bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacokinetics of propofol administered by continuous infusion in patients with cirrhosis
Authors: SERVIN F. , DESMONTS J. M. , FARINOTTI R. , HABERER J. P. , WTNCKLER C. 
Published: February 2007

SummaryAnaesthesia was provided by an infusion of propofol in six healthy patients and six patients with hepatic cirrhosis. There were no significant differences between the groups with regard to the central compartment volume, distribution volume at steady state, total apparent distribution volume, total body clearance or elimination half‐life, although the values were always greater in the cirrhotic patients. Recovery times were significantly longer in the patients with cirrhosis.
Effects of propofol on cardiovascular dynamics and coronary blood flow in geriatric patients
Authors: LARSEN R. , RATHGEBER J. , BAGDAHN A. , LANGE H. , RIEKE H. 
Published: February 2007

SummaryThe cardiovascular and myocardial effects of propofol and etomidate were studied in 20 geriatric patients (age 65–84 years) who underwent major upper abdominal surgery. Ten patients received propofol 1.5 mg I kg for induction of anaesthesia followed by a continuous infusion of 0.1 mg/kg I minute for maintenance; 10 patients received etomidate 18 mg for induction followed by 2.4 mg/minute for maintenance. Vecuronium was used for neuromuscular blockade. Cardiovascular dynamics were recorded in the awake state one minute after induction and 1, 5 and 30 minutes after tracheal intubation; coronary blood flow (argon wash‐in) and myocardial oxygen consumption were determined in the awake state and 5 and 30 minutes after intubation. Both anaesthetics decreased systolic, diastolic and mean arterial pressures, heart rate and cardiac index to the same extent. Myocardial blood flow and oxygen consumption were also reduced in both groups due to a reduction in cardiac work. Tracheal intubation produced a marked increase in arterial pressure in the etomidate group, while haemodynamic changes were absent in the propofol group, Myocardial lactate production was not observed in either group 5 or 30 minutes after tracheal intubation.
Propofol and emesis
Authors: GUNAWARDENE R. D. , WHITE D. C. 
Published: February 2007

SummaryNinety patients scheduled to undergo minor gynaecological surgery were divided into three groups. Group 1 received propofol only, for both induction and maintenance of anaesthesia. Group 2 were given propofol for induction and maintenance but inhaled 66% nitrous oxide in addition. Group 3 had propofol for induction only and were given nitrous oxide and enflurane thereafter. The incidence of nausea in group 1 was 0%, in group 2, 3.4% and in group 3, 9.4%. No patient vomited.
Use of propofol for sedation during gastrointestinal endoscopies
Authors: Dubois A. , Balatoni E. , Peeters J. P. , Baudoux M. 
Published: February 2007

SummaryThis study investigated the suitability of propofol as a sole agent for continuous sedation in 100 unpremedicated patients during gastrointestinal endoscopy. The propofol was given very slowly (average 62.7 seconds) in order to prevent apnoea during induction, and the dose adjusted according to age (68% of patients were older than 50 years) and ASA grade (32% were ASA grade 3 or 4). There was no correlation under these circumstances between the observed haemodynamic variations and the age or ASA grade of the patients. The infusion rate during maintenance was also adjusted for age, and for the type of endoscopy. The mean rate was 4.3 mg/kg/hour. Recovery was rapid and of excellent quality; 77 patients were awake within 10 minutes and 99 reported total amnesia.
Comparison between propofol and midazolam as sedative agents for surgery under regional anaesthesia
Authors: Fanard L. , Van Steenberge A. , Demeire X. , van der Puyl F. 
Published: February 2007

SummaryPropofol (25 patients) or midazolam (25 patients) was used to provide sedation in patients who underwent abdominal or orthopaedic surgery under epidural anaesthesia after intravenous premedication with droperidol 1 mg and fentanyl 20 μg. The quality of sedation whilst the block was performed, was assessed as good in 19 patients after propofol 1.49 mg/kg but six patients exhibited uncontrolled movement. Good sedation was provided in 22 patients after midazolam 3 mg. A mean infusion rate of propofol of 1.74 mg/kg/hour resulted in easily controllable sedation during the procedure. Eleven patients given midazolam required no further sedation but a mean of 5.79 mg was needed in the remaining 14 patients; the dose was unpredictable in individual patients. Recovery was significantly more rapid in the propofol group.
Intravenous infusion of propofol for induction and maintenance of anaesthesia during endoscopic carbon dioxide laser ENT procedures with high frequency jet ventilation
Authors: Mayne A. , Joucken K. , Collard E. , Randour P. 
Published: February 2007

SummaryFourteen patients of ASA grades 1 3 were anaesthetised with continuous infusions of propofol and alfentanil for endoscopic carbon dioxide laser ENT microsurgery. Their lungs were ventilated with an oxygen‐air mixture using a high frequency jet ventilator. Propofol was given at an initial rate of 120 μg/kg/minute for 10 minutes after a bolus dose of 2.6 mg/kg, and then at 80 fig μg/kg/minute. Alfentanil was given at a rate of 0.5 μg/kg/minute. Arterial pressure decreased significantly after the bolus dose. It increased significantly for a few minutes after laryngoscopy and returned to baseline values during maintenance of anaesthesia. Heart rate increased significantly during induction and until laryngoscopy was performed but it decreased below its initial value after 5 minutes of maintenance. Platelet count and the degree of aggregation did not change during infusion of propofol.
Effect of propofol on elevated intracranial pressure. Preliminary results
Authors: Herregods L. , Verbeke J. , Roily G. , Colardyn F. 
Published: February 2007

SummaryThe effects of a bolus injection of propofol on mean intracranial pressure were studied in six adult, comatose patients who had severe head injuries. Propofol 2 mg/kg was given intravenously over 90 seconds when the mean intracranial pressure reached or exceeded 25 mmHg. Arterial blood gas values, heart rate and central venous pressure remained stable at all measurements. Arterial blood pressure decreased statistically significantly (p < 0.05) within one minute after propofol administration. The mean (SEM) intracranial pressure decreased statistically significantly (p < 0.05) at 30 seconds and at J and 2 minutes, from 25 (3) to 11 (4) mmHg. The cerebral perfusion pressure decreased statistically significantly from 92 (8) mmHg at all measurements (p < 0.05). The lowest value at 3 minutes was 50 (7) mmHg but in jour patients at that time the perfusion pressure was below 50 mmHg.
Propofol in elderly high risk patients. A comparison of haemodynamic effects with thiopentone during induction of anaesthesia
Authors: Steib A. , Freys G. , Beller J. P. , Curzola U. , Otteni J. C. 
Published: February 2007

SummaryTwenty elderly patients of ASA grade 3 or 4, received either propofol 1 mg/kg or thiopentone 2 mg/kg for induction of anaesthesia. These doses provided a convenient level of anaesthesia for all patients. There were no significant intra‐ or intergroup haemodynamic changes, with the exception of a decrease in diastolic pressure and rate pressure product after propofol. It is concluded that propofol 1 mg/kg can be used to induce anaesthesia in elderly high risk patients without deleterious cardiovascular effects.
Minitracheotomy—a life‐threatening complication
Authors: DABORN A. K. , HARRIS M. N. E. 
Published: February 2007

SummaryA 55‐year‐old patient developed profuse haemorrhage immediately after insertion of a minitracheotomy tube. Measured blood loss was 1.1 litres, and the bleeding required to be controlled surgically. The cause was a subglottic granuloma which had developed after prolonged tracheal intubation and which was incised during insertion of the minitracheotomy.
Mortality during intensive care after orthotopic liver transplantation
Authors: PARK G. R. , GOMEZ‐ARNAU J. , LINDOP M. J. , KLINCK J. R. , WILLIAMS R. , CALNE R. Y. 
Published: February 2007

SummaryThe postoperative course of 335 adult patients who underwent orthotopic liver transplantation from 1968–1987 was reviewed retrospectively to identify patients who died in the intensive care unit and the causes of death. Forty‐four percent of all deaths occurred in the intensive care unit. The mortality rate in the intensive care unit peaked in 1984 (48%), but decreased to 11% in 1987. The main causes for death in the intensive care unit were infection (55%) and haemorrhage (19%). The patients who died spent more time in the intensive care unit, had a longer period of tracheal intubation and received a larger intra‐operative blood transfusion than patients who died in other locations.
The in vitro buffering capacity of soluble paracetamol
Authors: MILLS D. C. 
Published: February 2007

SummaryThe capacity to neutralise gastric acid was investigated in three over‐the‐counter paracetamol preparations. Panadol (Winthrop Laboratories) showed a buffering capacity equal to that of existing antacids because of the agents used to make it dissolve. This property, together with its mild analgesic action, widespread availability and palatability, may make it a useful agent, for acid aspiration prophylaxis.
Assessing the position of the tracheal tube The reliability of different methods
Authors: Andersen K. H. , Hald A. 
Published: February 2007

SummaryVarious methods have been developed to confirm proper intubation of the trachea. This blind, randomised study evaluates some of these quantitatively and qualitatively. Forty patients had both their trachea and oesophagus intubated. A procedure that included auscultation of the upper abdomen and lungs was 100% reliable independent of which tube was ventilated. Auscultation of the lungs resulted in a wrong conclusion in 15% (6–30, 95% confidence limits) of the cases when the oesophagus was ventilated: the sounds were misinterpretated as normal breath sounds. Suction on the tubes with a 60‐ml syringe was also a reliable test. Other methods assessed were observation for condensation of water vapor, and abnormal movements of the upper abdomen; these were unreliable.
Prophylactic analgesia for daycase termination of pregnancy A double‐blind study with controlled release dihydrocodeine
Authors: Heath P. J. , Ogg T. W. 
Published: February 2007

SummaryThe incidence and severity of pain and nausea experienced by 40 primigravid day patients who presented for vaginal termination of pregnancy were examined. Controlled‐release dihydrocodeine had no effect upon the incidence or severity of these minor sequelae. The requirements for escape analgesia and antiemetic therapy were less than anticipated and possible explanations are discussed. The low incidence of significant nausea and vomiting recorded in this study confirms that vaginal termination of pregnancy may be safely performed as day cases.
Prediction of neurological damage after cardiopulmonary bypass surgery
Authors: NEVIN M. , COLCHESTER A. C. F. , ADAMS S. , PEPPER J. R. 
Published: February 2007

SummarySixty‐five patients who had coronary artery graft surgery were subjected to detailed neuropsychometric assessment before operation and twice again within 7 days after operation. They were monitored continuously with a cerebral function analysing monitor during the operation. The results of the peroperative cerebral monitoring were compared on completion of the study with the neuropsychometric assessments. Seventy‐six percent of the patients with a significant neuropsychometric deficit after operation also showed significant peroperative changes on the analysing monitor; the majority occurred immediately after the start of perfusion. Twenty‐eight patients failed to demonstrate any evidence of neuropsychometric dejicit and six (21%) of these also showed significant peroperative changes. All patients whose traces demonstrated more than one significant change during the peroperative course had a significant neuropsychometric deficit afterwards.
Outpatient paediatric dental anaesthesia
Authors: SIMMONS M. , MILLER C. D. , CUMMINGS G. C. , TODD J. G. 
Published: February 2007

SummaryOne hundred and fifty unpremedicated children who presented for dental extractions were anaesthetised with nitrous oxide and halothane, enjurane or isofurane. Ventricular arrhythmias occurred only in the halothane group (14%). Respiratory problems and desaturation were significantly more common in the isoflurane group. Induction times differed significantly between the groups halothane < enflurane < isoflurane, while recovery time and induction to recovery time were significantly shorter in the enflurane group. We suggest that enflurane is the most suitable agent for anaesthetising these patients.
Advantages of the paramedian approach for lumbar epidural analgesia with catheter technique
Authors: BLOMBERG R. G. , JAANIVALD A. , WALTHER S. 
Published: February 2007

SummaryForty‐nine patients, scheduled for transurethral resection of the prostate or a bladder neoplasm on 50 occasions, were studied. The patients were randomly allocated to one of the two methods of puncture, midline or paramedian. Technical difficulties and the occurrence of complications were recorded. The extent of sensory and motor blockade was also compared. The paramedian approach was associated with a lower frequency of technical problems compared to the midline approach. Statistically significant differences were demonstrated between the two techniques for the following factors: repeated attempts at needle insertion; difficulty in identification of the epidural space; resistance to introduction of the catheter; resistance to injection through the epidural catheter; and the production of paraesthesiae (nine patients in the midline group compared to only one patient in the paramedian group, p < 0.01). The catheter entered a vessel at first in two patients in each group. No significant differences were demonstrated between the groups in the extent of sensory and motor blockade. The study supports the view that the paramedian approach has technical advantages over the midline approach for lumbar epidural analgesia with catheter technique.
Intravenous regional anaesthesia of the arm
Authors: HAASIO J. , HIIPPALA S. , ROSENBERG P. H. 
Published: February 2007

SummaryThe effects of different techniques of exsanguination of the upper arm during intravenous regional anaesthesia on prilocaine plasma concentrations, quality of anaesthesia, toxic symptoms after dejation of the tourniquet and injection pressure of the anaesthetic were studied in 10 healthy male volunteers. The nondominant arm was exsanguinated using either Esmarch's bandage or elevation of the arm for 2 minutes plus arterial occlusion by compression of the brachial artery. The injection pressure after the prilocaine dose (3 mg/kg) was signijcantly higher in the elevation group (maximally 98 mmHg). There were no statistically signijcant differences in the onset of, or recovery from, anaesthesia between the groups. Various mild toxic symptoms, were experienced in the central nervous system after dejation of the tourniquet. However, there was no correlation between the two techniques and the degree of severity of the toxic symptoms. The highest single venous plasma concentration (total) of prilocaine was 2.3 pgcglml measured from the contralateral cubital vein (elevation group, 2 minutes). The differences in prilocaine concentrations between the groups were not statistically significant.
Failure of rectal diclofenac to augment opioid analgesia after cholecystectomy
Authors: Colquhoun A. D. , Fell D. 
Published: February 2007

SummaryThe analgesic efjcacy of a single 100‐mg suppository of diclofenac sodium given after elective cholecystectomy was studied in 30 healthy patients in a double‐blind randomised controlled manner. The mean 24‐hour postoperative morphine consumption of the placebo group and the diclofenac group was similar (45 mg). Analysis of the cumulative hourly morphine consumption from the patient‐controlled analgesia system failed to show any statistically significant differences between the groups. Peak expiratory flow rate, forced expiratory volume at I second and forced vital capacity decreased 24 hours after operation to less than 50% of pre‐operative values in both groups. Subjective experiences of pain, nausea and drowsiness assessed by linear analogue scoring were similar in both groups.
The oculo‐emetic reflex
Authors: Van Den BERG A. A. , LAMBOURNE A. , CLYBURN P. A. 
Published: February 2007

SummaryData related to the incidence of postoperative vomiting were collected during prospective studies on 607 ophthafmic surgical patients of all ages who underwent halothane anaesthesia with spontaneous ventilation. Analysis of data in respect of age, sex and surgical site variables, and time of onset of vomiting, identified a female sex‐related vomiting incidence of about 13% and a squint‐related vomiting incidence of about 41%; no relationship between age and vomiting was identified. The analyses showed that squint surgery predisposed particularly to emesis, and was associated with a high incidence of both early and delayed vomiting. It is suggested that the apparent absence of an age‐vomiting relationship in ocular, and especially squint, surgery, and the high incidence of vomiting, particularly the early vomiting associated only with squint surgery, provide clinical evidence for the existence of an oculoemetic rejex. Our observations show that intra‐ and postoperative surgical stimulation of this oculoemetic repex is rejected in the incidences of vomiting after ocular surgery.
The tumour lysis syndrome Intensive care aspects of paediatric oncology
Authors: STOKES D. N. 
Published: February 2007

SummaryTurnour lysis syndrome occurs when chemotherapy is started in children who present with advanced lymphomas and leukaemias. Rapid cell lysis causes life‐threatening metabolic derangements because of the release of intracellular potassium, phosphate and uric acid. An alkaline diuresis is commonly established before the start of chemotherapy to minimise uric acid and phosphate deposition within the kidney. Two cases are described where intravenous fluid loading resulted in acute pulmonary oedema, and the intensive care management of such cases is discussed. The improved outcome from increasingly aggressive chemotherapeutic regimens means that children with advanced tumours and organ failure may present for supportive therapy during the early stages of treatment. Close liaison between paediatric oncologists and intensive care staff is essential to establish admission criteria for patients at risk of these complications, and to define therapeutic end points in the event of multisystem failure.
A comparison of anaesthetic breathing systems during spontaneous ventilation
Authors: CHAN A. S. H. , BRUCE W. E. , SONI N. 
Published: February 2007

SummaryFive anaesthetic breathing systems (Magill, Lack, Humphrey ADE, enclosed Magill and Bain) were compared using spontaneous ventilation in a simple lung model. The fresh gas flow at which rebreathing occurred was determined for each system by the application of four modified definitions of rebreathing. Two were based on the measurement of minimum inspired and two on end‐expired carbon dioxide. The four A systems performed similarly with each individual definition. The rebreathing points found for each individual breathing system differed markedly between definitions, with those determined by the minimum inspired CO2, occurring at low, and probably misleading, FGF/V̇E ratio. The Bain system demonstrated rebreathing at considerably higher fresh gas flows whichever definition was used.
Propofol infusion for sedation of patients with head injury in intensive care
Authors: FARLING P. A. , JOHNSTON J.R. , COPPEL D.L. 
Published: February 2007

SummaryPropofol was given by continuous intravenous infusion to 10 patients with severe head injuries in the intensive care unit. Heart rate, mean arterial blood pressure, intracranial pressure, cerebral perfusion pressure, pupil size and arterial carbon dioxide tension were recorded throughout the study period. A mean infusion rate of 2.88 mg/kg/hour provided satisfactory sedation, and recovery from the propofol was often rapid. Cerebral perfusion pressure was significantly increased at 24 hours.
The laryngeal mask airway
Authors: BRODRICK P. M. , WEBSTER N. R. , NUNN J. F. 
Published: February 2007

SummaryA prototype size 3 laryngeal mask was used in 100 patients by 18 anaesthetists with no previous experience of its use. A clear and unobstructed airway was obtained in 98% of patients, without requiring support of the jaw, thus leaving the anaesthetists' hands entirely free. The patency of the airway did not deteriorate during the course of the anaesthetic. In 10 patients there was obstruction of the airway at the first attempt to place it without the introducer and this obstruction appeared to be as a result of downfolding of the epiglottis. Subsequent attempts at passage were successful in all 10 patients. The seal between the mask and the larynx was adequate for artifical ventilation of the patients, but the meun leak pressure was 1.7 k Pa.
Pulse oximetry in the recovery room
Authors: Smith D. C. , Canning J. J. , Crul J. F. 
Published: February 2007

SummaryHaemoglobin oxygen saturation (So2) was measured percutaneously with a pulse oximeter, in a group of 150 healthy ambulant volunteers to determine the range of normal values. The measuring site was not arterialised in advance. So2 was below 94% in 13.3% of cases, while in no case was it below 90%. So2 was then measured in 350 patients in the recovery room after a variety of surgical and anaesthetic procedures. Only 1.1% of patients who received additional oxygen following general anaesthesia exhibited an So2 below 90%, compared to 16.7% of similar cases who did not receive additional oxygen. Administration of additional oxygen raised the So2, above 90% in all the latter cases. In only 55.3% of those who did not receive additional oxygen was the So2 above 94%, compared to 86.7% of normal volunteers and 73.9% of patients who received additional oxygen. This study reiterates the need to administer supplemental oxygen to all patients in the recovery room, unless facilities are available to measure So2. A lower alarm limit of 90% is appropriate for the peri‐operative period when using the Criticare Systems 501 oximeter.
The effect of acutely administered phenytoin on vecuronium‐induced neuromuscular blockade
Authors: GRAY H. St. J. , SLATER R.M. , POLLARD B.J. 
Published: February 2007

SummaryPhenytoin was administered intravenously in a dose of 10 mg/kg to a group of patients in whom steady state neuromuscular blockade had been established with an infusion of vecuronium. A control group of patients were given 0.9% saline instead of phenytoin. Administration of phenytoin produced significant augmentation of neuromuscular blockade (p < 0.001). The possible mechanism of this effect is discussed.