bluuebunny/crossref_metadata_2025_split huggingface dataset:
An epidural infusion technique for labour
Authors: Gaylard D.G. , Wilson I.H. , Balmer H.G.R. 
Published: February 2007

SummaryA regimen to facilitate control of epidural infusions in labour has been developed which allows midwives to alter infusion rates to maintain satisfactory analgesia. The technique was used successfully in 30 patients and, in a prospective study, was compared with women who received conventional top‐up epidurals. It was found that infusions provided comparable analgesia and decreased midwife workload but resulted in a higher dosage of bupivacaine.
Antiemetic studies with traditional Chinese acupuncture
Authors: Ghaly R.G. , Fitzpatrick K.T.J. , Dundee J.W. 
Published: February 2007

SummaryThe application of low frequency (10 Hz) electrical current for 5 minutes to an acupuncture needle placed at the P6 (Neiguan) point is as effective as manual needling in the reduction of emetic sequelae in women premedicated with nalbuphine 10 mg for a minor gynaecological operation carried out under a standard anaesthetic. Both were slightly, but not significantly, better than the antiemetic properties of cyclizine 50 mg.
High frequency ventilation and afferent vagal activity
Authors: HARROP‐GRIFFITHS A.W. , CHAKRABARTI M.K. , WHITWAM J. G. 
Published: February 2007

SummaryRecordings were made from pulmonary afferent fibres in the vagus nerves of anaesthetised dogs during conventional and high frequency ventilation. In single and multiple fibre preparations, the mean spike counts per minute at 14 breaths/minute were in the ranges 36.9–155.3 and 755–1921, respectively. These counts decreased by up to 61 and 44% respectively at 100 breaths/minute, and by 27–89% and 22–51% at 200 breaths/minute. At this frequency there was a further decrease of between 19 and 65% when the positive end expiratory pressure was removed. The findings of this study are intuitively acceptable, since pulmonary stretch receptor activity is proportional to tidal volume, and are in keeping with the clinical impression that high frequency ventilation per se does not eliminate respiratory drive.
Alfentanil infusions. Comparison of bolus administration of fentanyl with three alfentanil infusion regimens
Authors: Stuart‐Taylor M.E. , Sleigh J.W. 
Published: February 2007

SummaryThree different dosage regimens of alfentanil were compared with boluses of fentanyl in 80 patients who underwent a variety of surgical procedures. Alfentanil given by infusion at a rate of 7.5 μg/kg/minute for 10 minutes followed by 0.75 μg/kg/minute, was shown to provide a stable anaesthetic which minimises the use of a volatile agent for surgery that lasts more than 45 minutes.
Combined unilateral high frequency jet ventilation and contralateral intermittent positive pressure ventilation
Authors: MORGAN B. A. , PERKS D. , CONACHER I. D. , PAES M. L. 
Published: February 2007

SummaryThe anaesthetic management of a patient who required right lower lobectomy for bronchial carcinoma associated with emphysema, pneumoconiosis and a previous thoracoplasty for pulmonary tuberculosis, is described. A technique of unilateral high frequency jet ventilation plus conventional intermittent positive pressure ventilation to the contralateral lung was used.
Tracheal tubes in neuroanaesthesia. Nylon reinforced latex rubber tracheal tubes *
Authors: P. J. Wright FFARCS Consultant  , Mundy J. V. B. 
Published: February 2007

SummaryAn exercise in quality assurance during neuroanaesthetic procedures identified uncontrolled re‐use of armoured latex rubber tracheal tubes as a risk factor associated with equipment failure. We recommend that such lubes should be used once only. Alternatively, tubes made from more stable materials, such as polyvinyl chloride and silicone rubber, are available for clinical evaluation.
Pre‐eclampsia in a parturient with a history of myocardial infarction
Authors: DAWSON P. J. , ROSS A. W. 
Published: February 2007

SummaryA mother with pre‐eclamptic toxaemia and severe coronary artery disease was managed with epidural analgesia accompanied by invasive cardiovascular monitoring. Caesarean section was carried out uneventfully using the epidural. The literature is reviewed.
Clinical trial of the Continucath intra‐arterial oxygen monitor
Authors: PFEIFER P. M. , PEARSON D. T. , CLAYTON R. H. 
Published: February 2007

SummaryAn intra‐arterial continuous display oxygen electrode for radial artery cannulation is now available in the UK. Nine catheters were used in patients during and after hypothermic cardiac surgery. Results obtained were compared with those from conventional intermittent blood gas samples. Slow temperature response times negate its use during hypothermic surgery. A good correlation was found during the postoperative period. Indications for its use are discussed.
Low volume, high concentration block of the sciatic nerve
Authors: SMITH B. E. , SIGGINS D. 
Published: February 2007

SummarySciatic nerve block was performed in two groups of patients using a low power peripheral nerve stimulator to aid nerve location. In group A 1% prilocaine with felypressin was used as the local anaesthetic agent in a volume of 0.25 ml/kg body weight. In group B 3% prilocaine with felypressin was used in a volume of 0.08 ml/kg body weight (i.e. equal total drug dosages). Use of the 3% solution resulted in highly significant reductions in the mean latency for analgesia of the nerve block and in the latency and degree of motor block achieved (p < 0.005 in each case). The clinical value of high concentration, low volume nerve block is discussed.
A combined oxygen concentrator and compressed air unit
Authors: EASY W. R. , DOUGLAS G. A. , MERRIFIELD A.J. 
Published: February 2007

SummaryA prototype combined oxygen concentrator and air compressor is described. Laboratory assessment demonstrated satisfactory oxygen concentrations, flows, pressures and reliability. Its various modes of use in clinical practice are described. It is likely to be a valuable method to provide oxygen for anaesthesia both in remote areas and where nitrous oxide‐free anaesthesia is required, as well as a reliable alternative to commercially produced oxygen for therapeutic purposes.
Some observations of levels of plasma cholinesterase activity within an obstetric population
Authors: WHITTAKER M. , CRAWFORD J. S. , LEWIS M. 
Published: February 2007

SummaryAn account of plasma cholinesterase activity in samples of maternal and cord blood is presented. It is confirmed that plasma exchange markedly reduces the level of activity in maternal blood, and that the level is further reduced during the first 3–4 postnatal days. A particularly marked decrease was found in those cases in which spontaneous mid‐trimester abortion occurred. The level of activity in maternal blood (excluding mothers subjected to plasma exchange) at the time of delivery, was higher than that in cord blood in 61% of cases. In 23% of cases the level of activity was appreciably (0.05 units) higher in cord blood, and two‐thirds of these cord samples contained the E2+ electrophoretic variant of plasma cholinesterase. The mean levels of activity in maternal and cord blood of Rhesus negative patients were significantly lower than those among Rhesus positive patients but there was no such distinction between Rhesus positive and Rhesus negative males and nonpregnant females. We encountered an incidence of 1:228 abnormal phenotypes in a series of 1593 mothers who underwent Caesarean section under a technique of general anaesthesia which included a suxamethonium infusion. However, probably only two of the seven patients would definitely be sensitive when not pregnant.
Postoperative recovery after general anaesthesia with and without retrobulbar block in retinal detachment surgery
Authors: CHUNG F. , WESTERLING D. , CHISHOLM L. D. J. , SQUIRES G. W. 
Published: February 2007

SummaryThis study was to determine whether general anaesthesia plus retrobulbar block would be a better anaesthetic technique than general anaesthesia alone in retinal detachment surgery. Twenty‐eight patients were allocated randomly to either general anaesthesia with retrobulbar block or general anaesthesia alone. The anaesthetist involved was blinded as to whether a retrobulbar block was performed or not. Significantly fewer patients in the general anaesthesia plus block group complained of postoperative pain than patients in the general anaesthesia group (21.4% as compared with 64.3%, p < 0.05). Those who received general anaesthesia plus block recovered significantly more rapidly than those receiving general anaesthesia alone. The time to opening of eyes on command (p < 0.05), telling the correct date of birth (p < 0.01), reaching a full recovery score (p < 0.005) and performing a simple motor task (p < 0.025) was shorter in patients with general anaesthesia plus block. Thus general anaesthesia plus retrobulbar block was superior to general anaesthesia alone in terms of pain and recovery after operation.
The antigravity suit in neurosurgery
Authors: BRODRICK P. M. , INGRAM G. S. 
Published: February 2007

SummaryThe haemodynamic responses associated with inflation of the antigravity suit (G suit, aviation type) to 8.0 kPa were studied in a series of 40 patients who underwent neurosurgical operations in the sitting position. The study showed statistically significant increases in systolic arterial pressure (p < 0.005) and mean central venous pressure (p < 0.001) with inflation of the suit. The systolic arterial and mean central venous pressures remained significantly elevated immediately before deflation of the suit at the end of the operation (p < 0.001 and p < 0.005 respectively). The addition of 0.8–1.0 kPa positive end expiratory pressure during suit inflation was also investigated. A further increase in central venous pressure occurred but this did not achieve statistical significance.
The development of the anaesthetic vaporizer
Authors: ZUCK D. 
Published: February 2007

SummaryThe innovatory features incorporated into A.G. Levy's regulating chloroform inhaler, and their contribution to modern vaporizer design, are examined. Levy may be credited with the important realisation that the gas mixture which leaves the vaporizing chamber is fully saturated at all flow rates; with the concept of the splitting ratio; with appreciation of the importance of the application of Reynolds' researches on laminar and turbulent flow to the design of anaesthetic apparatus; and with the provision of a facility to compensate for changes of temperature in the vaporizing chamber.
Cricoid pressure and the pressor response to tracheal intubation
Authors: Mills P. , Poole T. , Curran J. 
Published: February 2007

SummaryForty healthy adults who underwent rapid sequence induction of anaesthesia were allocated randomly to receive either cricoid pressure or its simulation. The anticipated increase in systolic arterial pressure and heart rate after laryngoscopy and tracheal intubation were not altered significantly by the application of cricoid pressure.
Nifedipine and surgical removal of phaeochromocytoma
Authors: Chari P. , Katariya R. N. , Venkataraman R. K. , Trikha A. 
Published: February 2007

SummaryThe management of five patients with phaeochromocytoma undergoing surgical removal is described. Pre‐operative preparation with phenoxybenzamine and nifedipine for 7 days before surgery prevented excessive fluctuations in cardiovascular parameters in the peri‐operative period and resulted in an uneventful recovery.
Effects of beta‐adrenoceptor antagonism on the cardiovascular and catecholamine responses to tracheal intubation
Authors: ACHOLA K. J. , JONES M. J. , MITCHELL R. W. D. , SMITH G. 
Published: February 2007

SummaryThe catecholamine and cardiovascular responses to laryngoscopy and tracheal intubation were studied in 20 patients who underwent elective gynaecological surgery and who were allocated randomly to receive either practolol 10 mg or saline intravenously prior to induction of anaesthesia. Anaesthesia was induced with fentanyl and thiopentone; atracurium was administered and the lungs were ventilated artificially with 67% nitrous oxide in oxygen. Tracheal intubation was performed when muscle relaxation was adequate. Arterial pressure, heart rate, plasma noradrenaline and adrenaline concentrations were measured before and after tracheal intubation. A significant increase in catecholamine concentrations occurred in both groups in response to tracheal intubation but the magnitude of the increase in adrenaline was greater in the practolol group. There were no significant differences in arterial pressure or heart rate changes between the groups. We conclude that pretreatment with practolol is of no value in the attenuation of the hypertensive response to direct laryngoscopy and tracheal intubation in previously normotensive patients.
Plasma lignocaine levels during paediatric endoscopy of the upper respiratory tract
Authors: WHITTET H. B. , HAYWARD A. W. , BATTERSBY E. 
Published: February 2007

SummaryPlasma lignocaine levels were measured at 5, 10 and 15 minutes following local application (4 mg/kg) to the upper airway in children who underwent endoscopy under general anaesthesia. These levels were then correlated with the appearance of the moistness of the airway mucosa secondary to premedication with atropine. This latter assessment was carried out by one anaesthetist who used a predetermined scale of 1–5, where I was very dry and 5 very wet. Significantly higher (p < 0.05) plasma levels of lignocaine were achieved when the mucosa was ‘very dry’ especially in children under 2 years of age. The total dose of lignocaine applied to the upper airway of children should probably be reduced, in the presence of a ‘dry’ mucosa after effective antisialogogue premedication, and especially when less than 2 years of age.
The effect of changes in arm temperature on neuromuscular monitoring in the presence of atracurium blockade
Authors: THORNBERRY E. A. , MAZUMDAR B. 
Published: February 2007

SummaryThis study was designed to investigate the relationship between arm temperature and the degree of blockade as monitored by peripheral nerve stimulation by a comparison of both arms of each patient; one exposed to the environment and the other wrapped to maintain its temperature. The decrease in the temperatures of the exposed arms were significantly more than the wrapped arms. A discrepancy was noted proportional to the temperature difference between the two arms, when the train‐of‐four counts were compared. A recommendation is made to maintain the temperature of the monitored arm above 32°C.
Hypnosis and daycase anaesthesia
Authors: GOLDMANN L. , OGG T. W. , LEVEY A. B. 
Published: February 2007

SummaryFifty‐two female patients who underwent gynaecological operations as day cases received either a short pre‐operative hypnotic induction or a brief discussion of equal duration. Hypnotised patients who underwent vaginal termination of pregnancy required significantly less methohexitone for induction of anaesthesia. They were also significantly more relaxed as judged by their visual analogue scores for anxiety. Less than half of the patients were satisfied with their knowledge about the operative procedure even after discussions with the surgeon and anaesthetist. A significant correlation was found between anxiety and perceived knowledge of procedures. The results suggest that pre‐operative hypnosis can provide a quick and effective wav to reduce pre‐operative patient anxiety and anaesthetic requirements for gynaecological daycase surgery.
A comparison of two anaesthetic techniques for daycase arthroscopy
Authors: DICKSON D. M. , PRINGLE H. M. , BAMBER D. B. 
Published: February 2007

SummaryA randomised, double‐blind study of 100 patients admitted for daycase arthroscopy was undertaken. Fifty patients received alfentanil 500 μg and midazolam 5 mg, and 50 received alfentanil 500 μg alone, in each case 2 minutes before induction of anaesthesia with methohexitone. Anaesthesia was maintained in both groups with nitrous oxide, oxygen and enflurane. Recovery was assessed quantitatively by measuring time to when they awoke and by a comparison of pre‐ and postoperative performance of p‐deletion and postbox tests. Qualitative assessment of recovery and of postoperative pain was also undertaken. Patients completed a questionnaire to record the incidence of any anaesthetic‐related symptoms on the first and second postoperative days. Patients who received midazolam required a reduced dose of methohexitone but their initial recovery time was prolonged significantly. The incidences of anaesthetic‐related side effects and postoperative pain were similar in the two groups and while the questionnaires did not reveal any statistically significant differences in symptoms on the first 2 postoperative days, the results indicated that patients who received a larger induction dose of methohexitone were subjectively drowsier on the first day after operation.
Suxamethonium dosage in electroconvulsive therapy
Authors: KONARZEWSKI W. H. , MILOSAVLJEVIC D. , ROBINSON M. , BANHAM W. , BEALES F. 
Published: February 2007

SummaryA double‐blind study was conducted in 52 patients who received a total of 180 electroconvulsive therapy treatments. Patients‐were allocated randomly to receive doses of 15 mg, 25 mg or 50 mg of suxamethonium. Those who received suxamethonium 50 mg took significantly longer to breathe again compared with patients who received the lower doses, and were significantly more likely to have a very well modified convulsion than patients who received suxamethonium 15 mg. There were no differences among the groups in the incidences of muscle pains after treatment. We conclude that all three doses were acceptable; however, a dose of 25 mg had practical advantages over 50 mg and theoretical advantages over 15 mg.
Absorption of buccal morphine
Authors: FISHER A. P. , FUNG C. , HANNA M. 
Published: February 2007

SummaryThe absorption of buccal morphine was compared with that of slow‐release morphine sulphate in human volunteers. Morphine concentration was assayed by high pressure liquid chromatography in serum samples obtained at intervals up to 8 hours after administration of morphine 20 mg. Similar mean maximum concentrations were obtained by either route, hut the mean time to maximum concentration was longer after buccal than after enteral administration.
Recovery after single‐breath halothane induction of anaesthesia in daycase patients
Authors: NIGHTINGALE J. J. , STOCK J. G. L. , McKIERNAN E. P. , WILTON N. C. T. 
Published: February 2007

SummaryA single‐breath technique of inhalational induction of anaesthesia allows intravenous induction agents to be avoided. We have investigated recovery from anaesthesia in 40 daycase patients, using tests of psychomotor function. Patients anaesthetised with inhalational induction awaken earlier than those who receive thiopentone, but not significantly earlier. There were no significant differences in postoperative psychomotor function between patients who received thiopentone and those who had inhalational inductions. Single‐breath halothane, nitrous‐oxide, oxygen induction is an alternative to intravenous induction in cooperative adults, but does not confer significant benefits in terms of recovery.
Cocaine absorption from the nasal mucosa
Authors: BROMLEY L. , HAYWARD A. 
Published: February 2007

SummaryThe absorption of cocaine from the nasal mucosa was measured by serial plasma analysis in patients who received nasal cocaine for routine nasal surgery using the modified Moffett's method. Two groups were compared: one received cocaine alone and one with adrenaline 1:1000 added. Changes in pulse rate and blood pressure were recorded in each group. The group that received intranasal cocaine and adrenaline solution had significantly lower plasma cocaine levels. There was no significant difference in cardiovascular parameters between the two groups.
The effects of injected solution temperature on intravenous regional anaesthesia
Authors: PAUL D. L. , LOGAN M. R. , WILDSMITH J. A. W. 
Published: February 2007

SummaryTen healthy volunteers received three standard Bier's blocks. Prilocaine 0.5%, 40 ml was injected at a solution temperature of 0°C. 22°C or 37°C. Recordings were made of sensory block, motor block, intravenous pressure, limb temperature and pain on injection. There were no differences between the three treatments in the rate of development or in the quality of block but there was a significant difference in the comfort of injection. Cold solutions caused most, and warm solutions least discomfort.
Isoflurane for conscious sedation
Authors: RODRIGO M. R. C. , ROSENQUIST J. B. 
Published: February 2007

SummaryIsoflurane 0.5% in oxygen for conscious sedation was compared with placebo (oxygen) and with an equipotent concentration of nitrous oxide in oxygen, in patients scheduled for surgical removal of bilateral, similarly impacted lower third molars. The majority of patients were sedated with 0.5% isoflurane in oxygen and preferred it to both placebo and nitrous oxide in oxygen. It produced good operating conditions with cooperative patients and had no significant effect on vital signs. There were no significant intra‐ or postoperative adverse effects. Patients were street fit within 10 minutes after the end of the operation.
A drawover Boyle's machine
Authors: SINCLAIR J. R. , WILSON I. H. 
Published: February 2007

SummaryA standard Boyle International anaesthetic machine was modified to allow operation in either a continuous flow or a drawover mode. This was achieved by fitting a valve in the backbar which allows entrainment of air under drawover conditions. The details of the valve and modification are discussed and an evaluation of the machine in a Central African hospital is presented.
Comparison of propofol and methohexitone anaesthesia for thermocoagulation therapy of trigeminal neuralgia
Authors: KYTTÄ J. , ROSENBERG P. H. 
Published: February 2007

SummaryPropofol and methohexitone given in equipatent doses were compared for anaesthesia for thermocoagulation of trigeminal rootlets. Thirty‐eight patients received two to six injections of the induction agents in one therapy session. The increase in arterial blood pressure during coagulation was significantly lower in the propofol group. Respiratory problems were encountered more often in those who received methohexitone (7/19 patients) than propofol (2/19 patients). There was a small but significant increase in blood propofol concentrations as well as in methohexitone plasma concentrations after repeated injections. Individual wake‐up times increased to a statistically significant extent in relation to the number of doses of the induction agent but the increases were clinically unimportant (maximal mean change approximately 2 minutes). There were no differences in wake‐up times between the two anaesthetic groups.