bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of bromothymol blue and sodium thiopentone to confirm tracheal intubation
Authors: DEAN V. S. , DINGLEY J. , VAUGHAN R. S. 
Published: February 2007

SummaryThe possibility of using chemical changes to confirm correct tracheal tube placement was investigated with a view to their use in developing countries where more sophisticated methods are unavailable. The effect of bubbling expired gases through a 10% solution of bromothymol blue and a 0.25% solution of thiopentone led to chemical changes producing, in the case of bromothymol blue, a colour change and in that of thiopentone, precipitation, probably due to a change in pH caused by carbon dioxide. We also discovered that the time to precipitation of the thiopentone could be greatly reduced if it was mixed with a precise quantity of lignocaine. These simple end points can reliably confirm the correct placement of a tracheal tube at least as rapidly as the correct use of capnography.
An evaluation of the levering laryngoscope
Authors: Tuckey J. P. , Cook T. M. , Render C. A. 
Published: February 2007

SummaryThis study was undertaken to evaluate the effect of the levering laryngoscope on the view obtained at laryngoscopv. Two hundred and ten consecutive patients who required tracheal intubation were studied. The view at laryngoscopy with the levering laryngoscope blade in the neutral and elevated positions was recorded. In patients in whom there was a Cormack and Lehane grade 3 view of the larynx with the blade in the neutral position, elevation of the levered tip of the blade significantly improved the visualisation of the larynx. In patients where the view of the larynx was grade 1 or 2 with the blade in the neutral position, elevation of the levered tip often (23%) resulted in the view being impaired. This was not a clinical problem as the blade could simply be returned to the neutral position. The levering laryngoscope is a useful additional aid to laryngeal visualisation.
Peri‐operative hypoxaemia in children undergoing application of a plaster jacket for scoliosis
Authors: LOVELL A. T. , RAY S. , FOX R. S. R. , TAYLOR V. M. 
Published: February 2007

Summary Twenty children (six female), median age 24 months (range 12–156) who presented for application of a plaster jacket for scoliosis were studied pre‐operatively with pulse oximetry overnight and on the first postoperative night. Pre‐operatively the median (range) arterial oxygen saturation was 97 (95–98)%, although eight children had short episodes of desaturation to <90%. Postoperatively the median saturation was unchanged, and nine children had short episodes of desaturation. Neither the presence of episodes of desaturation pre‐operatively, nor the median or lowest saturation recorded were predictors of postoperative median saturation or the presence of episodes of desaturation. Despite the presumed reduction in chest wall compliance, the application of a plaster jacket for scoliosis in these young children was not associated with a significant change in their oxygenation.
Quantifying the effect of isoflurane on mivacurium infusion requirements
Authors: MD M. KANSANAHO , OLKKOLA K. T. 
Published: February 2007

Summary We evaluated the effect of different concentrations of isoflurane in a nitrous oxide/oxygen mixture on the infusion requirements of mivacurium in 60 adult surgical patients. Anaesthesia was induced with thiopentone andfentanyl, and intubation was facilitated with mivacurium 0.15mg.kg‐1. The patients were randomly assigned to one of four study groups. The control group received nitrous oxide in oxygen (2:1) anaesthesia supplemented with fentanyl. In the other groups, isoflurane was administered at different end‐tidal concentrations: 0.29%, 0.58% and 1.15%, corresponding to 0.25, 0.5 and 1.0 MAC of isoflurane, respectively. Neuromuscular block was maintained at 95% with a computer‐controlled infusion of mivacurium and monitored with electromyography. The mean (SD) steady‐state infusion requirements of mivacurium in patients receiving nitrous oxide‐fentanyl anaesthesia or isoflurane 0.25–0.5 MAC were similar, ranging from 6.1 (2.2) to 5.1 (2.1) μg.kg‐1.min‐1. Isoflurane 1.0 MAC reduced mivacurium infusion requirements by 32% (p < 0.01). Interindividual differences in mivacurium infusion requirements were large.
Comparison of bladder, oesophageal and pulmonary artery temperatures in major abdominal surgery
Authors: Russell S. H. , Freeman J. W. 
Published: February 2007

SummaryIn this study we compared urinary bladder and oesophageal temperatures with the core temperature obtained from a pulmonary artery catheter in patients undergoing orthotopic liver transplantation. The bladder temperature was a closer approximation to pulmonary artery temperature in this group of patients than the oesophageal temperature and has much to recommend it in terms of convenience, safety and postoperative patient comfort.
Postanaesthetic shivering in children
Authors: LYONS B. , TAYLOR A. , POWER C. , FFARCSI W. CASEY 
Published: February 2007

SummaryThis study was designed to assess the incidence, severity and possible aetiological factors ofpostanaesthetic shivering in children. Three hundred and seventy‐six children undergoing general anaesthesia were enrolled in the study. Tympanic membrane temperatures were recorded pre‐operatively and every 15 min postoperatively in the recovery room until discharge to the ward. Also recorded were all anaesthetic data including fluid administration, methods of temperature preservation used, sedation scores and shivering (using a four‐point scale). The overall incidence of shivering was 14.4%. Multiple regression analysis identified three factors that were significantly related to shivering: age, the administration of atropine and peri‐operative temperature changes. Children who shivered rewarmed faster in the recovery room.
The effect of syntocinon on blood loss during first trimester suction curettage
Authors: Ali P. B. , Smith G. 
Published: February 2007

SummaryWe have studied 64 pregnant women (9 weeks gestation and greater undergoing elective vaginal termination of pregnancy.) They were allocated randomly to one of two groups to receive either 1 ml (10 units) of syntocinon or 1 ml of saline (placebo) after cervical dilatation. Anaesthesia was standardised and surgery was performed by a single blinded gynaecologist, who assessed the size of the uterus and graded uterine contractility. All patients received a Cervagem vaginal suppository 70‐270 min before surgery. The volume of blood loss was calculated colorimetrically and found to be less than 100 ml in all patients. The median blood loss in the syntocinon group (n = 30) was 17.6 ml, (range 6.1‐12.7) and was significantly less than that in the placebo group (n = 34), median blood loss 24.5ml, (range 6.7–94.3) (p = 0.02). Six patients in the saline group had unsatisfactory uterine contraction compared with none in the syntocinon group (p = 0.025).
Does post‐laparoscopy pain relate to residual carbon dioxide?
Authors: Jackson S. A. , Laurence A. S. , Hill J. C. 
Published: February 2007

SummaryWe studied 20 day case gynaecological laparoscopy patients, who had an erect chest X ray taken before discharge. Patients were telephoned the next day for a semi‐structured interview. Particular note was made of shoulder tip pain and pain relieved by changing posture. The X ray was analysed for measurements of the length of arc and height of the gas bubble under each hemi‐diaphragm, from which an estimation of bubble volume was also made. We found statistically significant correlations between both the length of arc (p = 0.005) and volume of gas bubble (p = 0.008) on the right side, with the pain score. Residual gas can be a prominent cause of post‐laparoscopy pain.
The haemodynamic effects of propofol in combination with ephedrine
Authors: Gamlin F. , Vucevic M. , Winslow L. , Berridge J. 
Published: February 2007

SummaryForty ASA1 patients presenting for minor gynaecological surgery were randomly allocated into four study groups to compare the haemodynamic effects of adding different doses of ephedrine to an induction dose of propofol. Heart rate, oxygen saturation and non‐invasive arterial blood pressure were monitored before and for 5 min after induction. In those patients who received propofol alone, there was a significant decrease in both systolic (p < 0.001) and diastolic (p = 0.003) blood pressure. The addition of ephedrine 15 mg or 20 mg to 1% propofol 20 ml was very effective in maintaining blood pressure at pre‐induction values. There was a statistically significant increase from baseline in systolic (p = 0.004) and diastolic (p = 0.031) pressures, but this only occurred at 1 min postinduction. The addition of ephedrine 10 mg was insufficient to prevent hypotension. There was no significant effect on either heart rate or oxygen saturation in any group. We conclude that ephedrine may be safely employed to reduce the degree of hypotension during induction with propofol in this patient group.
Spinal anaesthesia induced by intrathecal magnesium sulphate An experimental study in a rat model
Authors: BAHAR M. , CHANIMOV M. , GRINSPUN E. , KOIFMAN I. , COHEN M. L. 
Published: February 2007

SummaryWe have demonstrated in a rat model that the intrathecal injection of 0.02 ml of 6.3% magnesium sulphate, a concentration iso‐osmolar with rat plasma, will produce a state of spinal anaesthesia and general sedation, lasting approximately 1 h. These effects reversed completely after 6 h, without evidence of neurotoxicity, immediately or during the period 1 week following the injection. The accompanying changes in haemodynamic and respiratory functions were minimal throughout the period of anaesthesia and compare favourably with those induced by an intrathecal bolus of 0.04 ml of 2% lignocaine.
An investigation of the effects of heparin, low molecular weight heparin, protamine, and fentanyl on the balance of pro‐ and anti‐inflammatory cytokines in in‐vitro monocyte cultures
Authors: McBRIDE W.T. , ARMSTRONG M.A. , McMURRAY T.J. 
Published: February 2007

SummaryWe report a study conducted to determine if drugs given peri‐operatively during cardiac surgery could themselves modulate the balance of pro‐ and anti‐inflammatory cytokines. We determined the cytokine response of 10 separate in vitro monocyte cultures to the administration of drugs at concentrations used during cardiac surgery: fentanyl (25ng.ml‐1), heparin 2.5 i.u.ml‐1, heparin with an equal concentration of protamine, and enoxaparin 2.5i.u.ml‐1. Fentanyl, heparin and low molecular weight heparin (enoxaparin) led to increased tumour necrosis factor alpha but this did not reach statistical significance. Tumour necrosis factor soluble receptor 1 and 2 was not elevated. Interleukin‐1 beta was increased by heparin (p < 0.05), whereas interleukin‐1 receptor antagonist was increased by fentanyl (p < 0.05). Protamine blocked the heparin‐induced increase in tumour necrosis factor alpha and interleukin‐1 beta. These data raise the possibility that endogenous and exogenously administered opioids may be partly contributing to the interleukin‐1 receptor antagonist response seen during major surgery.
Silent myocardial ischaemia in patients undergoing transurethral prostatectomy
Authors: WINDSOR A. , FRENCH G. W. G. , SEAR J. W. , SEAR J. W. , FOËX P. , MILLETT S. V. , HOWELL S. J. 
Published: February 2007

SummaryNinety four patients undergoing transurethral resection of the prostate underwent Holter electrocardiographic monitoring pre‐and postoperatively. There was no difference in silent myocardial ischaemia incidence or load between the spinal (n = 60) ami the general anaesthesia (n = 34) groups. Ischaemic heart disease and a higher Detsky score both significantly increased the incidence of silent myocardial ischaemia but not the ischaemic load of those patients that actually demonstrated ischaemia. In this specific surgical population, not undergoing cardiac or vascular surgery, both ischaemic heart disease and cardiac risk scores are poor predictors of ischaemic load. Merely the presence of short duration silent myocardial ischaemia probably has little predictive value for postoperative adverse outcome.
Prolapsed intervertebral disc after epidural analgesia in labour
Authors: Forster M. R. , Nimmo G. R. , Brown A. G. 
Published: February 2007

SummaryBack pain and minor neurological symptoms are commonly experienced postpartum, often being attributed to non‐specific causes such as maternal obstetric factors, or the use of epidural analgesia. We report a case in which neurological problems associated with a prolapsed intervertebral disc occurred after epidural analgesia in labour and a normal vaginal delivery.
Lignocaine to aid the insertion of the laryngeal mask airway with thiopentone
Authors: Cook T. M. , Seavell C. R. , Cox C. M. 
Published: February 2007

SummaryConditions for insertion of a laryngeal mask airway in 90 unpremedicated adult patients were assessed in a randomised, single‐blinded trial. Each patient received fentanyl 1 μg.kg‐1 and thiopentone 5 mg.kg‐1, and this was preceded either by lignocaine 0.5mg.kg‐1intravenously (group 1), lignocaine 1.5mg.kg‐1 intravenously (group 2) or 40mg of topical lignocaine spray to the posterior pharyngeal wall (group 3). Conditions for laryngeal mask airway insertion were recorded. The group receiving topical lignocaine had a lower incidence of laryngospasm (p < 0.05), required fewer attempts for successful insertion of the laryngeal mask (p < 0.05) and coughed or gagged less frequently than either group receiving lignocaine intravenously (p > 0.05). Overall, the conditions for laryngeal mask airway insertion were better in the topical group (p < 0.05). There were no significant differences in haemodynamic response and apnoea between the three groups. Topical lignocaine spray prior to thiopentone provides conditions for insertion of a laryngeal mask that are superior to those provided by lignocaine and thiopentone intravenously.
The effect of the addition of lignocaine on propofol emulsion stability
Authors: LILLEY E. M. M. , ISERT P. R. , CARASSO M. L. , KENNEDY R. A. 
Published: February 2007

SummaryThe stability of propofol emulsion following the addition of various amounts of lignocaine solution was investigated, The investigations used were macroscopic and microscopic observations and electroacoustic determination of both droplet size and zeta potential. Evidence of emulsion instability was present following the addition of even small amounts of lignocaine. Resultant changes are unlikely to be clinically important following the addition of less than 20 mg of lignocaine to 200 mg of propofol (20 ml of propofol emulsion). It is recommended, however, that anaesthetists consider the possibility of destabilisation of propofol emulsion when adding larger doses of lignocaine, or when there is a delay between formulation and administration of the propofol‐lignocaine mixtures.
Thiopentone requirements in adults after varying pre‐induction doses of fentanyl
Authors: WANG L. P. , HERMANN C. , WESTRIN P. 
Published: February 2007

Summary The thiopentone dose needed for satisfactory induction of anaesthesia was determined in 60 adult patients using a double‐blinded study design. No premedication was given. The effect of pretreatment with four different doses of fentanyl on ED50 for thiopentone was determined and compared with a control group not receiving fentanyl. The cardiovascular effects of the combinations were also studied. ED50 for thiopentone was reduced from 4.0 mg kg‐1 in the control group to 2.2mg kg‐1 in patients receiving fentanyl 5.0 μg kg‐1. Only in the group of patients receiving fentanyl 5.0 μg. kg‐1 was there no significant change in systolic arterial blood pressure. An increased heart rate was noted in patients induced with thiopentone in combination with fentanyl 0.625 μg kg‐1. No adcerse effkcts of thiopentone, fentanyl or the combinations were noted.
A new critical incident monitor for use with the paediatric T‐piece
Authors: HATCH D. J. , JACKSON E. A. 
Published: February 2007

Summary In vitro studies and clinical evaluation suggest that the Magtrak Infanta Electronic respirometer provides a useful additional critical incident monitor for use with the paediatric T‐piece. During ventilation with the Nuffield 200 ventilator and Newton valve it provides early warning of leaks or disconnections in the breathing system, airway obstruction and reduction in fresh gas flow. Some of these events may not be detected by, conventional monitors.
The hazards of anaesthetic gas scavenging systems
Authors: Farquhar‐Thomson D. R. , Goddard J. M. 
Published: February 2007

Summary The function of scavenging equipment is to remove waste anaesthetic gases from the operating theatre and thus reduce the potentially harmful effects these agents may have on staff. However, these systems can pose a serious risk to patients which is not well recognised. We describe two cases where harm to patients could have occurred as a result of faulty or inappropriate equipment being used and inadequate checking of scavenging systems.
Remote controlled prolonged conscious sedation for gynaecological radiotherapy
Authors: Oei‐Lim V. L. B. , Kalkman C. J. 
Published: February 2007

Summary Conscious sedation with subanaesthetic doses of propofol is an effective technique for the management of highly anxious patients in dentistry. Prolonged administration of propfol to achieve conscious sedation in spontaneously breathing patients without an airway adjunct has not been reported previously. We describe the management of target‐controlled conscious sedation with propofol for 21 h in a patient undergoing gynaecological radiotherapy.
Intrathecal administration of morphine for elective Caesarean section
Authors: Milner A. R. , Bogod D. G. , Harwood R. J. 
Published: February 2007

Summary This study compared the quality of analgesia and incidence of adverse effects with two doses of intrathecal morphine in patients undergoing elective Caesarean section. Fifty patients were randomly allocated to receive either morphine 0.1 mg or 0.2 mg in addition to a standard intrathecal dose of 2.5 ml bupivacaine 0.5% in 8% dextrose. The quality of analgesia was assessed using visual analogue scores and the incidence of nausea, vomiting and itching were recorded during the first 24 h postoperatively. There was no statistically significant difference in the quality of analgesia nor in the incidence and severity of itching between the two groups. Fewer patients in the 0.1 mg morphine group experienced postoperative nausea and vomiting (7 versus 14, p < 0.05). We conclude that the use of 0.1 mg morphine intrathecally produces comparable analgesia to 0.2 mg after Caesarean section with significantly less nausea and vomiting.
Routine suxamethonium in children
Authors: Robinson A. L. , Jerwood D. C. , Stokes M. A. 
Published: February 2007

Summary This survey aimed to assess the extent and pattern of use of suxamethonium for elective tracheal intubation in children and the occurrence of major complications. A postal questionnaire was sent to 280 consultant anaesthetists and senior registrars in the West Midlands Region. Of the 180 replies received, 84% of respondents use suxamethonium routinely. Usage was more common amongst those more recently trained (all anaesthetists with less than 10 years experience reported using suxamethonium for routine intubation compared with 81% of those with over 20 years experience). Reported side effects directly attributable to suxamethonium were common, the most freqent being cardiac arrhythmias (especially bradycardia) following the first dose (24% respondents) or the second dose (43%), and prolonged apnoea (36% of respondents). There were 13 reported cardiac arrests (requiring external cardiac massage), three of which were associated with repeat dosing and one with undiagnosed Duchenne muscular dystrophy. Three cases of documented hyperkalaemia did not lead to cardiac arrest. There were two deaths, neither of which could be solely attributed to the use of suxamethonium. We conclude that suxamethonium remains popular in puediatric practice and that minor side effects are common and usually preventable. Life‐threatening reactions are rare and until a truly comparable alternative is produced this drug will continue to be used in children.
WVD2 is a novel microtubule‐associated protein in Arabidopsis thaliana
Authors: Perrin Robyn M. , Wang Yan , Yuen Christen Y.L. , Will Jessica , Masson Patrick H. 
Published: February 2007

SummaryArabidopsis WAVE‐DAMPENED 2 (WVD2) was identified by forward genetics as an activation‐tagged allele that causes plant and organ stockiness and inversion of helical root growth handedness on agar surfaces. Plants with high constitutive expression of WVD2 or other members of the WVD2‐LIKE (WDL) gene family have stems and roots that are short and thick, have reduced anisotropic cell elongation, are suppressed in a root‐waving phenotype, and have inverted handedness of twisting in hypocotyls and roots compared with wild‐type. The wvd2‐1 mutant shows aberrantly organized cortical microtubules in peripheral root cap cells as well as reduced branching of trichomes, unicellular leaf structures whose development is regulated by microtubule stability. Orthologs of the WVD2/WDL family are found widely throughout the plant kingdom, but are not similar to non‐plant proteins with the exception of a C‐terminal domain distantly related to the vertebrate microtubule‐associated protein TPX2. in vivo, WVD2 and its closest paralog WDL1 are localized to interphase cortical microtubules in leaves, hypocotyls and roots. Recombinant glutathione‐S‐transferase:WVD2 or maltose binding protein:WVD2 protein bind to and bundle microtubules in vitro. We speculate that a C‐terminal domain of TPX2 has been utilised by the WVD2 family for functions critical to the organization of plant microtubules.
A high‐throughput screen of cell‐death‐inducing factors in Nicotiana benthamiana identifies a novel MAPKK that mediates INF1‐induced cell death signaling and non‐host resistance to Pseudomonas cichorii
Authors: Takahashi Yoshihiro , Nasir Khairun Hisam Bin , Ito Akiko , Kanzaki Hiroyuki , Matsumura Hideo , Saitoh Hiromasa , Fujisawa Shizuko , Kamoun Sophien , Terauchi Ryohei 
Published: February 2007

SummaryA high‐throughput overexpression screen of Nicotiana benthamiana cDNAs identified a gene for a mitogen‐activated protein kinase kinase (MAPKK) as a potent inducer of the hypersensitive response (HR)‐like cell death. NbMKK1 protein is localized to the nucleus, and the N‐terminal putative MAPK docking site of NbMKK1 is required for its function as a cell‐death inducer. NbMKK1‐mediated leaf‐cell death was compromised in leaves where NbSIPK expression was silenced by virus‐induced gene silencing. A yeast two‐hybrid assay showed that NbMKK1 and NbSIPK physically interact, suggesting that NbSIPK is one of the downstream targets of NbMKK1. Phytophthora infestans INF1 elicitor‐mediated HR was delayed in NbMKK1‐silenced plants, indicating that NbMKK1 is involved in this HR pathway. Furthermore, the resistance of N. benthamiana to a non‐host pathogen Pseudomonas cichorii was compromised in NbMKK1‐silenced plants. These results demonstrate that MAPK cascades involving NbMKK1 control non‐host resistance including HR cell death.