bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal anaesthesia with hyperbaric lignocaine for elective Caesarean section
Authors: BEMBRIDGE M. , MACDONALD ROSEMARY , LYONS G. 
Published: February 2007

SummaryThis study was carried out in 30 patients undergoing elective Caesarean section to assess the predictability and reliability of spinal anaesthesia with 5% hyperbaric lignocaine, with a view to incorporating the technique in our failed intubation drill. The spinal was performed with a 25‐gauge needle in either the sitting (15 patients) or left lateral position (15 patients). The speed of onset of anaesthesia to T6 was significantly faster (p < 0.01) in the lateral group. but the duration of action was similar in both groups. Twelve patients had hypotension and four developed severe postspinal headaches. The block progressed to the C2 dermatome in four patients and was associated with dysphagia. This was totally unpredictable and may be due to altered cerebrospinal fluid dynamics in late pregnancy. Therefore, the use of spinal anaesthesia with heavy lignocaine may be inadvisable in obstetric patients, especially following failed intubation.
Postoperative nitrous oxide analgesia
Authors: GODDARD J.M. 
Published: February 2007

SummaryNitrous oxide is occasionally used as an analgesic agent in the postoperative period. The feasibility of administering a known concentration from an air entrainment oxygen mask, using a primary flow of Entonox, (50% oxygen/50% nitrous oxide) was investigated. Accurox (C.R. Bard Canada Znc.) blenders, disconnected from their facemasks, were studied using a primary flow of Entonox. An increase in air entrainment of approximately 13% was demonstrated. Concentrations of about 20% nitrous oxide in oxygen enriched air, appropriate for postoperative analgesia, can be produced, but the methods are extravagant in the use of Entonox and are likely to be slightly unreliable.
Status epilepticus following enflurane anaesthesia
Authors: NICOLL J. M. V. 
Published: February 2007

SummaryTwo patients had generalised convulsions which occurred several hours afer anaesthesia supplemented with enpurane. One patient had to be treated for life threatening status epilepticus 7 hours after anaesthesia and the other had a myoclonic convulsion 17 hours after recovery from anaesthesia. Neither had any relevant pre‐operative history of epilepsy or convulsions. Possible synergistic roles of the metabolite of atracurium. laudanosine, as well as of cephazolin and photic stimulation, are discussed.
The effects on gas exchange of a large mediastinal tumour
Authors: Fletcher R. , Nordstrom L. 
Published: February 2007

SummaryA 14‐year‐old boy with a mediastinal tumour large enough to cause dyspnoea at rest was anaesthetised for a biopsy. The tumour was believed to compress the tracheal bifurcation. After tracheal intubation, the expiratory breath sounds were heard to be intermittent. The expiratory flow pattern showed irregularities synchronous with the electrocardiogram. With constant flow inflation, the inspiratory pressure profile was suggestive of mechanical obstruction with a resistance which decreased during inspiration. The airway dead space was greatly reduced, suggesting that the obstruction was near the tracheal tube opening and that there was pooling of carbon dioxide behind this obstruction. The alveolar deadspace fraction was increased and the shape of the carbon dioxide single breath test suggested severe airway obstruction. These findings can be explained on the basis of large airway obstruction, partly intermittent because of the heart's movement, and also reduced lung volume and uneven gas distribution caused by the tumour and pleural fluid.
Benzodiazepine antagonist Ro 15‐1788
Authors: Kirkegaard L. , Knudsen L. , Jensen S. , Kruse A. 
Published: February 2007

SummaryIn a double‐blind, randomised trial the efficacy and safety of Ro 15‐1788, a new benzodiazepine antagonist, was assessed in forty adults undergoing gastroscopy under diazepam sedation. Criteria of efficacy were the degree of sedation and anterograde amnesia. There was a significantly faster recovery of the patients after the injection of 0.61.0 mg of Ro 15‐1788 than after placebo. Patients were awake shortly after Ro 15‐1788, but remained drowsy or asleep after placebo administration. There were no side effects of note.
Glycine and transurethral resection
Authors: Alexander J.P. , Polland A. , Gillespie I.A. 
Published: February 2007

SummaryFifty patients undergoing transurethral resection of the prostate were studied for evidence of glycine absorption and haemodilution. Plasma glycine levels increased substantially in nine patients and, in five, calculated irrigant, fluid absorption ranged from 619–1582 ml; another patient had absorbed 1360 ml fluid with only a small rise in plasma glycine. Two illustrative case histories are presented. The role of glycine us an inhibitory neurotransmitter is discussed and the possibility of toxic mechanisms other than dilational hyponatraemia is mentioned. Intravenous diuretics, hypertonic saline, and perhaps calcium salts, are recommended for the overt transurethral resection syndrome.
Combination treatment with ranitidine and sodium bicarbonate prior to obstetric anaesthesia
Authors: MATHEWS H. M. L. , WILSON C. M. , THOMPSON E. M. , MOORE J. 
Published: February 2007

SummaryThe gastric pH and volume were measured in 175 patients undergoing elective, and 313 undergoing emergency, obstetric procedures. Ranitidine 150 mg was administered orally every 6 hours in labour and at least 2 hours before elective Caesarean section. Patients received20 ml of8.4% sodium bicarbonate orally immediately prior to induction of anaesthesia. The combination of ranitidine and sodium bicarbonate produced marked alkalinisation of gastric contents (mean pH 8.9). The administration of sodium bicarbonate pre‐operatively in patients who received ranitidine less than 2 hours before operation led to satisfactory elevation of gastric pH. Only four patients had a gastric pH < 2.5, one patient refused any medication, two received only ranitidine and one patient had a long interval from administration of bicarbonate to aspiration of gastric contents. Gastric volumes were high in labouring patients (mean 84 ml) despite administration of ranitidine. The effectiveness of sodium bicarbonate as a single dose antacid therapy prior to obstetric anaesthesia requires further study.
The influence of nitrous oxide on oxyhaemoglobin dissociation and measurement of oxygen tension
Authors: SHAH M. V. , ANDERSON L. K. , BERGMAN N. A. 
Published: February 2007

SummaryThere are conflicting reports of the effect of nitrous oxide on the oxyhaemoglobin dissociation curve. We have therefore determined P50 of haemoglobin in the presence of either nitrous oxide or nitrogen and studied the upper portion of the curve in greater detail. No significant differences in the oxyhaemoglobin dissociation curve were observed when nitrous oxide was substituted for nitrogen. The oxygen tensions measured in gas mixtures were not significantly different when determined simultaneously with a polarographic oxygen electrode and the mass spectrometer when nitrous oxide was used instead of nitrogen.
Peri–operative management of carcinoid syndrome using ketanserin
Authors: HOUGHTON K. , CARTER J. A. 
Published: February 2007

SummaryThis report describes the successful use of ketanserin, a 5–HT2 receptor antagonist, for the acute control of systemic blood pressure in a patient with the carcinoid syndrome. undergoing hepatic artery embolisation. Serial measurements of plasma 5–hydroxyindoles. platelet 5–hydroxytryptamine and plasma cate–cholamines are also given.
Acute rhabdomyolysis following surgery for burns
Authors: PFEIFER P. M. 
Published: February 2007

SummaryA case is reported of acute rhabdomyolytic renal failure following surgery for minor superficial skin burns. Rhabdomyolysis apparently started peri‐operatively. Possible initiating causes are discussed, notably tourniquet ischaemia. The pathophysiology, diagnosis and treatment are reviewed.
Intensive care aspects of severe Legionella pneumonia
Authors: POWER K.J. , BOWEN D.J. 
Published: February 2007

SummaryA case of extensive Legionella pneumonia is presented. The patient required an extended period of artificial ventilation, notably punctuated by episodes of dysrhythmia and severe haemodynamic instability, but who nevertheless eventually recovered. Intensive care aspects of Legionnaires' disease are discussed.
A new double lumen tube adaptor
Authors: SIBAI A. N. , BARAKA A. 
Published: February 2007

SummaryThe report describes a new double lumen tube adaptor which provides selective one lung ventilation without external clamping. It also facilitates, without disconnexion and remantling, both correct bronchial cuff inflation and continuous positive airway pressure administration using an underwater seal chest bottle. Oxygenation can be kept optimal during one lung anaesthesia by applying 1.0 kPa continuous positive airway pressure to the nonventilated lung using an oxygen flow of 1–2 litres/minute.
The work of the Leeds Malignant Hyperpyrexia Unit, 1971–84
Authors: ELLIS F. R. , HALSALL P. J. , HARRIMAN D. G. F. 
Published: February 2007

SummaryA detailed account of the procedure of muscle biopsy for screening patients suspected of being susceptible to malignant hyperpyrexia is given, together with a review of the results obtained from 1127 patients screened over the last 14 years. The information should help anaesthetists to discuss the investigation fully with probands and other members of their families before referral for further specific investigation.
Tumours of the glomus jugulare
Authors: MATHER S. P. , WEBSTER N. R. 
Published: February 2007

SummaryTwo cases are reported using a two stage procedure for the excision of glomus jugulare tumours. The anaesthetic problems which this may produce are discussed, and recommendations are made regarding the anaesthetic conduct for this procedure. A two stage, combined procedure is suggested to reduce anaesthetic morbidity.
New syringes for arterial blood sampling
Authors: WISBORG T. , BAKKE P. , GULSVIK A. 
Published: February 2007

SummaryTwo new syringes for arterial blood sampling were compared. Fifty syringes of each type were randomly tested in awake patients and no signifcant differences were found regarding time taken to collect samples, or the pain experienced by the patient. Air bubbles were found in, and blood leaked, from the Pulsator syringes signijcantly more often than from the Radiometer B 129 syringes (p < 0.00s).
Anaphylactoid reaction complicating neonatal anaesthesia
Authors: Pollock E. M. M. , Macleod A. D. , Mcnicol L. R. 
Published: February 2007

SummaryA three‐week‐old girl presented for surgery for congenital pyloric stenosis. The anaesthetic technique included intravenous induction with thiopentone and neuromuscular blockade with atracurium. The administration of these drugs was followed within 2–3 minutes by oedema of the eyelids and epiglottis, reduced peripheral circulation and central cyanosis.
An evaluation of the Datex Normac anaesthetic agent monitor
Authors: Colquhoun A. D. , Gray W. M. , Asbury A. J. 
Published: February 2007

SummaryA new monitor for volatile anaesthetics, the Datex Normac, was assessed in the laboratory and operating theatre. The instrument had a warm up time of 90 minutes from cold, but only 5 minutes from standby. Zero drift was less than 0.01% over 7 hours, and repeated measurements of gain showed a coefficient of variation of less than 1%. However, gain drift of 6% occurred when the instrument was switched off between periods of use. Signal noise was less than 0.02 vol % on a new instrument, but was about six times greater on an instrument that had been in use for a year. The response time of 550 ms is short enough to allow breath by breath monitoring. When the instrument was calibrated on the enjurane setting, measurements made on the enflurane, halothane and isojlurane settings were accurate to within 6% of the reading. This is satisfactory for clinical purposes, but not for more demanding applications. Calibration canisters are available, and two that we tested were accurate to better than 0.1 vol %. Nitrous oxide, carbon dioxide and water vapour have very small effects on the monitor. The instrument provided trouble‐free monitoring in theatre.
Vecuronium induced neuromuscular blockade
Authors: CASSON W. R. , JONES R. M. 
Published: February 2007

SummaryThe speed of onset of neuromuscular blockade was measured for increasing doses of vecuronium. Onset times were found to be shorter with larger doses, up to a limit of ED95× 3 (0.15 mg/kg). Thereafter, increasing the dose, even up to ED95× 8 (0.4 mg/kg), did not appreciably shorten the time to full neuromuscular blockade. The clinical implications of, and pharmacokinetic basis for, these findings are discussed.
Carcinoid syndrome with myasthenia gravis
Authors: KEENS S. J. , DESMOND M. J. , UTTING J. E. 
Published: February 2007

SummaryThe anaesthetic management of a patient suffering from carcinoid syndrome and myasthenia gravis is described including the successful treatment of a carcinoid attack with intravenous aprotonin. The differences between myasthenia gravis and the myasthenic (Eaton‐Lambert) syndrome are considered and the rationale for the choice of vecuronium as the muscle relaxant is discussed.
The use of antacids as a prophylaxis against Mendelson's syndrome in the United Kingdom. A survey
Authors: Sweeney B. , Wright I. 
Published: February 2007

SummaryMaternal mortality from aspiration of gastric contents still remains unacceptably high, despite various recommended prophylactic measures. In order to establish which jorms of antacid prophylaxis are currently being used, a questionnaire was sent to anaesthetists working in obstetric units in the United Kingdom. Despite its limitations. magnesium trisilicate remains the most popular antacid during labour and before Caesarean section.
Intravenous feeding with medium chain triglycerides. Effect on blood gases and the complement system in critically ill patients
Authors: Ball M. J. , Sear J. W. 
Published: February 2007

SummaryCritically ill patients are usually in a catabolic state and may require total parenteral nutrition; this often includes lipid emulsions. Any adverse effects of constituents on pulmonary function, white cell function or the haemocoagulation system could have disastrous consequences in such patients. We have investigated the effects of a new intravenous lipid preparation containing medium chain triglyceriks, which, in severely ill malnourished patients are theoretically a preferable energy source to conventional drug chain triglycerides. In a pilot study 17 critically ill patients whose lungs were artificially ventilated were given this lipid emulsion; no adverse eflects were observed. Arterial oxygen and carbon dioxide tensions, ratio of inspired oxygen fractional concentration to arterial oxygen tension. platelet and white cell counts all remained constant and the complement system was not activated.
Single breath induction of anaesthesia, using a vital capacity breath of halothane, nitrous oxide and oxygen
Authors: WILTON N. C. T. , THOMAS V. L. 
Published: February 2007

SummaryInhalational induction of anaesthesia. using a single vital capacity breath of 4% halothane in 66% nitrous oxide and 33% oxygen was evaluated in 100 unpremedicated outpatients. The technique was found to be acceptable to most (91%) of the patients studied, with a mean (SD) induction time (measured from beginning of inspiration to loss of‘eyelash reflex? of 83(21) seconds. Relative cardiovascular stability was a notable finding of the technique. with a slight decrease in the mean arterial pressure of only 10%. Anaesthetic induction time was unaffected by age, weight or smoking habits. The technique of single breath induction is therefore proposed as a safe and acceptable alternative to intravenous induction in co‐operative adult patients.
Influence of ketanserin pretreatment on the haemodynamic responses to sternotomy
Authors: CASHMAN J. N. , THOMPSON M. A. , BENNETT A. 
Published: February 2007

SummaryThe effect of intravenous ketanserin on the pressor response to sternotomy was studied in 36 patients undergoing coronary artery surgery. Two doses of the drug (10 mg and20 mg) were compared with a placebo injection of saline. After induction of anaesthesia, haemodynamic variables were measured until the institution of cardiopulmonary bypass. Plasma and platelet 5‐hydroxyindoles and 5‐hydroxytryptamine were measured in a subset of 13 patients. Ketanserin induced a dose‐dependent amelioration of the pressor response to sternotomy. Plasma 5‐hydroxyindoles and platelet 5‐hydroxytryptamine levels did not correlate with clinical response. The increased effectiveness of the higher dose of ketanserin may be due to an effect other than serotonin antagonism.
Selective bronchial intubation for one lung anaesthesia in thoracic surgery
Authors: NAZARI S. , TRAZZI R. , MONCALVO F. , ZONTA A. , CAMPANI M. 
Published: February 2007

SummaryAnew method for one lung anaesthesia in thoracic surgery is described. Separate lung ventilation is obtained with selective main bronchus intubation. by means of an appropriate cuffed tube inserted through a standard orotracheal tube. Ventilation is carried out separately through the bronchial tube on one side and the residual tracheal tube lumen on the other side. This method greatly simplifies the technique of bronchial intubation and offers many advantages over commercially available double–lumen tubes.
A comparison of five heat and moisture exchangers
Authors: SHELLY MAIRE , BETHUNE D. W. , LATIMER R. D. 
Published: February 2007

SummaryFive heat and moisture exchangers were investigated to compare their efficiency of humidification, their ability to filter bacterial spores and their various physical properties. The results are presented and the various mechanisms of heat and moisture exchange are reviewed. The Pall Ultipor BB50. because of its hydrophobic properties, has a slightly different action from heat and moisture exchangers already in use. The place of the Pall Ultipor BB50 in clinical practice is discussed.
Pethidine compared with meptazinol during labour
Authors: MORRISON C. E. , DUTTON D. , HOWIE H. , GILMOUR H. 
Published: February 2007

SummaryA randomised double‐blind comparison of pethidine and meptazinol used as analgesics in labour was carried out in 1100 consecutive women who would normally have received intramuscular pethidine. Pain assessments at 30‐minute intervals were made independently by patients and midwives. Maternal and neonatal side effects were noted. The babies' requirements for resuscitation and weight changes in the first 5 days were studied. There was no difference in the analgesia provided by the two drugs; the pattern of side effects was similar, but the incidence of vomiting was greater following meptazinol administration. The babies in the two groups were similar with respect to resuscitation received, weight gains or losses and the incidence of clinical neonatal jaundice. The most striking findings were the poor quality of pain relief experienced by both groups following parenteral analgesics and the high incidence of side effects.
Insertion of intratracheal stents
Authors: SHERRY K. M. , KEELING P. A. , JONES H. M. , AVELING W. 
Published: February 2007

SummaryThe case histories of two patients who required the insertion of intratracheal stents are presented. The peroperative anaesthetic management of one case included the use of high frequency jet ventilation of the lungs; in the other case, partial cardiopulmonary bypass was used. The advantages and disadvantages of these two methods are discussed.
Morbidity and early retirement among anaesthetists and other specialists
Authors: McNAMEE R. , KEEN R. I. , CORKILL C. M. 
Published: February 2007

SummaryAn historically prospective study of the rates of early retirement due to permanent ill health, early retirement between 60 and 64 years of age for other reasons, and deaths while in post, among consultant anaesthetists in England was carried out. The control group comprised consultants in four other hospital specialty groups. Approximately two‐thirds of all consultants employed in the five specialties at National Health Service hospitals in England during 1966–83 were included in the study. Ill‐health retirements among male anaesthetists were more than twice those expected on the basis of rates in the control group (p < 0.001). The number of other early retirements between 60 and 64 was a third higher than expected (p < 0.005). The number of deaths in post was also raised. For the smaller group of female anaesthetists there was not a statistically significant excess of ill‐health retirements, but the number of early retirements between 60 and 64 was significantly greater than expected (p < 0.005), as was the number of deaths in post (p < 0.001). Possible causes of these excesses are discussed.
Spurious central venous pressure
Authors: BARROWCLIFFE M. P. 
Published: February 2007

SummaryA patient is described in whom two different sites of cannulation of central veins produced markedly different pressures with potentially dangerous consequences. Falsely elevated pressures recorded from a catheter inserted via the subclavian vein were related to the patency in the arm of an arteriovenous shunt. The likely cause of this phenomenon is discussed.
Nausea and vomiting after prostaglandins in day case termination of pregnancy The efficacy of low dose droperidol
Authors: MILLAR J. M. , HALL P. J. 
Published: February 2007

SummaryThe antiemetic effects of low dose droperidol (0.25 and 0.5 mg) and a placebo were compared in patients who had received prostaglandin for day case termination of pregnancy. The incidence of nausea and vomiting was high. Low dose droperidol significantly reduced postoperative nausea and vomiting without any delay in immediate recovery or discharge home (p < 0.05). Droperidol 0.25 mg was equally effective as an antiemetic, as 0.5 mg.
Recovery from propofol infusion as the main agent for outpatient arthroscopy
Authors: ZUURMOND W. W. A. , VAN LEEUWEN L. , HELMERS J. H. J. H. 
Published: February 2007

SummaryPropofol by continuous intravenous infusion has been compared with isoflurane as the main anaesthetic agent for outpatient arthroscopy of the knee. In 40 unpremedicated patients, anaesthesia was induced with propofol 2 mg/kg and vecuronium bromide 0.1 mg/kg and maintained after tracheal intubation with nitrous oxide 66% in oxygen. One group received 3% isoflurane prior to intubation and 0.9% during maintenance, while the other received a continuous intravenous infusion of propofol at a rate of 10 mg/kg/hour. Recovery was assessed by the time to opening eyes, to be able to answer five questions correctly, to recovery of ocular balance (Maddox Wing test) and by comparing pre‐ and postoperative performance in a paper and pencil test (the p‐deletion test). After 3 hours all the patients were fit for discharge. Recovery tests showed no differences between the groups. All patients were satisfied with the anaesthesia. Full recovery took on average 1.5 days (range between I hour and 14 days) in both groups. Patients' opinion 1 month after the procedure should be included in every study concerning recovery. Anaesthesia by continuous propofol infusion results in quick recovery comparable with that following isoflurane anaesthesia.