bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accidental intrapulmonary Clinifeed
Authors: HARVEY P.B. , BULL P.T. , HARRIS D.L. 
Published: February 2007

SummaryA case is described in which a narrow bore nasogastric tube was passed into the bronchial tree and feeding with half‐strength Clinifeed commenced before the malposition was recognised. The management of the resulting acute respiratory failure is discussed, and the successful outcome attributed to the bland nature of the Clinifeed. The need for radiological confirmation of the position of narrow bore nasogastric tubes before feeding is emphasised.
Maternal fetal and placental gastrin concentrations
Authors: ATTIA R. R. , EBEID A. M. , FISCHER J. E. , GOLDSOUZIAN N. G. 
Published: February 2007

SummaryThe radioimmunoassay technique was used to measure maternal, placental and fetal serum gastrin levels. A progressive increase in gastrin levels occurred with the advance of pregnancy reaching mean peak levels of 62 (SEM 12) pg/ml during labour. Umbilical artery (74 pg/ml: SEM 7) or vein (73 pg/ml: SEM 7) gastrin concentration was higher than maternal gastrin levels. Placental gastrin concentration was 840 pg/g (SEM 96) and amniotic fluid contained 22 pg/ml (SEM 2). This study implies that one of the reasons for increased maternal gastric residue seen during pregnancy is due to an increased serum gastrin concentration. Also the advanced stage of development of gastrointestinal system of the newborn is in accord with high fetal gastrin concentration.
Severe hypertension and flushing in a patient with a non‐metastatic carcinoid tumour
Authors: JONES R. M. , KNIGHT DANA 
Published: February 2007

SummaryA case of multiple endocrine adenopathy type I associated with a solitary carcinoid tumour is described. During anaesthesia the characteristic syndrome consisting of hypertension, tachycardia and flushing occurred. The possible mechanisms for this are discussed.
Blood loss during transurethral resection of the prostate
Authors: Abrams P.H. , Shah P.J.R. , Bryning K. , Gaches C.G.C. , Ashken M.H. , Green N.A. 
Published: February 2007

SummaryBlood loss during operation was measured in 106 patients undergoing transurethral resection of the prostate, using a colorimetric technique. The total blood loss was related to the length of operation and the weight of prostate resected. There was no relationship between blood pressure and the blood loss during operation. However there was a significant reduction in blood loss if the patient received a regional rather than a general anaesthetic. Blood loss was lower in those patients undergoing prostatectomy for carcinomatous disease.
Hypoxic pulmonary vasoconstriction and the pharmacologically denervated lung
Authors: OHMURA A. , PACE N. L. , WONG K. C. , JOHANSEN R. K. 
Published: February 2007

Summary The roles of the autonomic nervous system and cardiac output on hypoxic pulmonary vasoconstriction were studied in 15 mongrel dogs anaesthetised with intravenous pentoharbitone (30 mg/kg) and the lungs mechanically ventilated to maintain normal arterial blood gases. After a hypoxic challenge in Group I (n =6) and Group II (n =3) animals, autonomic denervation was achieved by total spinal block with tetracaine (20 mg) injected into the cisterna magna. Group I animals received a large volume of intravenous fluid (80 ml/kg normal saline) before the block while Group II animals were given minimum fluid. When Group I animals were exposed to 10% inspired oxygen, mean pulmonary arterial pressure increased by 88 and by 72% before and after the block, respectively. The cardiac output increased by 27% with hypoxia before the block while it did not change significantly with hypoxia after the block. The pulmonary vascular resistance increased by 65 and by 152% with hypoxia before and after the block. Group II animals were also exposed to 10% inspired oxygen. They showed a similar response to Group I animals before the block. However, after the block irreversible hypotension developed with hypoxia. In Group III animals (n =6), the same anaesthesia and hypoxic challenge protocol was used. Immediately after measurements at 10 minutes of hypoxia, the inferior vena cava was constricted to reduce the cardiac output to the control level and another set of measurements were made. The cardiac output increased by 30% with hypoxia and then was reduced to the control level with vena caval constriction. The mean pulmonary arterial pressure increased by 125% with hypoxia and then it decreased slightly with the inferior vena cava constriction. The pulmonary vascular resistance increased by 95% with hypoxia and then it further increased by 28% with the vena caval constriction. These results suggest that sympathectomy accentuates rather than attenuates the hypoxic pulmonary vasoconstriction and that an increase in cardiac output counteracts hypoxic pulmonary vasoconstriction. The results also suggest that adequate intravascular volume and oxygenation are extremely important for maintaining homeostasis when reflex sympathetic stimulation to the cardiovascular system has been eliminated.
Current management of patients after cardiopulmonary bypass
Authors: HINDS C. J. 
Published: February 2007

SummaryThe postoperative management of cardiac surgical patients is reviewed with particular reference to some of the recent advances and current controversies. It is emphasised that there has been a marked decrease in the incidence of many of the major problems associated with cardiopulmonary bypass and that, in the majority of cases, cardiac surgery is now a routine procedure associated with a very low morbidity and mortality.
Doxapram and the fractured femur
Authors: OWEN H. , HUTTON P. 
Published: February 2007

SummaryIn a double‐blind trial the effects of a single dose of doxapram (1–1.5 mg/kg) on the postoperative arterial oxygen tension of patients who had undergone surgical fixation of a fractured neck of femur was measured. In contrast to other reports of the effect of a single dose of doxapram, there was no improvement in arterial oxygen tension with respect to the control group. It is reasoned that doxapram may exert its effect by increasing the functional residual capacity in the immediate postoperative period. The central analeptic properties of doxapram may be grossly underestimated.The widely held assumption that patients with a fractured neck of femur are significantly hypoxic pre‐operatively is questioned.
Reduced plasma cholinesterase following haemodilutional cardiopulmonary bypass
Authors: JACKSON S. H. , BAILEY G. W. H. , STEVENS G. 
Published: February 2007

SummaryThis case report presents a prolonged apnoea following the administration of suxamethonium to a patient whose plasma cholinesterase concentration was reduced as a consequence of haemodilutional cardiopulmonary bypass.
Althesin infusions for maintenance of anaesthesia
Authors: TOWLER C. M. , GARRETT R. T. , SEAR J. W. 
Published: February 2007

SummaryThe intravenous anaesthetic Althesin may be administered by continuous intravenous infusion for maintenance of general anaesthesia, sedation in patients in intensive care units or during investigational procedures. Published reports of experience with this technique are reviewed, with particular attention to the rates of administration employed and the influence of other anaesthetics and analgesic agents used concurrently.
Prostaglandin E1 as a hypotensive drug during general anaesthesia
Authors: GOTO F. , OTANI E. , KATO S. , FUJITA T. 
Published: February 2007

SummaryHypotension induced by prostaglandin E1 (PGE1) infusion (100–150 ng/kg/minute) during halothane anaesthesia to reduce operative blood loss during mastectomy was investigated. PGE1 decreased systolic arterial pressure approximately 34% from pre‐administration values. The duration of induced hypotension was about 75 minutes. When the infusion was stopped, blood pressure returned to within 15% of the control with 15 minutes. Heart rate did not change significantly during PGE1 infusion; the pre‐ejection period and left ventricular ejection period were shortened. Renal function during the hypotensive period was well maintained. Blood loss during surgery was significantly decreased. These findings suggest that PGE1 can be used safely to control arterial pressure during surgery.
Anaesthesia for cystectomy
Authors: RYAN D. W. 
Published: February 2007

SummarySixty‐two patients who underwent radical cystectomy for deeply infiltrating cancer of the bladder were reviewed. Twenty‐four received an epidural anaesthetic and 38 a conventional muscle relaxant and fentanyl anaesthetic. The epidural technique was found to offer advantages because of its hypotensive effects reducing blood loss intra‐operatively and its use to provide analgesia after surgery.A high incidence of complications accompanied the surgery and frail patients (below 50 kg) and those with symptomatic respiratory disease had a high mortality. Greater attention to pre‐operative care of such patients is indicated.
Function of the Oxford Ventilator at high pressure
Authors: SAYWOOD A. M. , HOWARD R. , GOAD R. F. , SCOTT C. 
Published: February 2007

SummaryThe Penlon Oxford Ventilator functioned well to 6 atmospheres absolute in an air environment and to 31 atmospheres absolute in an oxyhelium environment, as assessed remotely utilising a lung ventilator performance analyser. It features easily comprehensible controls and functions, and its use in prolonged ventilatory support could be taught to non‐anaesthetists with relative ease. In addition to its relative simplicity, it is reliable, readily available, and requires only fitting with a male Schrader valve for use at high pressures. The ventilator is recommended for ventilatory support under extreme hyperbaric conditions.
Anaesthesia and intra‐ocular pressure: a comparison of total intravenous anaesthesia using etomidate with conventional inhalation anaesthesia
Authors: Thomson M.F. , Brock‐Utne J.G. , Bean P. , Welsh N. , Downing J.W. 
Published: February 2007

SummaryIntra‐ocular pressure (IOP) was measured in two comparable groups of anaesthetised patients under standardised conditions. Group 1 received etomidate 0.3 mg/kg fentanyl 100 μg and droperidol 5 mg, with etomidate 20 μg/kg/minute for maintenance. Group 2 received thiopentone 3.5 mg/kg and were maintained with halothane 0.5% in nitrous oxide (60%) with oxygen.Both groups of patients were ventilated to normocapnia. Blood pressure, heart rate, central venous pressure and 10P were measured at 5 minute intervals from pre‐induction to 30 minutes postinduction.A significantly greater reduction in mean IOP (p < 0.05) occurred in group I. A maximum fall in IOP of 61% was obtained, compared to a maximum fall of 45% in group 2.Blood pressure fell in both groups. The fall was greater (23%) in group 2 than in group 1 (18% and in no case was considered excessive.Total intravenous anaesthesia using etomidate is suggested as a useful technique for open eye surgery.
The respiratory depression of epidural morphine
Authors: McCAUGHEY W. , GRAHAM JOAN L. 
Published: February 2007

SummaryIn order to investigate the time course of the late respiratory depression which has been reported following epidural opiates, the response to CO2 was measured in 11 patients. Epidural morphine 2 mg was given 1 hour after operation under bupivacaine epidural anaesthesia, and the patients nursed supine. The results show a consistent pattern of respiratory depression commencing at approximately 4–8 hours, and continuing until 18–24 hours after administration of morphine. A similar group of 10 patients nursed in a sitting position did not show the same degree of depression, and a modifying effect of posture on the development of central effects is suggested.
Scoliosis correction and epidural analgesia
Authors: PURNELL R. J. 
Published: February 2007

SummaryThis case report illustrates the problems which may arise when an epidural block is used during an operation to correct a spinal deformity. In this case, the block was more profound and persistent than expected. This could have been due to spinal cord compression or to ischaemia following the correction with Harrington rods, so the rods had to be removed and re‐inserted later, after the paraparesis had resolved.
A ventilator for use during mobile intensive care and total intravenous anaesthesia
Authors: PARK G. R. , JOHNSON S. 
Published: February 2007

SummaryA fluid logic ventilator with significant advantages over other compact portable ventilators is described. The variable Flo2, airway pressure gauge and versatility of the ventilator make it suited to mobile intensive care units and use during total intravenous anaesthesia.
Adverse reactions to intravenous codeine phosphate in children
Authors: SHANAHAN E. C. , MARSHALL A. G. , GARRETT C. P. O. 
Published: February 2007

SummaryAdverse reactions ranging from tachycardia and cutaneous vasodilatation to severe hypotension and apnoea occurred in three children who were given codeine phosphate intravenously. The cause of these reactions is discussed and a review of the literature on the parenteral use of codeine phosphate is presented. The findings indicate that the standard reference formularies and pharmacopeoiae, with one exception, deal inadequately with the parenteral use of codeine phosphate. On the evidence of the cases presented we would support the conclusion of the American Medical Association's drug evaluations, that codeine phosphate should not be used intravenously in children.
Rectal ketamine for induction of anaesthesia in children
Authors: Idvall Jan , Holasek Jiri , Pål Stenberg Värnamo 
Published: February 2007

SummaryRectal premedication with atropine and diazepam and rectal induction of anaesthesia with ketamine have been used in 30 healthy children undergoing minor surgetv. The anticholinerigic and sedative effects of the premedication were satisfactory. Induction of anaesthesia was smooth with no adverse circulatory or respiratory effects. No psychotomimetic side‐effects were seen, and analgesia persisted into the recovery period. Plasma concentrations of ketamine and norketamine were measured in eight childrer: and revealed a pharmacokinetic pattern indicating comparatively low bioavailability probably due to incomplete absorption from the rectum and a high ‘first‐pass’ metabolism. The technique of rectal administration of ketamine needs further pharmacokinetic evaluation before it can be generally recommended.
Mechanical ventilation with air‐oxygen mixtures during total intravenous anaesthesia
Authors: DAVEY A. J. , RILEY B. 
Published: February 2007

SummaryMechanical ventilation with air‐oxygen mixtures during total intravenous anaesthesia is discussed with the associated problem of obtaining a medically suitable source of air in British rooms. Independently powered ventilators capable of entraining filtered room air were thought to be the best solution.The Penlon Nuffield Series 400 ventilator was modified and assessed for use in this mode. An entrapment adapter and circuit was devised which allowed the ventilator to entrain more than sufficient ambient air. premixed with added oxygen for patient ventilation even under adverse conditions. The entrainment system ensured good mixing of the entrained air and oxygen and allowed accurate determination of oxygen concentration in the patient system using a suitable nomogram and without an oxygen analyser.An assessment of one‐way patient valves was also undertaken. The Laerdal valve was found to be the most suitable for use with the system described.
Does obesity affect recovery?
Authors: KUMAR V. , HARVEY J. , COOPER G. M. 
Published: February 2007

SummaryOne hundred and twenty unpremedicated patients, scheduled for minor gynaecological procedures, were randomly allocated to receive Althesin or methohexitone to supplement N2O and O2 anaesthesia. Patients were assessed as thin, medium or fat according to the degree of obesity as measured by skinfold calipers. The range of mean times for the patients to open their eyes was 3.1–4.0 minutes, to be orientated was 4.4–6.7 minutes and to perform a manipulative test was 27.7–32.1 minutes. No statistically significant differences were seen in these indices of recovery whether they received Althesin or methohexitone or whether they were thin, medium or fat. A paper and pencil test was also performed.Induction doses of the intravenous agent were calculated on a body weight basis and increments given only in response to movement. The mean total dose of Althesin was decreased from 1.33 mg total steroid 1 kg for thin patients to 1.06 mg total steroid/kg for fat patients (p < 0.01). The mean total dose of methohexitone was decreased from 3.4 mg/kg for thin patients to 2.9 mg/kg for fat patients which was not significant.
Femoral neck surgery using a local anaesthetic technique
Authors: Howard C.B. , Mackie I.G. , Fairclough J. , Austin T.R. 
Published: February 2007

SummaryThirty cases of femoral sub‐capital fractures, Garden grades 1–4, were reduced and internally fixed with crossed Garden screws using femoral nerve block. In addition, sedation and analgesia was provided by low dose ketamine and diazepam. No deaths or other complications occurred in these patients. In a similar group of patients who received spinal analgesia in the same unit under similar conditions there was one death and two cerebrovascular accidents.
Formalin toxicity in hydatid liver disease
Authors: AGGARWAL A. R. , GARG R. L. 
Published: February 2007

SummaryTwo cases of formalin toxicity developed within 5 to 10 minutes of the placement of packs soaked in formalin within hepatic hydatid cysts. Hypotension, severe tachycardia, postoperative anuria, tachypnoea, restlessness, unconsciousness and coma developed. There was no response to the treatment given. Treatment was continued for about 12 hours. The problems associated with the use of formalin are discussed.
Breathing system disconnexions and misconnexions
Authors: SPURRING P. W. , SMALL L. F. G. 
Published: February 2007

SummaryReports of breathing system disconnexions and misconnexions suggest that such occurrences are now amongst the most frequent causes of accident or near accident during anaesthesia or lung ventilation in which equipment is involved. These reports usually blame the breathing system connectors for failing to make a secure joint but much of the evidence suggests that the choice of an unsuitable or unsatisfactory component or the manner in which it is used may be more likely to be at fault. Several previous articles in Health Equipment Information1,2 have drawn attention to these problems. The purpose of this one is to review the various types of connector that are available, to explain how some accidents have occurred, and to mention some developments intended to provide better security.
Inhalational anaesthesia in developing countries
Authors: EZI‐ASHI T. I. , PAPWORTH D. P. , NUNN J. F. 
Published: February 2007

Summary We have examined the requirements for inhalational anaesthesia in the developing countries with particular reference to the problems posed by difficulties in the supply of compressed gases. A scheme is proposed to circumvent these difficulties without loss of the quality of anaesthesia other than foregoing the use of nitrous oxide.
Inhalational anaesthesia in developing countries
Authors: EZI‐ASHI T. I. , PAPWORTH D. P. , NUNN J. F. 
Published: February 2007

Summary We have reviewed the availability of apparatus which permits the maximum use to be made of available supplies and services in developing countries. In particular we have stressed the use of electrically operated air compressors and oxygen concentrators to drive sophisticated anaesthetic apparatus which is not dependent on supplies of compressed gases in cylinders.
Anaesthesia during the Falklands campaign
Authors: BULL P. T. , MERRILL S. B. , MOODY R. A. , BAKER D. J. , YATES A. , GERAGHTY I. F. , TIGHE S. Q. M. , SQUIRES S.J. , STOOT C. J. 
Published: February 2007

Summary The work of nine Naval anaesthetists deployed with the Task Force during the Falklands campaign is described. The anaesthetists worked in a field hospital (Ajax Bay), a hospital ship (SS Uganda), a troop ship (SS Canberra), aircraft carriers (HMS Hermes and HMS Invincible) and a Royal Fleet Auxiliary (Tidespring). The problems of staffing and providing the stores for various teams in different locations at short notice are discussed.
Etomidate infusion in thoracic anaesthesia
Authors: Carli F. , Stribley G.C. , Clark M. 
Published: February 2007

Summary An etomidate infusion was used in the place of nitrous oxide during one lung anaesthesia for 40 patients undergoing thoracic surgery. Analgesia was provided by fentanyl. A mixture of oxygen and air was used to maintain arterial oxygen tension within normal limits despite one lung anaesthesia and enabled the use of nitrous oxide to be avoided in several patients who had lung cysts. Recovery was fairly rapid (mean (SEM) 11.5 (1.4) minutes). There was no incidence of awareness or dreams. This technique provides satisfactory anaesthesia and oxygenation during thoracic surgery when one lung only is being ventilated.
A training programme for fibreoptic nasotracheal intubation. Use of model and live patients.
Authors: Ovassapian Andranik , Dykes Michael H.M. , Golmon Melton E. 
Published: February 2007

Summary A scheme for teaching nasotracheal intubation with the aid of fibreoptic instruments on models and live patients is described and evaluated. Twelve trainees completed 74 out of 75 intubations successfully on sedated patients to the satisfaction of themselves, their patients and their instructors.
Penile block for circumcision?
Authors: YEOMAN P. M. , COOKE R. , HAIN W. R. 
Published: February 2007

SummaryA prospective blind trial was conducted comparing the analgesia and adverse effects produced by caudal extradural blockade (caudal block) with blockade of the dorsal nerves of the penis (penile block) in 38 boys undergoing elective circumcision. Analgesia was assessed by senior nurses using a linear analogue scale and by the response to direct questioning over the first 7 hours after surgery. The degree and duration of postoperative analgesia was similar in the two groups. However, the caudal block group had a higher incidence of motor blockade (p = < 0.01). One technical failure occurred in the penile block group.It is concluded that a penile block is a satisfactory alternative to caudal blockade with regard to postoperative analgesia and offers several specific advantages.
Quantitative effects of respired helium and oxygen mixtures on gas flow using conventional oxygen masks
Authors: VATER M. , HURT P. G. , AITKENHEAD A. R. 
Published: February 2007

SummaryA model lung system with a variable artificial constriction was used to quantify the changes in flow produced by the addition of helium to the gas mixture in the system. The tracheal concentration of helium obtained when administering 79% helium/21% oxygen to the system via conventional, disposable face masks was determined using a resuscitation dummy. The greatest proportion of the increase inflow through the orifice occurred at concentrations of helium up to 40%. A tracheal concentration of 40% helium could be obtained with all oxygen masks at fresh gas flow rates greater than 8 litres/minute. These findings will help to rationalise the administration of 79% helium/2 /% oxygen to patients with upper respiratory tract obstruction.
The optimum concentration for epidural fentanyl
Authors: WELCHEW E.A. 
Published: February 2007

SummaryA randomised, double‐blind study comparing a variety of different concentrations of fentanyl with and without 1:200000 adrenaline is described. It was shown that the quality and duration of analgesia with epidural fentanyl was concentration‐dependent below 10 fig/ml, but that the addition of adrenaline abolished this phenomenon. The rate of failure to achieve any analgesia was very high with the more dilute solutions, but adrenaline reversed this problem. In general the incidences of side effects were related to the concentrations of fentanyl used and apart from itching, the incidences of these side effects were reduced by the addition of adrenaline.