bluuebunny/crossref_metadata_2025_split huggingface dataset:
Second stage of labour with or without extradural analgesia
Authors: PHILLIPS K. C. , THOMAS T. A. 
Published: February 2007

SummaryTwo groups of parturients who had received selective extradural analgesia were studied. In Group A patients the regional block was allowed to wear off for the second stage of labour whereas in Group B patients' analgesia was maintained throughout labour.The maintenance of selective analgesia was of positive benefit to the mothers. They experienced much less pain, labour was not prolonged, dosage of bupivacaine was not increased, the forceps delivery rate was lower and there were fewer persistent malrotations.
Cardiovascular response to intubation
Authors: BORALESSA H. , SENIOR D. F. , WHITWAM J. G. 
Published: February 2007

SummaryThe cardiovascular response evoked by tracheal intubation was observed in 20 patients undergoing elective abdominal surgery in whom anaesthesia was induced with either midazolam 0.3 mg/kg or thiopentone 4.5 mg/kg followed by pancuronium 0.1 mg/kg. In the thiopentone group, intubation caused a mean rise in systolic arterial pressure from 141 to 193 mmHg (p < 0.0005) and in the heart rate‐systolic pressure product from 11101 to 21763 (p < 0.05); 5 minutes later the mean values were still 173 mmHg and 19030 respectively. In the midazolam group systolic arterial pressure and the rate pressure product increased from 138 to 151 mmHg and 10960 to 14267 respectively in response to intubation. These values were significantly lower than the thiopentone group (p < 0.005 in each case) and were relatively transient and returned to control values within 5 minutes.
Pethidine, atropine, metoclopramide and the lower oesophageal sphincter
Authors: HEY V. M. F. , PHILLIPS K. , WOODS I. 
Published: February 2007

SummaryThe effects of an intramuscular injection of pethidine (1.5 mg/kg) plus atropine 0.5 mg, or pethidine (1.5 mg/kg) plus atropine 0.5 mg plus metoclopramide 10 mg on the lower oesophageal sphincter pressure have been studied manometrically in human volunteers. The mean barrier pressure in the former group was significantly lower than the baseline for the 75 minutes studied. In the latter group the mean barrier pressure was significantly lower than the baseline value for the first 45 minutes only of the study. The addition of atropine 0.5 mg to pethidine 1.5 mg/kg further lowers the barrier pressure when compared with the depression seen with pethidine alone in a previous study. While the addition of intramuscular metoclopramide to the mixture of pethidine and atropine fails to return the mean barrier pressure to the baseline value, it does raise the mean barrier pressure to a level which is probably above the opening pressure of the lower oesophageal sphincter.
An unusual complication of lithotripsy
Authors: SUNDNES K. O. , VAAGENES P. , KVARSTEIN B. 
Published: February 2007

SummaryThe case described illustrates a most unusual course of events due to a perforation in the wall of the bladder during transurethral lithotripsy. Irrigation fluid forced its way retroperitoneally to the mediastinum. The differential diagnostic problems encountered are discussed.
An apparatus for the delivery of 50% premixed nitrous oxide and oxygen on demand or by controlled ventilation
Authors: NANCEKIEVILL D. G. 
Published: February 2007

SummaryA small, portable and robust apparatus for the administration of 50% premixed nitrous oxide and oxygen mixture for analgesia for hospital and emergency use is described. The equipment can deliver the mixture on demand or by intermittent positive pressure ventilation. It has important advantages over earlier devices particularly in the accident and emergency field in which it has already proved successful.
Lorazepam as a premedicant for regional anaesthesia
Authors: RUSSELL W. J. 
Published: February 2007

SummaryIn a double‐blind controlled trial of male patients undergoing transurethral resection of the prostate, oral lorazepam was assessed against a placebo. The same anaesthetist performed all spinal blocks and made all assessments. The patients who received lorazepam had substantial amnesia for the operation and were drowsier, but remained cooperative during the procedure. Patient anxiety as assessed by the anaesthetist and as recalled by the patient was decreased, although anxiety assessment by linear analogue was the same for both groups. Lorazepam significantly increased the patient acceptability of spinal anaesthesia.
Hypersensitivity reactions to Althesin infusion: measurement of complement involvement
Authors: BENOIT Y. , CHADENSON O. , DUCLOUX B. , VEYSSEYRE C. M. , BRINGUIER J. P. , VEYSSEYRE C. , DESCOTES J. 
Published: February 2007

SummaryTwo cases of hypersensitivity reactions in the course of slow infusion of Althesin are reported. Serial examination of their complement system showed a marked activation of the alternate pathway which returned almost to normal within 24 hours.
Plasma concentrations of atropine after rectal administration
Authors: OLSSON G. L. , BEJERSTEN ANNETTE , FEYCHTING H. , PALMÉR LENA , PETTERSSON BRITT‐MARIE 
Published: February 2007

SummaryThe rectal administration of the premedication for children is often preferred in order to minimise discomfort. The appropriate dose of atropine when rectally administered is poorly documented. In this study six children weighing between 7.5 and 41 kg were given 0.02 mg atropine sulphate/kg rectally and four children were given the same doses intramuscularly. Plasma concentrations of atropine were analysed at several intervals after administration by a modified mass fragmentographic method accurate to 0.1 ng/ml. Peak plasma concentration of atropine, reached after 15 minutes, was 0.7 ng/ml, compared with 2.40 ng/ml reached after 5 minutes for the intramuscular route. The relation between intramuscular and rectal peak concentration was 3.2:1.
Antidiuretic hormone concentrations following midazolam premedication
Authors: Sjövall Sari , Kanto Jussi , Grönroos Matti , Himberg Jaakko‐Juhani , Kangas Lauri , Viinamäki Osmo 
Published: February 2007

SummaryMidazolam given orally the night before and on the morning of operation had a distinct subjective pre‐operative sedative effect as compared with placebo. Patients receiving midazolam also experienced less apprehension and excitement before surgery, but in relation to quality of sleep, the difference between the two groups was not statistically significant. Antidiuretic hormone (ADH) concentrations were determined just before induction of anaesthesia and were significantly lower in the midazolam group (2.14 pg/ml, SD 0.96) than in the placebo group (3.07 pgjml, SD 1.73). Our results show that midazolam is a useful sedative anxiolytic oral premedicanl, which appears to prevent initiation of a stress reaction before induction of anaesthesia.
Pre‐oxygenation–how long?
Authors: BERTHOUD MIRIELLE , READ D. H. , NORMAN J. 
Published: February 2007

SummaryPre‐oxygenation was studied in 12 fit volunteers and 20 patients using an oxygen flow of 8 litres/minute delivered from a standard anaesthetic machine via a Magill or Bain breathing attachment. End‐tidal nitrogen concentrations of 4% or less were achieved within 3 minutes; the fastest times were achieved using the Magill breathing System when the reservoir bag was filled with oxygen prior to application to the face. Gas‐tight fits of face masks on patients were found to be essential.
Failure of diazepam to prevent the suxamethonium‐induced rise in intra‐ocular pressure
Authors: FENECKL R. O. , COOK J. H. 
Published: February 2007

SummaryThe effects of intravenous suxamethonium chloride (1 mg/kg) on intra‐ocular pressure (IOP) were studied following pretreatment with diazepam 0.05 mg/kg, tubocurarine 0.05 mg/kg, and in a control group, at induction of anaesthesia. In all three groups, a significant increase in IOP was seen during the induction sequence.In a further study, the effects of intravenous suxamethonium chloride (1 mg/kg) on IOP were studied following a period of stable general anaesthesia and pretreatment with diazepam 0.05 mg/kg. A significant rise in IOP was again seen following the administration of suxamethonium. The authors conclude that neither of the techniques described herein will reliably and predictably prevent the rise in IOP seen following the use of suxamethonium.
Protamine titration after cardiopulmonary bypass
Authors: DUTTON D. A. , HOTHERSALL A. P. , McLAREN A. D. , TAYLOR K. M. , TURNER M. A. 
Published: February 2007

SummaryA method of protamine titration, with the use of the ‘Haemochron 400’ system for reversal of heparinisation after cardiopulmonary bypass is described. Twenty‐three patients, average age 47 years, undergoing this procedure for either valve replacement or coronary artery bypass grafting were studied. Accurate reversal of heparinisation was achieved using comparatively small doses of protamine. A linear relationship between the dose ratio of protamine and heparin and the time interval between their respective administrations was defined where only a single dose of heparin had been administered.
The radiological characteristics of bronchopleural fistula following pneumonectomy
Authors: LAUCKNER MORAG E. , BEGGS I. , ARMSTRONG R. F. 
Published: February 2007

SummaryThe radiological appearances of bronchopleural fistula are poorly recorded in the anaesthetic literature. Anaesthetists carry increasing responsibility for postoperative respiratory management. We have, therefore, reviewed the X‐rays of five cases of proven bronchopleural fistula following pneumonectomy and summarised the findings.
Restricted spread of analgesia following epidural blood patch
Authors: RAINBIRD A. , PFITZNER J. 
Published: February 2007

SummaryA complete restriction of upward spread of local analgesic solution in the epidural space is reported in a patient who three years earlier had received an epidural blood patch for post‐spinal headache. Organisation of the blood clot with fibrous tethering of the dura to the wall of the spinal canal is suggested as the most likely cause of this apparent obstruction to spread. Other potential complications of epidural blood patch are presented. It is concluded from the literature on the subject that there is a need for a multi‐centre analysis of the factors which might influence the incidence of inadvertent dural tap with an epidural needle.
Recessive dystrophic epidermolysis bullosa
Authors: TOMLINSON A. A. 
Published: February 2007

SummaryA case report is presented of a patient with recessive dystrophic epidermolysis bullosa requiring anaesthesia for thoraco‐abdominal surgery. The classification and pathology of epidermolysis bullosa is considered together with the clinical features and treatment. The problems associated with anaesthesia and this disease are discussed with special reference to the airway.
Coma following ingestion of halothane
Authors: WIG JYOTSNA , CHAKRAVARTY SATISH , KRISHNAMURTHY K. , MEHTA DAVINDER 
Published: February 2007

SummaryThe management of a rare case of halothane ingestion and a review of the relevant literature is presented. A 35‐year‐old hospital technician who had ingested halothane was admitted to hospital in grade IV coma. He made an uneventful recovery after support in an intensive care unit.
Suxamethonium apnoea associated with pregnancy and liver dysfunction in a treated cretin
Authors: FERGUSON ANN , WHITTAKER MARY , BRITTEN JUDITH J. , PERRISS B. W. 
Published: February 2007

SummaryA patient, with a history of cretinism, who developed suxamethonium apnoea as a consequence of a reduction in plasma cholinesterase activity secondary to the concurrence of pregnancy and liver dysfunction associated with pre‐eclampsia is reported. The patient had a normal phenotype for plasma cholinesterase.
Electroencephalographic changes and arousal time after atropine or glycopyrrolate
Authors: Cozanitis D.A. , Paloheimo M. , Jones C.J. 
Published: February 2007

SummaryThe Anaesthesia and Brain activity Monitor was used to determine if any electroencephalographic variation becomes evident following the administration to patients of either atropine sulphate or glycopyrrolate when given with neostigmine to reverse a non‐depolarising neuromuscular blockade. The apparatus was also used to study possible earlier arousal times by electroencephalography and electromyography in those patients who had received glycopyrrolate with neostigmine compared with those who had atropine as an anticholinergic. The apparatus was not sensitive enough to detect changes resulting from atropine injection but clearly demonstrated earlier arousal times by electromyography in patients who had received glycopyrrolate.
Total intravenous anaesthesia by an intermittent technique. Use of methohexitone, ketamine and a muscle relaxant
Authors: Knell P.J.W. 
Published: February 2007

SummaryGood quality anaesthesia with smooth recovery can be induced by methohexitone 40 mg, ketamine 100 mg, diazepam 5 mg and alcuronium 15–20 mg and maintained with methohexitone 30 mg and ketamine 10 mg at 5‐minute intervals and controlled ventilation with 30% oxygen in air. The technique is economical in running and capital costs and may have special implications for avoiding atmospheric pollution, for use in developing countries, and in emergency situations.
Hypertensive anaesthesia for operations on the ear, nose and parotid gland. Use of intravenous metoprolol as an adjunct to sodium nitroprusside and halothane
Authors: Rollason W.N. , Kemp R.J. , Wills L.C. 
Published: February 2007

SummaryFifty‐seven patients had arterial hypotension induced by a technique with halothane and sodium nitroprusside during operations on the ear, nose and parotid gland. Metoprolol, a cardioselective beta‐adrenergic blocker, was used when required to maintain the pulse rate at 80 beats per minute or less and to assist in reducing the blood pressure. Metoprolol was used in 50 cases while 7 cases remained at a pulse rate of less than 80 bpm spontaneously.
Allergy, atopy and IgE
Authors: FISHER M. McD. , ROFFE D. J. 
Published: February 2007

SummaryIgE levels were measured in 105 patients after immediate (101) and delayed (4) anaphylactoid reactions to anaesthetic drugs. It was not possible on the basis of allergic history and IgE levels in patients to determine the drugs to which the patients were likely to react. A history of allergy, atopy with or without elevated IgE levels, does not aid the selection of anaesthetic drugs for initial or repeat anaesthesia.
Anaesthetic considerations in patients with paroxysmal supraventricular tachycardia
Authors: JONES R. M. , BROADBENT M. P. , ADAMS A. P. 
Published: February 2007

SummaryParoxysmal supraventricular tachycardia is a common cardiac dysrhythmia which may or may not be associated with heart disease. The underlying mechanisms in the genesis of this dysrhythmia are alterations in automaticity or re‐entry of the cardiac impulse. These mechanisms are reviewed in the context of the stresses of the peri‐operative and operative periods. The anaesthetic management of three patients, particularly prone to paroxysmal supraventricular tachycardia, is described based on principles derived from the pathophysiology of re‐entrant or ectopic atrial tachydysrhythmias.
Oral bromazepam in premedication. A comparison with diazepam
Authors: Chalmers P. , Horton J.N. 
Published: February 2007

SummaryBromazepam, a relatively newly benzodiazepine with marked anxiolytic effects, was compared in a randomised, double‐blind manner with diazepam for its effectiveness as an oral premedicant drug. A scoring system was used to assess sedation, relief of anxiety, nausea, and cardiovascular effects in two groups of women having gynaecological operations. No difference was demonstrated between the effectiveness of the two drugs.
Intracranial pressure after phenoperidine
Authors: GRUMMITT R. M. , GOAT V. A. 
Published: February 2007

SummaryThe problem of sedating patients requiring prolonged controlled ventilation has recently received considerable attention.1‐3 Various therapeutic regimes are available and there appears to be a general move away from the use of muscle relaxants towards sedative drugs. Phenoperidine is a popular agent for this purpose. One survey from a district general hospital reported that 66% of their ventilated intensive therapy unit patients received phenoperidine, either alone or as part of a sedation regime.4 However, enthusiasm for its use must be tempered by recent reports of cardiovascular collapse following its administration. 5,6 We wish to report a case of intracranial hypertension following the use of phenoperidine in a ventilated patient with a severe head injury.
Accumulation of thymol in halothane vaporizers
Authors: ROSENBERG P. H. , ALILA A. 
Published: February 2007

SummaryThymol may accumulate in halothane vaporizers and influence their accuracy. We determined the thymol concentration in residual liquid halothane of 28 vaporizers in regular use. Two halothane samples were brownish, probably due to a long exposure to light and irregular drainage. Irregularly drained vaporizers contained higher thymol concentrations than those drained weekly (p < 0.05). The highest individual thymol concentration was 19 times that found in fresh halothane. Halothane vapour concentration deviated most from setting in Fluotec Mark II vaporizers, but this did not correlate with thymol concentrations in halothane liquid. The need for weekly drainage and regular service of halothane vaporizers is stressed.
Effects of high‐dose fentanyl anaesthesia on the established metabolic and endocrine response to surgery
Authors: BENT J. M. , PATERSON J. L. , MASHITER K. , HALL G. M. 
Published: February 2007

SummaryThe effect of the administration of fentanyl 50 μg/kg body weight on the established metabolic response to pelvic surgery was investigated. In comparison with a control group of patients in whom anaesthesia was supplemented with halothane, fentanyl was associated with a significant decrease in only blood lactate concentrations and heart rate. There were no significant differences in blood glucose, plasma non‐esterified fatty acids, and plasma cortisol values between the two anaesthetic techniques. It is concluded that the administration of high‐dose fentanyl has little effect on the established metabolic response to surgery, compared with the marked changes observed when the same dose is given before the onset of surgical stimulation.
Premedication for children with oral trimeprazine and droperidol
Authors: LAYFIELD D. J. , WALKER A. K. Y. 
Published: February 2007

SummaryIn 60 children aged 1–9 years, weighing under 33 kg, oral trimeprazine and oral trimeprazine plus droperidol were compared as premedicants in a controlled, double‐blind clinical trial. The addition of droperidol to the trimeprazine syrup produces greater uniformity in pre‐operative sedation, a low incidence of postoperative vomiting, and a reduced requirement for postoperative analgesia.
Laryngeal muscle recovery after suxamethonium
Authors: BAER G. A. 
Published: February 2007

SummaryComplications due to intratracheal jet ventilation are often caused by the unrecognized recovery of laryngeal muscles. The rate of rise of pressure in a main bronchus alters with changes of the glottic aperture during jet ventilation. The special pressure curve monitor sets off an alarm when the steepness of the rising curve changes. During recovery these alarms, as well as the onset of phonation, coughing, spontaneous breathing and forearm muscle activity are recorded simultaneously. Forearm muscle activity always appears later than the alarm, and often later than the other recorded phenomena. Pressure curve monitoring provides advance warning of returning muscle activity in the larynx, but conventional muscle activity monitoring in the forearm does not.
Bupivacaine and prilocaine in intravenous regional anaesthesia
Authors: McKEOWN D. W. , MEIKLEJOHN B. , SCOTT D. B. 
Published: February 2007

SummarySix volunteers underwent intravenous regional anaesthesia of the non‐dominant arm on four occasions using two equipotent doses of bupivacaine and prilocaine, administered in a randomised double‐blind sequence. Equipotent doses produced similar degrees of motor and sensory blockade. Bupivacaine produced more rapid motor power loss and delayed motor recovery (p < 0.01). Prilocaine produced more prolonged objective blockade following tourniquet release (p < 0.01), although this was not clinically useful, and bupivacaine led to a marked prolongation of subjective blockade (p < 0.01). Increase of dose with both drugs gave more rapid and complete sensory and motor blockade and delayed recovery (p < 0.05). This was, however, associated with more marked toxicity. It is suggested that in intravenous regional anaesthesia there are no clinical differences between the drugs in equipotent solutions, and that the lower concentrations are the appropriate ones for standard use.
Acute acalculous cholecystitis following multiple skeletal trauma
Authors: BUCKLEY P. M. , HUNTER JENNIFER M. 
Published: February 2007

SummaryThree cases of acute acalculous cholecystitis are reported in patients with multisystem failure following major long‐bone trauma. The diagnosis should be suspected in any such patient who develops septicaemia from an unidentified site. A high index of suspicion should be maintained, especially in patients who are sedated or in receipt of mechanical ventilation of the lungs and in whom physical signs may be minimal or absent.
Emergency surgery complicated by thyrotoxicosis and thyrotoxic periodic paralysis
Authors: ROBSON N. J. 
Published: February 2007

SummaryA general anaesthetic was administered for emergency surgery to a patient with a bleeding gastric ulcer in the presence of undiagnosed thyrotoxicosis. The case is presented to illustrate firstly how hyperthyroidism may be masked by other acute illnesses, and secondly an unusual complication of thyrotoxicosis. The anaesthetic management of thyrotoxic patients undergoing incidental emergency surgery is discussed.
Expiratory valves and anaesthetic reservoir bags
Authors: MOSTAFA S. M. , HALL I. D. 
Published: February 2007

SummaryThe pressure‐volume characteristics of 24 new and old ‘2‐litre’ anaesthetic reservoir bags of three different makes were measured. When inflated with gas to a pressure of 50 Pa all the new bags and six used ones contained 1.6 litres and when filled with 2 litres of gas, the pressure within them exceeded 700 Pa. The opening pressures and pressure drops to 30 litres/minute gas flow of scavenging adjustable pressure limiting valves were also investigated. Tests were carried out on 44 valves of four different types, all with their adjusting screws in the fully open position. All the valves had low opening pressures and pressure drops which were both further decreased when the orientation of the valves was changed to the inverted position. A substantial proportion of them remained permanently open. After one year's use th opening pressure and pressure drop tended to rise, the proportion of permanently open valves increased and the discs of some valves were damaged.