bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total intravenous anaesthesia: a technique using flunitrazepam, ketamine, muscle relaxants and controlled ventilation of the lung
Authors: Barclay A. , Houlton P.C. , Downing J.W. 
Published: February 2007

SummaryA potentially acceptable and uncomplicated technique of total intravenous anaesthesia is described using flunitrazepam for induction, and maintenance by ketamine infusion with neuromuscular blockade and controlled ventilation using oxygen‐enriched room air.A significant complication was the 23% incidence of nausea and/or vomiting encountered in the fifty‐six patients studied. Definite factual recall of the surgical experience was reported by one patient. This was attributable to an accidental error in technique. Postoperative drowsiness was also a feature of the technique. The usual cardiovascular and psychomimetic effects associated with ketamine administration appeared markedly attentuated by flunitrazepam induction. Fifty‐three (96–3%) patients expressed their willingness to receive the same anaesthetic again. Further experience of total intravenous anaesthesia with the introduction of cerebral function monitoring, allowing correlation of depth of anaesthesia with drug dosage, should allow further refinement of the technique to ensure successful and acceptable anaesthesia.
Droperidol and endotracheal intubation Attenuation of pressor response to laryngoscopy and intubation
Authors: Curran J. , Crowley M. , O'Sullivan G. 
Published: February 2007

SummaryThe cardiovascular responses to anaesthesia, laryngoscopy and tracheal intubation were studied in 20 healthy adult patients. The mean arterial pressure increase following intubation was 1–60 mmHg (SEM ± 3 52 mmHg) in patients to whom droperidol 150 μg/kg was given intravenously before anaesthesia compared with a rise of 26 50 mmHg (SEM ± 4 35 mmHg) in a control group of patients.
Cardiac arrest during moderate hypothermia for cerebrovascular surgery
Authors: BELOPAVLOVIC M. , BUCHTHAL A. 
Published: February 2007

SummaryA case of cardiac arrest during moderate hypothermia and profound hypotension following rupture of a cerebral aneurysm is described. The patient survived with few neurological sequelae directly attributable to the period of cerebral ischaemia. The protective effect of hypothermia in the prevention of neurological damage is illustrated as are the difficulties of resuscitation.
Morbidity after outpatient Anaesthesia.
Authors: HENEGHAN CHRISTOPHER , McAULIFFE ROMAYNE , THOMAS DAVID , RADFORD PATRICK 
Published: February 2007

SummaryA comparison was made of two anaesthetic techniques for outpatient dental surgery; the basis for comparison was symptomatic morbidity. One group of patients was managed with spontaneous breathing of nitrous oxide, oxygen and halothane; the other was ventilated mechanically, and received fentanyl and alcuronium. The latter anaesthetic was associated with a significantly higher incidence of morbidity on the day of operation, but not subsequently. The incidence of dysrhythmias was not significantly different. The comfort and safety of patients are discussed in relation to the choice of anaesthetic.
Plasma cortisol levels
Authors: SAINSBURY J.R.C. , STODDART J.C. , WATSON M.J. 
Published: February 2007

SummaryThe plasma cortisol levels of 30 very sick patients were measured to determine whether evidence of suprarenal failure could be found. Volunteers were given 100 mg hydrocortisone intravenously and their plasma cortisol leoels were measured.The results suggest that suprarenal failure is a very uncommon occurrence. The results obtained from the volunteers imply that relatively small amounts of hydrocortisone given intravenously cause a marked elevation of plasma cortisol levels.
Unexpected complication of successful nerve block
Authors: HANKS G.W. , TWYCROSS R.G. , LLOYD J.W. 
Published: February 2007

SummaryA case is reported of a 76‐year‐old man with a right‐sided mesothelioma who required large doses of oral narcotics to control his severe chest pain. After a successful chlorocresol intrathecal nerue block, respiratory failure was induced by doses of oral morphine at the same level as those used before the block, and also by substantially smaller doses. A considerable reduction in analgesic requirements may be possible following non‐drug intervention to relieve pain and may be essential in patients with compromised respiratory function. This observation emphasises the importance of pain as a potent stimulator of the respiratory centre in patients with reduced respiratory reserue who are receiving narcotic drugs.
Adverse reaction to methohexitone and gallamine
Authors: HARRISON G.R. , THOMPSON I.D. 
Published: February 2007

SummaryA case is presented in which a patient detieloped an acute anaphylactoid reaction after receiving methohexitone and gallamine for the induction of Anaesthesia. The problem of eliciting the responsible agent is discussed, with comments on the method of treatment and preventative measures.
Postoperative pain relief
Authors: KAY B. 
Published: February 2007

SummaryThe rate of use of alfentanyl was compared with that of fentanyl for the treatment of postoperative pain in 21 patients using an On‐Demand Analgesia Computer. Both drugs produced good pain relief. The mean rate of use of fentanyl was 0·88 μg/minute and of alfentanyl 8·1 μg/minute, a ratio of 1:9·2, which correlates well with an estimated potency ratio of 3:1, and duration of action ratio of 3:1.
Supernumerary senior house officers in anaesthesia: a review of a regional training scheme, 1962–1972
Authors: Thornton J.A. , Sharman E.M. 
Published: February 2007

SummaryThe Shefield Regional Hospital Board, which became the Trent Regional Health Authority in 1974. initiated a scheme for training of Senior House Oficers in anaesthesia in 1962; between 1962 and 1972, 73 graduates passed through the scheme of whom 29 (40%)* held consultant posts at the time of the review (mid 1979), another 8 (11%)* were senior registrars and on the way to consultant status. None of the 16 overseas graduates had achieved consultant status although one was a senior registrar. Twenty‐six (35.6%)* of the 73 doctors (15 (20.5%)* United Kingdom or Republic of Ireland graduates and 11 (15.1%)* from overseas) are thought to have left the practice of anaesthesia although some of these were not traced and may indeed be practising. and some of the females have indicated an intention to return to the specialty when their children are older.
The Blease 5300 ventilator: an assessment
Authors: FLETCHER I.R. , HEALY T.E.J. , POOLE T.R. 
Published: February 2007

SummaryThe Blease 5300 ventilator is described. A laboratory assessment of its performance gave satisfactory results and confirmed the favourable impressions formed by medical and nursing staff, in the intensive therapy unit during a trial lasting 3 months.
The microcomputer in self‐assessment for examinations in anaesthesia
Authors: Parbrook Geoffrey D. , Davis Paul D. , Parbrook Evelyn O. 
Published: February 2007

SummaryA series of 30 multiple choice questions were modified for presentation on a microcomputer which was programmed to present them to the user and mark them. In a preliminary study, 15 trainee anaesthetists all agreed the system was satisfactory as an aid to preparation for the FFARCS.
Magnesium flux during open heart surgery
Authors: MANNERS J.M. , NIELSEN M.S. 
Published: February 2007

SummaryThe Hearse St Thomas' Hospital cardioplegia infusate is one method of preserving the myocardium in the absence of coronary perfusion, during open heart surgery. The infusate contains 16 mmol magnesium/litre and 20 mmol potassium/litre. Peri‐operative plasma magnesium levels and urinary excretion of magnesium have been measured, when the infusate was returned to the circulation in 12 patients. The plasma level (±SEM) rose to 1·86 mmol/litre (±0·1) 5 minutes after cardiopulmonary bypass commenced, was 1·57 mmol/litre (±0·09) shortly before termination of cardiopulmonary bypass but was normal on the first day after surgery.Urinary excretion of magnesium was 55% of the administered quantity by Day 1 and 77% by the second day. Two patients excreted less than 40% of the administered magnesium within 24 hours probably indicating magnesium depletion. There were no adverse effects from a magnesium load of 16–32 mmol magnesium given during cardiopulmonary bypass.
Intensive care in England and Wales
Authors: GILSTON ALAN 
Published: February 2007

SummaryA questionnaire circulated to members of the Intensive Care Society in England and Wales brought 101 replies, representing 74 hospitals, including 16 teaching hospitals. Anaesthesia is the dominant specialty in this field and the majority of general units included in this survey are staffed and directed by consultants from this specialty, though their involvement in such work varies widely. Only about half the units are largely supervised by consultants with a heavy commitment to it. The junior staff too are predominantly anaesthetists. Whilst the FFARCS examination strongly emphasises the importance of intensive care to the specialty, only about half the members believe present training in this field, including academic activity, is satisfactory. The dearth of full‐time training posts, their brevity and their domination by the teaching hospitals are major problems. There is considerable support for the idea of National Training Standards, and for a full‐time training period of not less than 2 years, including special experience in certain fields, for those with a special interest in and aptitude for this type of work. But there is much less support for a Diploma.Despite this agreement on special training, only a small minority of members believe intensive care work should largely be restricted to separate career specialists, ‘intensivists’. However most recognise the need for each unit to have a largely full‐time manager and coordinator, whose personal qualities are more important than his original specialty.Most units have one kind of problem or another, the most common being a shortage of money and nurses.
Mixed neuromuscular block
Authors: FERGUSON ANN , BEVAN D.R. 
Published: February 2007

SummaryThe effects of precurarisation, with small doses of pancuronium, curare or gallamine, on the neuromuscular blockade following suxamethonium, 1 mg/kg, were studied using train‐of‐four stimulation. The duration of the block was reduced by pretreatment with d‐tubocurarine and gallamine but increased with pancuronium.The degree of competitive neuromuscular blockade, both after administration of the precurarising dose and at full recovery from suxamethonium was mild and was insufficient to be a cause of postoperative muscle weakness.
Fentanyl and the metabolic response to gastric surgery
Authors: COOPER G.M. , PATERSON J.L. , WARD I.D. , HALL G.M. 
Published: February 2007

SummaryThe effect of the supplementation of nitrous oxide‐oxygen anaesthesia with either 50 μg fentanyl/kg body weight or 0·5–1·0% halothane on the metabolic and hormonal response to gastric surgery was investigated in 16 patients. Those patients who received fentanyl showed a significant decrease (p<0·05) in the hyperglycaemic response to surgery after 30 and 90 minutes and a significant decrease (p<0·05) in the plasma cortisol response after 30 minutes. Profound respiratory depression occurred at the end of surgery in all patients who were given fentanyl. This required the intravenous administration of naloxone and careful supervision in the early postoperative period. It is concluded that the transient metabolic and endocrine benefits produced by fentanyl do not compensate for the severe respiratory problems postoperatively and thus ‘high‐dose fentanyl’ cannot be recommended for upper abdominal surgery.
Chondro‐calcinosis and difficult intubation in acromegaly
Authors: EDGE W.G. , WHITWAM J.G. 
Published: February 2007

SummaryDifficulties encountered in carrying out tracheal intubation in acromegalic patients have been well documented.1–8 This paper reports the difficulty encountered in a patient with acromegaly complicated by extensive calcification of the larynx.
Clinical evaluation of an automatic potassium electrode.
Authors: TREASURE TOM , AVELING W. 
Published: February 2007

SummaryA Nova 1 potassium analyser has been evaluated for the first 3 months of its use in a cardiac surgical intensive care unit. The machine was out of action for 11 out of 104 days. 515 external calibrations were performed with 4·50 mmol/l potassium standards: mean 4·49 mmol/l, standard deviation 0·07. 692 comparisons were made with routine laboratory flame photometer measurements on the same sample: correlation coefficient r=0·815. It is concluded that Nova 1, if kept in working order, can provide potassium estimations quickly and accurately.
Selective obstetric epidural service in a developing country
Authors: Ukpoma S.O. , Oronsaye A.U. 
Published: February 2007

SummaryEpidurals were performed on 100 Nigerian women in labour in an attempt to assess the feasibility of setting up an epidural service in a developing country. The results indicate that a service is possible, constraints notwithstanding, provided patients are carefully selected and the personnel involved are properly trained.
Intubating conditions with ORG NC45
Authors: HARRISON P. , FELDMAN S.A. 
Published: February 2007

SummaryThe ease oftracheal intubation using two doses of the new steroidneuromuscular blocking compound ORG NC45 (Nor cur on) 0.1 and 0.15 mg/kg was compared with a standard dose ofpancuroniwn 0.1 mg/kg at 60, 90 and 120 seconds. The results did not reveal any statistically significant benefit of the new drug within 2 minutes of administration over the control.
The para‐carotid approach for internal jugular catheterization
Authors: Oda M. , Fukushima Y. , Hirota T. , Tanaka A. , Aono M. , Sato T. 
Published: February 2007

SummaryWe have deqeloped a para‐carotid approach for internal jugular cannulation which utlizes only the carotid artery as a landmark. This technique allows us to locatedhe puncture site regardless of an individual patient's physical, skeletal or postural variations. This study was undertaken in the period from January 1979 to June 1980 on 456 consecutive patients in a wide range of age groups and various clinical conditions. The overall success rate was 96.1%. The only complications encountered during our study were Five carotid artery punctures with formation of two haematomas.
Effects of intravenous administration of glycopyrrolate and atropine in anaesthetised patients
Authors: MIRAKHUR R. K. , JONES C. J. , DUNDEE J. W. 
Published: February 2007

SummaryThe effects of glycopyrrolate in doses of 5, 10 and 15 μ/kg and atropine 10, 20 and 30 μ/kg on heart rate and rhythm were studied in anaesthetised patients. Both drugs produced a dose‐related increase in heart rate. Glycopyrrolate was approximately twice as potent as atropine in increasing heart rate. The average time taken to achieve peak effect was 2.6 and 3.7 minutes for atropine and glycopyrrolate respectively, and this was significantly different. The smallest doses of both drugs were generally associated with supraventricular dysrhythmias, whereas these were mainly ventricular following the highest doses of both drugs.
Rectal premedication in children
Authors: LINDAHL STEN , OLSSON A.‐K. , THOMSON DICK 
Published: February 2007

SummaryRectal premedication with diazepam, morphine and hyoscine has been used in 20 healthy children undergoing minor surgery. Satisfactory sedation was achieved in the majority of children and the anticholinergic effects were also adequate. Peak plasma levels of diazepam and morphine were reached within 30 minutes, and the plasma levels decreased after 2 hours. No adverse effects on ventilation were seen during anaesthesia.
Bupivacaine infiltration after lumbar laminectomy
Authors: TEDDY P.J. , FABINYI G.C.A. , KERR J.H. , BRIGGS M. 
Published: February 2007

SummaryThis is a report of a double‐blind controlled trial to test the hypothesis that peroperative local infiltration of the wound of lumbar laminectomy with bupivacaine produces a significant reduction in postoperative back pain. No such effect was demonstrated when the linear analogue was used to record the patients' subjective response to pain. It is suggested that this treatment is not indicated as a routine method.
Acceptability of continuous nasal nitrous oxide during labour—a field trial in six maternity hospitals
Authors: ARTHURS G. J. , ROSEN M. 
Published: February 2007

SummaryIn six maternity hospitals 516 mothers during labour received 50% nitrous oxide and 50% oxygen (Entonox) continuously at 5 litres/minute through a single‐end nasal catheter and intermittently by a mouthpiece for a mean duration of 3 hours 30 minutes (513 mothers). A comparison was made with a control group of 575 mothers who had intermittent inhalation of Entomox only for a mean duration of 3 hours 6 minutes (574 mothers). The midwives had no difficulty learning to manage the administration of nasal Entonox. Eighty‐six per cent of mothers agreed to use the nasal method and 70% continued for the duration of their labour. The midwives reported that pain relief was improved, and 51 (92%) would wish to continue offering the technique.
Cardiopulmonary resuscitation in a teaching hospital
Authors: Scott Ralph P.F. 
Published: February 2007

SummarySeventy‐eight cases of cardic arrest occurring outside intensive care units and emergency rooms were analysed. 44° of patients were initially resuscitated, and 14° were still alive at 28 days. The preiously well documented relationships between survival and location of arrest, age of patient and initial dysrhythmia were confirmed.A diurnal variation in the incidence of cardiac arrest has recently been postulated, but was not noted in this survey. However, the proportion of arrest patients who were initially resuscitated did show a significant fluctuation over the 24‐hour period as tested by a sinusoidal logistic regression.
The relationship between reported atopy or allergy and immunoglobulins: a preliminary study
Authors: WATKINS J. , CLARKE R.S.J. , FEE J.P.H. 
Published: February 2007

SummaryThe serum of 50 surgical patients with a history of asthma, hay fever or allergy has been analysed for IgE levels and compared with a control group without such a history. The values in the ‘normal’ group largely fell within the accepted range (below 200 iu./ml). Those in the ‘hypersensitive’ group had a wide range extending to over 1000 iu./ml but many of those with low values in this group had contact dermatitis and similar minor allergies. However, analysis of cases studied shows that any patient with a history of atopy or allergy is at risk from Cremophor‐containing intravenous anaesthetics.
Minaxolone: an evaluation with and without premedication
Authors: McNEILL H.G. , CLARKE R.S.J. , DUNDEE J.W. , BRIGGS L.P. 
Published: February 2007

SummaryMinaxolone, a water‐soluble steroid intravenous anaesthetic, has been used in clinical trials for induction and maintenance in patients presenting for minor operations. A standard induction dose of 0.5 mg/kg was given. There was a low incidence of pain on injection and venous sequelae. Excitatory effects occurred commonly at induction but these were reduced by opiate premedication. The frequency of uneventful induction was significantly greater when the 5 mg/ml solution of minaxolone was given at a rate of 6 ml/minute than at a rate of 24 ml/minute. Minaxolone has been withdrawn from clinical trials following equivocal toxicological findings in rats which require further investigation.
Narcotic addiction in patients with chronic pain
Authors: EVANS P.J.D. 
Published: February 2007

SummaryThe notes of 717 patients attending the Regional Pain Relief Unit, Abingdon, were reviewed. One hundred and thirty patients (18°) were taking narcotic analgesics. Of these, 74 were suffering from cancer and 56 (9·7°) had chronic benign pain. Nine patients were considered to be addicted to their analgesics.Nine men and five women were able to discontinue their narcotic analgesics as a result of therapy. All of these patients had been receiving oral agents for more than one year.
Postoperative analgesia for day‐case herniorrhaphy patients
Authors: WOOD G.J. , LLOYD J.W. , BULLINGHAM R.E.S. , BRITTON B.J. , FINCH D.R.A. 
Published: February 2007

SummaryPatients were admitted as day‐cases for inguinal herniorrhaphy under epidural anaesthesia and chlormethiazole sedation. The patients were given oral analgesia, and in addition, some were given either a paravertebral block with a dextran/bupivacaine mixture or cryoanalgesia of the ilio‐inguinal nerve for postoperative pain relief. These anaesthetic and analgesic techniques are discussed in relation to day‐case herniorrhaphy.
Influence of cerebrospinal fluid on epidural pressure
Authors: Shah J.L. 
Published: February 2007

SummaryThe pressure in the epidural space was measured with a water manometer in 40 women receiving elective epidural for pain relief in labour, and in three patients who were undergoing lumbar puncture. Injection of a small volume of fluid in the epidural space produced a positive pressure in all subjects, with a mean of 14 cmH2O (range 6·5–20 cmH2O). Pressure varied with posture, respiration, cough and jugular venous compression. The variations in pressure agreed closely with those reported for cerebrospinal fluid (CSF) pressure. It is suggested that in the lumbar region the dura fills the vertebral canal and is both compressible and expansile. When fluid is injected into the epidural space, the dura acts as a movable membrane and pressures on either side of it tend to equalise. Measurement of epidural pressure may provide a less traumatic way of estimating CSF pressure than traditional methods.
Pain relief in labour using epidural pethidine with adrenaline
Authors: Perriss Brian W. , Malins Andrew F. 
Published: February 2007

SummaryThe degree of pain was assessed by use of a visual analogue scale in 20 patients in established labour before and after the epidural injection of pethidine 50 mg with adrenaline 1: 200,000. Forty‐two doses were administered and of these 83% gave good pain relief and only 5% had no effect at all. The duration of action was longest following the first dose decreasing with subsequent doses. No evidence of sympathetic or motor blockade was found and side‐effects were minimal. In the postpartum period 17 of the mothers expressed full satisfaction with the technique.
A field trial of cimetidine as the sole oral antacid in obstetric anaesthesia
Authors: JOHNSTON J. R. , McCAUGHEY W. , MOORE J. , DUNDEE J. W. 
Published: February 2007

SummaryCimetidine was used as the routine antacid treatment for 1323 parturients. The findings from 70 of those who needed an emergency general anaesthetic are reported. Once sufficient time had elapsed for absorption of the drug, and provided that the dosage regime was adhered to, 96% of the women studied had an intragastric pH above 2.5. Neonatal monitoring revealed no abnormalities related to the cimetidine treatment.
Evaluation of a computer simulation program for teaching halothane uptake and distribution
Authors: HEFFERNAN P. B. , GIBBS J. M. , McKINNON A. E. 
Published: February 2007

SummaryA pilot evaluation of a simulation program used during a tutorial for the teaching of uptake and distribution of the inhalational anaesthetic halothane shows a highly significant improvement in the students' answers after the tutorial using a ‘before and after’ questionnaire. The students showed an understanding of the program's display and model limitations. This encourages the further use of the program.