bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contamination control in long‐term ventilation
Authors: GALLAGHER J. , STRANGEWAYS J. E. M. , ALLT‐GRAHAM J. 
Published: February 2007

SummaryTwenty‐eight patients who required periods of mechanical ventilation for up to 22 days in the intensive therapy unit were studied to evaluate the clinical use of the Pall Ultipor Breathing System Filter (BB50T) as a heat‐ and moisture‐exchanging bacterial filter. Results in this group of patients showed that there was no longer any need to sterilise breathing systems or decontaminate ventilators if these filters were used. They also performed satisfactorily as a heat and moisture exchanger in patients in need of long‐term ventilation, and their use appears to offer substantial advantages as regards cost, ease of use and patient safety.
Prolongation of neuromuscular blocking effect of vecuronium by antibiotics
Authors: JEDEIKIN R. , DOLGUNSKI E. , KAPLAN R. , HOFFMAN S. 
Published: February 2007

SummaryA case is described of prolonged neuromuscular block in a patient who was given the muscle relaxant vecuronium followed by bolus injections of the antibiotics gentamycin and clindamycin.
Histamine levels and cardiovascular responses during splenectomy and splenorenal shunt formation in a patient with systemic mastocytosis
Authors: SMITH G. B. , GUSBERG R. J. , JORDAN R. H. , KIM B. 
Published: February 2007

SummarySystemic mastocytosis is a rare disorder characterised by the infiltration of many tissues by abnormal numbers of mast cells. Life‐threatening episodes of bronchospasm and hypotension are common in response to a variety of triggers which cause mast cell degranulation. We present the case history of a patient with severe mast cell disease who successfully underwent splenectomy and portocaval anastomosis. Peri‐operative therapy was directed towards mast cell stabilisation, and histamine‐releasing drugs were avoided. Cardiovascular data, together with blood histamine levels and thrombin times, indicated that mast cell degranulation did not occur. A review of the current literature concerning mast cell disease as it relates to anaesthesia is presented and suggestions for the safe management of such cases are given.
Arterial oxygen saturation during general anaesthesia for paediatric dental extractions
Authors: Bone M. E. , Galler D. , Flynn P. J. 
Published: February 2007

SummaryArterial oxygen saturation (Sao2) was measured in 50 healthy children undergoing dental extractions under general anaesthesia. An inhalational anaesthetic technique was employed, with an inspired oxygen concentration of 33%. There were decreases in Sao2 of greater than 5% of the baseline value in 70% of patients, and greater than 10% in 26% of patients. The majority of these decreases were associated with teeth extractions or during placement of dental prop and pack. Non‐Caucasion children showed a significantly (p < 0.05) greater maximum decrease in Sao, from baseline value compared to Caucasian children. The maximum decreases in Sao2 from baseline value in children anaesthetised by supervised dental students, and in children whose extractions were performed by dental students, were significantly (p < 0.05) greater than in children whose anaesthetic and surgery were performed by members of staff.
Monitoring neuromuscular blockade
Authors: DUNDAS C. R. , LEVACK I. D. , BROCKWAY M. S. 
Published: February 2007

SummaryA simple and inexpensive force transducer made from a stainless steel table knife is described. Construction is straightforward and utilises strain gauges that are readily available. Amongst its attributes are lightness, ease of application, low sensitivity to postural changes and linearity over extended periods of time.
The respiratory depressant effects of nalbuphine and papaveretum as intramuscular premedication
Authors: RUTTHR G. G. R. , AVELING W. , TUSIEWICZ K. 
Published: February 2007

SummaryForty‐four patients scheduled for routine gynaecological surgery through a Pfannenstiel incision were given either nalbuphine or papaveretum as premedication, with hyoseine. Respiratory depression was measured by carbon dioxide rebreathing before and one hour after premedication. Both combinations produced significant respiratory depression as measured by the rebreathing test but no significant difference could be shown between the drugs in this respect.
Subarachnoid block with hyperbaric lignocaine
Authors: EWART M. C. , RUBIN A. P. 
Published: February 2007

SummaryA double‐blind study was carried out in 20 patients to compare 5% hyperbaric lignocaine and 0.5% hyperbaric bupivacaine Jar subarachnoid block. The injections were made in the lateral position and the patients turned supine immediately. The onset, extent and duration of sensory and motor blockade, the quality of anaesthesia, cardiovascular effects and the frequency of side effects were studied. Cephalad spread of analgesia was high (T4–5) with both solutions. Bupivacaine produced a longer duration of action in the lumbar and sacral segments but the duration in the thoracic segments was similar. There was a considerable degree of hypotension in both groups but this responded readily to ephedrine. Hyperbaric lignocaine is an alternative to hyperbaric bupivacaine and its shorter duration of action in the lumbar and sacral segments is advantageous when a fast recovery is desirable.
Spinal cord compression during chronic epidural morphine administration in a cancer patient
Authors: van DIEJEN D. , DRIESSEN J. J. , KAANDERS J. H. A. M. 
Published: February 2007

SummaryA case is described of thoracic spinal cord compression that occurred during continuous epidural administration of morphine. Sensory loss and motor weakness in the legs disappeared after catheter removal and antibiotic treatment.
Upper airway obstruction in neurofibromatosis
Authors: CROZIER W. C. 
Published: February 2007

SummaryA patient with von Recklinghausen's neurofibromatosis developed severe upper airway obstruction at the induction of anaesthesia and required emergency cricothyroidotomy. The cause was a neurofibroma at the base of the tongue. Features of von Recklinghausen's neurofibromatosis which may be of importance to the anaesthetist are reviewed.
Potential leaks from anaesthetic machines
Authors: McQUILLAN P. J. , JACKSON I. J. B. 
Published: February 2007

SummaryTwenty anaesthetic machines were examined to detect leakage of fresh gas through open Rotameter flow control valves and empty cylinder yokes. Significant leakage was demonstrated in most machines. Any leakage in machines which comply with ISO 5358, where oxygen is the last gas into the common gas manifold, is selective for nitrous oxide and, conversely, it is selective for oxygen in machines where oxygen is the first gas into the common gas manifold. Leakage is augmented by back pressure from ventilators that function as minute volume dividers. In ventilated patients the leakage described may contribute to hypoventilation and patient hypoxia or to pollution of the operating theatre and patient awareness.
Serum fluoride levels in morbidly obese patients: enflurane compared with isoflurane anaesthesia
Authors: STRUBE P. J. , HULANDS G. H. , HALSEY M. J. 
Published: February 2007

SummaryObese patients are known to metabolise anaesthetic agents more than patients of normal weight. The extent of this was investigated by the measurement of serum fluoride concentrations in 10 morbidly obese patients undergoing gastroplasty. Five were allocated to receive enflurane and five to receive isoflurane supplemented anaesthesia. The mean peak serum fluoride concentrations after enflurane anaesthesia were greater (22.7 μmol/litre, SE 2.9) than after isoflurane anaesthesia (6.5 μmol/ litre. SE 0.6). The mechanisms and implications of this finding are discussed.
Brachial plexus block
Authors: MANARA A. R. 
Published: February 2007

SummaryA supraclavicular brachial plexus block was performed which resulted in unilateral sensory and motor blockade of the thoracic and abdominal walls. General anaesthesia was therefore used and postoperatively it was noticed that analgesia of the upper limb had developed. It is likely that the blockade resulted from an intrapleural injection of local anaesthetic.
One lung anaesthesia
Authors: JENKINS J. , CAMERON E. W. J. , MILNE A. C. , HUNTER R. M. 
Published: February 2007

SummaryTen patients about to undergo left‐sided thoracotomy for carcinoma of the lung were entered into a crossover trial to compare cardiovascular and respiratory function during high frequency jet ventilation and conventional mechanical ventilation for one lung anaesthesia. All patients were anaesthetised with a standard technique using double lumen tubes and placed in the lateral position with the left chest open.The results showed no significant differences with regard to ventilation sequence but one lung high frequency jet ventilation gave higher values than one lung conventional ventilation for shunt (p < 0.01) and positive end expiratory pressure (p < 0.05) and lower peak inflation pressure values (p < 0.01). There were no significant differences in cardiac output, pulmonary capillary wedge pressure, arterial carbon dioxide or available oxygen.Surgical conditions were satisfactory during both methods of ventilation and satisfactory gas exchange occurred. It was, however, more difficult to assess adequacy of ventilation during high frequency jet ventilation and the routine use of this method of ventilation is not recommended during one lung anaesthesia.
Suxamethonium in myasthenia gravis
Authors: WAINWRIGHT A. P. , BRODRICK P. M. 
Published: February 2007

SummaryThe effects of suxamethonium 1.0 and 0.5 mg/kg were studied in myasthenie patients. Resistance was not encountered at the 1.0 mg/kg dose but was seen at the lower dose. A non‐depolarising type of block developed in patients in both groups. However, recovery from the non‐depolarising block was not prolongea beyond the requirements of surgery. The neurophysiological basis for, and clinical implications of these findings are discussed.
Persistent pneumothorax treated with continuous positive airway pressure
Authors: ELPHINSTONE M. G. , GRANT I. S. 
Published: February 2007

SummaryA patient who presented with persistent pneumothorax after blunt chest trauma is described. The lung re‐expanded partially in response to chest drain suction but some areas remained collapsed. The institution of continuous positive airway pressure on an intermittent basis, was followed by complete re‐expansion of the lung and resolution of the pneumothorax.
Isoflurane as an alternative to halothane for Caesarean section
Authors: GHALY R. G. , FLYNN R. J. , MOORE J. 
Published: February 2007

SummaryTwo series of 25 patients who underwent elective Caesarean section with general anaesthesia were given either 0.75% isoflurane or 0.5% halothane as supplements to 50% nitrous oxide in oxygen used for maintenance. The potent inhalational agent was given for the entire operative period and no case of intra‐operative dreaming or awareness was reported. The infusion dose of suxamethonium was significantly less with isoflurane, 50 μg/kg/minute (SD 17), as compared to halothane, 64 μg/kg/minute (SD 24) (p < 0.02). Recovery from anaesthesia was more rapid with isoflurane. The surgeon's assessment of uterine relaxation and bleeding using a visual analogue score indicated that this was significantly less with isoflurane. Infant well‐being as judged by Apgar score and cord blood gas analysis, showed little difference between the two inhalational agents.
Pressure infuser devices
Authors: COX P. 
Published: February 2007

SummaryThree currently available pressure infusor devices, based on three different principles, were tested to see if the pressure reading on the infusor manometer corresponds to the pressure generated in the infusion system. Each device was tested in two ways. First, the pressure generated in the infusion system was measured when the infusor bag pressure was maintained at 300 mmHg while the infusion bag was emptied in aliquots of 50 ml. Second, the pressures in the infusor bag required to maintain a pressure of 300 mmHg were measured as the infusion bag was emptied stepwise.The results reveal surprisingly large discrepancies between the pressure registered on the infusor manometer and the actual pressure generated in the fluid, which are not due to manometer inaccuracy. The degree of discrepancy depends on the amount of fluid that remains in the infusion bag and, when the infusor manometer shows a pressure of 300 mmHg, pressure in the fluid can be as much as 170 mmHg above or 200 mmHg below this value. Furthermore, it was impossible to maintain a pressure of 300 mmHg in the infusion system using one of the devices despite the fact that 100 ml fluid remained. The clinical significance of these findings is discussed.
Total intravenous anaesthesia for military surgery. A technique using ketamine, midazolam and vecuronium
Authors: Restall J. , Tully A. M. , Ward P. J. , Kidd A. G. 
Published: February 2007

SummaryKetamine and midazolam were used for induction of anaesthesia and by continuous intravenous infusion for maintenance to assess their suitabiliity for use in a total intravenous anaesthetic technique in the management of battle casualties. Muscular relaxation was provided by vecuronium and the patients' lungs ventilated with air. Ketamine was infused at a rate of 2 mg/kg/hour. This was achieved by mixing ketamine 200 mg, midazolam 5 mg and vecuronium 12 mg in 50 ml normal saline. The rate of infusion of the mixture (ml/hour) was then equal to 50% of the body weight in kg. The technique proved to he simple, effective and versatile and should be adaptable for use in the management of battle casualties.
Temazepam and recovery in day surgery
Authors: Obey P. A. , Ogg T. W. , Gilks W. R. 
Published: February 2007

SummaryA double‐blind trial of temazepam premedication for day cases was undertaken. Effective anxiolysis was recorded in the groups that received temazepam 10 or 20 mg and there was no prolongation of delayed recovery times as measured by memory test cards. All patients were, discharged from the day unit 3 hours after the administration of general anaesthesia.
Hypoxaemia after premedication in cardiac patients. Glycopyrronium compared with hyoscine
Authors: Hetreed M. A. , Aps C. 
Published: February 2007

SummaryArterial blood gases were analysed before and approximately one hour after premedication in two groups of 10 patients awaiting cardiac surgery. One group received intramuscular papaveretum and hyoscine, the other papaveretum and glycopyrronium. Similar, small but statistically significant reductions in mean arterial oxygen tension and oxygen saturation, and increases of arterial carbon dioxide tension occurred in both groups. Hypoxaemia in individual patients was unpredictable and in some was clinically relevant.
Adult respiratory distress syndrome—how many cases in the UK?
Authors: WEBSTER N. R. , COHEN A. T. , NUNN J. F. 
Published: February 2007

SummaryPreviously reported figures for the incidence of Adult Respiratory Distress Syndrome, based largely on American results, would suggest that the average British Health District of 200 000 people could expect to see 130 cases per year. This figure is greatly in excess of that expected from our clinical experience. We have undertaken a retrospective survey of patients within a British Health Region (population, 3 599 400). Results indicate an incidence of nine for an average Health District of 200 000 population, or 2.5% of all admissions to intensive therapy units, or 0.045 per 1000 resident population.
Rectus sheath block for diagnostic laparoscopy
Authors: SMITH B. E. , SUCHAK M. , SIGGINS D. , CHALLANDS J. 
Published: February 2007

SummarySixty adult females of ASA grade 1 or 2 scheduled to undergo diagnostic laparoscopy were allocated randomly to one of two groups. In group A, laparoscopy was performed with a standardised general anaesthetic technique alone. In group B, the same general anaesthetic technique was supplemented with bilateral rectus sheath block. Postoperative analgesia was assessed at 1, 6 and 10 hours after operation. Visual analogue pain scores in group B were significantly lower than in group A despite a greater use of intramuscular analgesic injections in group A (p < 0.005 in each case).
Anaphylactic reaction after atropine
Authors: AGUILERA L. , MARTINEZ‐BOURIO R. , CID C. , ARINO J. J. , DE EGUILAZ J. L. SAEZ , ARIZAGA A. 
Published: February 2007

SummaryA 38‐year‐old woman developed symptoms of anaphylactic shock after intravenous atropine and required adrenaline to maintain per fusion pressure. A strongly positive response was obtained on intradermal testing. The Prausnitz‐Kuestner test was also positive, which indicated the presence of drug specific IgE antibodies. No response was obtained after hyoscine.
Fatal anaphylactic reaction to suxamethonium: new screening test suggests possible prevention
Authors: ASSEM E. S. K. , LING Y. B. 
Published: February 2007

SummaryA 40‐year‐old woman suffered cardiovascular collapse, cardiac ischaemia and arrest during induction of anaesthesia. Sever cerebral ischaemic damage was sustained during this episode and the patient died 4 days later. This fatal reaction was shown to be anaphylactic in origin; the causative agent was suxamethonium. High levels of IgE antibodies specific to the quaternary ammonium group (two of which are present in suxamethonium) were detected by the radioallergosorbent test. Results of the leucocyte histamine release test were less clear, partly as a result of steroid treatment. The two most relevant points were the absence of a history of previous anaesthesia, and involvement of the heart as the principal target of the reaction. This unfortunate and extreme case indicates the necessity for allergy testing (screening) before anaesthesia, and the need for organisation and funding of this procedure, if these fatal or near‐fatal reactions are to be prevented. It is a timely reminder that action should be taken, since neuromuscular blockers have been confirmed as the most common culprits, and that specific tests for IgE antibodies are now available against haptenic groups generally common to all neuromuscular blockers.
Respiratory failure following envenomation
Authors: KARALLIEDDE L. D. , SANMUGANATHAN P. S. 
Published: February 2007

SummaryRespiratory failure may occur after envenomation. We report our experiences of a patient who required ventilatory care after krait bite. The krail (Bungarus) venom is known to contain bungarotoxins which act at the neuromuscular junction. No cardiac, renal or coagulation disorders were associated with the muscle paralysis after the snake bite. Ventilatory care was easy to institute and was life saving.
A comparison of isoflurane and halothane in anaesthesia for intra‐ocular surgery
Authors: CRAIG J. F. , COOK J. H. 
Published: February 2007

SummaryIsoflurane 0.75% was compared with halothane 0.5% as the volatile supplement in a normocapnic technique for intra‐ocular surgery. Both agents gave satisfactory conditions for operation with a comparable reduction in intra‐ocular pressure during the procedure. Systolic arterial pressure, however, was significantly lower in the isoflurane group at the end of surgery and after tracheal extubation than in the halothane group. Isoflurane provides a useful alternative to halothane in anaesthesia for intraocular surgery.
Perineuronal morphine: a comparison with epidural morphine
Authors: DAHL J. B. , DAUGAARD J. J. , KRISTOFFERSEN E. , JOHANNSEN H.V. , DAHL J. A. 
Published: February 2007

SummaryIn a double‐blind, randomised controlled cross‐over study the effects of perineuronal (perifemoral) injections of morphine were compared with epidural injections with the same amount of morphine in patients after knee surgery. Better pain scores were achieved during treatment with epidural morphine. We have not been able to confirm the hypothesis of neuro‐axonal transport of morphine from the periphery to the spinal cord.
The nasocardiac reflex
Authors: BAXANDALL M. L. , THORN J. L. 
Published: February 2007

SummaryThe oculocardiac reflex is well described and recognised in anaesthesia. The nasocardiac reflex is less well‐known. We describe a clinical manifestation of this reflex and describe the relevant anatomy. This reflex may be obtunded during general anaesthesia, during general anaesthesia.
Propofol: clinical strategies for preventing the pain of injection
Authors: Scott R.P.F. , Saunders D.A. , Norman J. 
Published: February 2007

SummaryEight modes of administration of propofol were assessed in order to minimise the pain of injection. An intravenous bolus injection in the antecubital fossa was the only approach that caused no pain. When administered intravenously in the dorsum of the hand the pain score and the number of patients who experienced pain was reduced significantly by mixing the agent with lignocaine when compared with a bolus injection. Slowing the speed of injection caused the greatest discomfort. An indirect biochemical mechanism for the pain is proposed.
High frequency jet ventilation in intensive care—a review of 63 patients
Authors: Smith B. E. , Scott P. V. , Fischer H. B. J. 
Published: February 2007

SummaryHigh frequency jet ventilation has been used clinically in this unit for over 2 years. During this time we have treated 63 intensive care patients for whom the mean duration of ventilatory support was 3.4 days, which represents more than 5000 patient hours in total, with the Penlon Bromsgrove humidified jet ventilator. The series comprises a wide variety of general intensive care patients; a review of these cases is presented.
Induction characteristics of propofol in children: comparison with thiopentone
Authors: Mirakhur R. K. 
Published: February 2007

SummaryThe induction characteristics of propofol were studied and compared with thiopentone in children aged 3–14 years who received either no premedication or pethidine‐atropine or trimeprazine. Anaesthesia was maintained with nitrous oxide in oxygen, and isoflurane. The induction doses of propofol and thiopentone were 2.9 mg/ kg and 6.5–7.1 mg/kg respectively; premedication had no significant effect on the induction doses of either agent. Spontaneous movement and hypertonus occurred in about 20% of children with both agents. The use of propofol was associated with a high incidence of pain on injection (injections were mostly in veins on the dorsum of the hand), but this was reduced by mixing lignocaine with propofol. Cardiovascular effects were not clinically significant with either agent. Apnoea occurred in 35% of patients given propofol and in 50% of those given thiopentone. Children anaesthetised with propofol awoke significantly earlier after cessation of all anaesthesia. It is concluded that the use of propofol is safe in children and may have advantages where early recovery from anaesthesia is desirable, but offers no advantage over thiopentone for routine induction of anaesthesia.
A comparison of different methods of lubrication of glass syringes used to identify the epidural space
Authors: LEIMAN B. C. , KATZ J. , SALZARULO H. , WARTERS R. D. , BUTLER B. D. 
Published: February 2007

SummaryMeasurement of loss of resistance in glass syringes is a method widely used to locate the epidural space in epidural anaesthesia. Static and dynamic forces were measured under four experimental conditions in new glass syringes: unpolished, dry; polished, dry; unpolished, saline lubricated; and polished, saline lubricated. The unpolished saline lubricated syringes had a mean (SD) static force of 53.18 (15.0) g and dynamic force of 40.88 (15.2) g. These values were significantly greater than for polished dry syringes where the values were 5.27 (2.1) g and 4.38 (0.94) g, respectively. The results show that the least amount of resistance to plunger movement is obtained by dry polishing glass syringes.