furthermore, both agents produced a high quality of induction and recovery. All patients were discharged home 2 hours postoperatively and there was no obvious delay in recovery. This study has altered clinical practice in our Day Surgery Unit.
A severe coagulopathy following volume replacement with hydroxyethyl starch in a Jehovah's Witness
Authors: LOCKWOOD D. N. J. , BULLEN C. , MACHIN S. J. 
Published: February 2007

SummaryBlood volume was maintained by an infusion of hydroxyethyl starch 2000 ml (Hespan: HES) during and for the first 28 hours after a major orthopaedic operation in a 13‐year‐old girl who was a Jehovah's Witness. This was responsible for a generalised clinical haemorrhagic state, an acquired coagulopathy associated with a shortened thrombin, prolonged prothrombin and activated partial thromboplastin times, and an acquired von Willebrand syndrome. The coagulation, after cessation of the infusion of HES, did not become normal until approximately 72 hours later.
One lung high frequency ventilation for peroral sealing of bronchial stump fistulae
Authors: Mallios C. , van Stolk M. A. , Scheck P. A. , Overbeek S. E. , Sie T. H. 
Published: February 2007

SummaryThe use of high frequency ventilation for 28 repairs of bronchial stump fistulae with fibrin sealant is discussed. Intravenous anaesthesia with continuous infusions of methohexitone, alfentanil and suxamethonium was employed. This method of anaesthesia and ventilation proved to be satisfactory.
Teaching guided fibreoptic nasotracheal intubation
Authors: Coe P. A. , T. A. King, MB, ChB, FFARCS  , R. M. Towey, MB, ChB, FFARCS  
Published: February 2007

SummaryAn anaesthetic technique suitable for training infibreoptic intubation is described. It uses a capped oropharyngeal airway which leaves the nose free for fibreoptic intubation and allows the airway to be maintained and ventilation to be controlled if necessary. An assessment is made of the technique after 50 fibreoptic intubations with the Olympus LF‐1 fibrescope. There were no failed intubations and no serious complications.
Urea and electrolyte measurement in pre‐operative surgical patients
Authors: McCleane G.J. 
Published: February 2007

SummaryIn a prospective study of 1062 patients who presented for routine and emergency surgical procedures, the frequency of urea and electrolyte measurement was determined. In addition, the incidence of abnormal urea and electrolyte measurements were recorded. It was found that these abnormal values were most frequent in the paediatric population (though they they had the fewest urea and electrolyte measurements performed) and in the over 60s. The American Society of Anesthesiologists' grade was found to he a useful predictor as to whether the urea and electrolyte measurement could be expected to be abnormal. It is suggested that American Society of Anesthesiologists' Grade I patients do not require routine urea and electrolyte measurements whilst those in grades 3, 4 and 5 and those on diuretics do.
Effects of thiopentone, etomidate and propofol on the haemodynamic response to tracheal intubation
Authors: HARRIS C. E. , MURRAY A. M. , ANDERSON J. M. , GROUNDS R. M. , MORGAN M. 
Published: February 2007

SummaryThe haemodynamic response to tracheal intubation was compared in 303 patients in whom anaesthesia was induced with either thiopentone 4 mg/kg, etomidate 0.3 mg/kg or propofol 2.5 mg/kg, with and without fentanyl 2 μg/kg. There was after propofol alone a significant decrease in arterial blood pressure, which did not increase above control values after intubation. Significant increases in arterial pressure followed intubation in patients induced with thiopentone or etomidate alone. Increases in heart rate occurred with all agents after laryngoscopy. The use of fentanyl resulted in arterial pressures lower than those after the induction agent alone, and in an attentuation, but not abolition of the responses to largyngoscopy and intubation.
Effect of propofol on cerebral blood flow and metabolism in man
Authors: VANDESTEENE A. , TREMPONT V. , ENGELMAN E. , DELOOF T. , FOCROUL M. , SCHOUTENS A. , de ROOD M. 
Published: February 2007

Summary Cerebral blood flow, cerebral oxygen consumption, lactate and glucose metabolism were measured in 13 patients during anaesthesia with nitrous oxide, oxygen and enflurane 0.5% and after 30 minutes infusion of propofol. The mean blood concentration of propofol was 4.06μg/ml. Cerebral blood flow decreased by 27.6% and cerebral vascular resistance by 51%. There were no changes in lactate and glucose metabolism. Cerebral oxygen consumption decreased by 18.25%. Changes in the electroencephalograph were related to the blood levels of propofol.
Changes in intra‐ocular pressure in the elderly during anaesthesia with propofol
Authors: GUEDES Y. , RAKOTOSEHENO J. C. , LEVEQUE M. , MIMOUNI F. , EGRETEAU J. P. 
Published: February 2007

SummaryVariations in intra‐ocular pressure during anaesthesia were studied in two groups of 15 elderly patients selected randomly. The groups were not significantly different with regard to age, sex, weight or ASA classification. The first group received intravenous propofol as a bolus followed by a continuous infusion. The second group received a bolus of thiopentone followed by maintenance with enflurane. Intra‐ocular pressure, heart rate and arterial pressure were measured before and after induction, after intubation and at the end of the operation. Overall, compared with baseline values, the results showed a decrease in intra‐ocular pressure of 31% in group I and 17% in group 2, and a decrease in systolic arterial pressure of 14% in both groups.
Propofol for electroconvulsive therapy
Authors: ROUSE E. C. 
Published: February 2007

SummaryTwenty patients who received electroconvulsive therapy were anaesthetised with either propofol or methohexitone in a randomised crossover study. Recovery times were similar but patients who received propofol tended to be arientated sooner. The decrease in arterial blood pressure after induction was greater with propofol than with methohexitone. There was an increase in blood pressure immediately after therapy in patients who received methohexitone but not in those given propofol. There was a slight difference in pain on injection. The mean duration of convulsion (measured in 10 patients) during anaesthesia was shorter with propofol than with methohexitone.
A comparison between propofol and ketamine for anaesthesia in the elderly. Haemodynamic effects during induction and maintenance
Authors: Maneglia R. , Cousin M. T. 
Published: February 2007

SummaryThe haemodynamic effects of propofol and ketamine were studied in two groups of eight randomly allocated elderly patients (mean age 85.8 years) anaesthetised for hip replacement. Group 1 patients received propofol 1 mg/kg by intravenous bolus for induction and 0.1 mg/kg/minute by continuous infusion for maintenance. Group 2 patients received ketamine 1.5 mg/kg by intravenous bolus as induction dose and 50 μg/kg/minute by continuous infusion for maintenance. All patients breathed spontaneously via a facemask at FIO2 1.0. Haemodynamic status was established before induction and at 1, 3, 5, 10 and 15 minutes after induction. Arterial pressure and cardiac output decreased slightly in group 1 but heart rate, right atrial pressure and pulmonary arterial pressure remained unchanged. Myocardial oxygen consumption showed a significant decrease of 27%. There was a significant increase in blood pressure and pulmonary capillary wedge pressure (by 97%) in group 2. Cardiac output and systemic vascular resistance remained unchanged whereas myocardial oxygen consumption showed a very significant increase of 100%.