bluuebunny/crossref_metadata_2025_split huggingface dataset:
The loading dose for continuous infusion epidural analgesia
Authors: MACLEOD D. M. , TEY H. K. , BYERS G. F. , DOLLERY W. C. , TUNSTALL M. E. 
Published: February 2007

SummaryThe effects of 0.08% and 0.5% bupivacaine, given in equal volumes as the loading dose prior to continuous infusion epidural analgesia, were compared. The incidence of hypotension, as well as the height of sensory blockade. was markedly lowered by reducing the loading dose of bupivacaine. However, the efficacy of the epidural analgesia was maintained by using the same volume for the loading dose. The mean onset of analgesia was delayed from 9.1 to 13.6 minutes. There were fewer calls for intervention consequent upon the reduction in adverse effects. The use of 8 ml 0.08% bupivacaine for the loading dose or for subsequent top‐ups is recommended. The concept of a liquid sleeve of local anaesthetic in the epidural space is further supported.
Treatment of severe accidental hypothermia using the Clinitron bed
Authors: MILES J. M. , THOMPSON G. R. 
Published: February 2007

SummaryTwo cases of severe accidental hypothermia (core temperature (28°C) rewarmed employing the Clinitron system are described. The physiological changes during hypothermia and rewarming are discussed and the current concepts of rewarming (active external versus internal) outlined. It is suggested that severely hypothermic patients can be successfully treated by rapid external rewarming using the Clinitron heated fluidised‐bead bed. This method combines the advantages of rapid rewarming, minimal physiological disturbance and is non invasive.
A new ventilator for closed breathing systems
Authors: Twigley A. , Chakrabarti M. K. , Whitwam J. G. 
Published: February 2007

SummaryA new electronic ventilator for application during closed breathing system anaesthesia is described (OAV7700, Ohmeda). It is easy to use and can be mounted on any conventional anaesthetic machine. It has several desirable features, such as a simple control and display panel, appropriate alarms and a patient breathing system that can be autoclaved. Observations were made on seven patients undergoing major surgery. Anaesthetic gases were introduced at 1, 2 and 4 litres/minute at three points in the breathing system, one conventionally in the closed system, one at the ventilator and one in the tracheal tube. Carbon dioxide homeostasis was maintained during this procedure. The application of fresh gas flows of 2 and 4 litres/minute in the tracheal tube allowed a small but significant reduction in the mean tidal volume. However, it was concluded that a fresh gas flow of 1 litre/minute applied conventionally either into the closed system or at the ventilator, provided optimal conditions.
The acute effects of intravenous isosorbide dinitrate during cardiac surgery
Authors: PARSONS R. S. , WETZEL R. C. , MOHANDAS K. 
Published: February 2007

SummaryThe acute effects of intravenous isosorbide dinitrate during open heart surgery were studied in 15 adult patients. Consistent and significant (p < 0.001) reductions in pulmonary vascular resistance (25% before. 23% after, cardiopulmonary bypass) and mean pulmonary artery pressure (14% before, 13% after, cardiopulmonary bypass) were observed in the absence of significant changes in cardiac index, mean systemic arterial pressures or right or left atrial filling pressures. These findings indicate that after cardiopulmonary bypass, when right ventricular dysfunction with raised pulmonary vascular resistance may occur, selective reduction of right ventricular afterload with isosorbide dinitrate may prove beneficial.
Effects of benzodiazepines on laryngeal reflexes
Authors: GROVES N. D. , REES J. L. , ROSEN M. 
Published: February 2007

SummaryOf 20 volunteers, five were given intravenous Diazemuls 15 mg over 15 seconds, and three groups of five were given lormetazepam 2 mg intravenously over 10, 20 and 60 seconds, respectively. Laryngeal reactivity and psychomotor function were tested at intervals from prior to injection until 4 hours after injection. For equivalent degrees of depression of psychomotor function, lormetazepam depressed the laryngeal reflex less than Diazemuls (p = 0.004). Lormetazepam given over 60 seconds depressed the laryngeal reflex more than when given over 10 seconds (p = 0.008) or over 20 seconds (p = 0.048), although a significant difference was not demonstrated between the 10‐second and 20‐second groups. These results concur with experimental evidence that benzodiazepine receptor multiplicity exists, which allows various members of the benzodiazepine group of drugs to exhibit differing therapeutic ratios for their various effects.
Basophil histamine release
Authors: WITHINGTON D. E. , LEUNG K. B. P. , BROMLEY L. , SCADDING G. K. , PEARCE F. L. 
Published: February 2007

SummaryA patient who suffered a severe hypotensive episode after induction of anaesthesia, was subsequently found to show positive skin‐test responses to suxamethonium. Investigation revealed that suxamethonium induced basophils from the patient to release histamine to an extent comparable to that found after exposure to anti‐IgE. Basophils from control subjects showed no such response. Basophil histamine release may offer a useful approach to the investigation of adverse drug reactions.
Hypercholinesterasaemia and suxamethonium resistance
Authors: WARRAN P. , THEEMAN M. , BOLD A. M. , JONES S. 
Published: February 2007

SummaryA case is reported of resistance to the muscle relaxing action of suxamethonium due to the rare inherited condition of hypercholinesterasaemia. Family studies suggest dominant inheritance. It is suggested the condition should be considered whenever there is unexpected resistance to the muscle relaxing action of suxamethonium.
A new laryngoscope
Authors: NUNN G. 
Published: February 2007

SummaryThis is a report of a modification to one design of laryngoscope to increase the angle between blade and handle, to facilitate intubation in cases of difficult access, such as in obstetric practice or in patients in whom neck flexion is limited, for example by skull traction. The modification offers the unique advantage of two useful blade angles in one instrument. The first type described would be suitable for use in small units where it is thought that a laryngoscope solely for use in rare cases of difficult access would not be justified. It would also be suitable for inclusion in resuscitation kits for use both within and outside hospital. The second type would be more suitable for the maternity or spinal injuries unit, or the difficult intubation box of a general operating theatre suite.
The influence of premeditation on the occurrence of dysrhythmias during oral surgery
Authors: Smith D. C. , O'Connell P. 
Published: February 2007

SummaryThe incidence of cardiac dysrhythmia during inpatient dental anaesthesia with enflurane was studied following either hyoscine or droperidol as a supplement to papaveretum premedication. None of the subgroup given droperidol exhibited dysrhythmias, compared to 4.4% of those patients given hyoscine. This difference was not significant at the 5% level (0.2 > p > 0.1).
Cardiac arrest in near‐term pregnancy
Authors: LINDSAY S. L. , HANSON G. C. 
Published: February 2007

SummaryThis case study emphasises the multiple factors that may be involved in the precipitation of electromechanical dissociation, which are compounded by additional problems that relate to pregnancy. It reinforces the value of the tracheal route for drug administration when a central vein is not cannulated and stresses the importance of posture and early consideration of Caesarean section in the pre‐term gravid patient who has sustained a cardiac arrest.
A case of prolonged hypotension following intravenous guanethidine block
Authors: SHARPE E. , MILASZKIEWICZ R. , CARLI F. 
Published: February 2007

SummaryA 25‐year‐old female developed causalgia following a nerve injury in the left hand, and this was treated successfully with a series of intravenous guanethidine blocks. However, after the 13th block, systolic arterial blood pressure decreased to 60 mmHg and remained tow (80 mmHg)for one week. Accumulation of guanethidine at the sympathetic nerve ending, resulting in autonomic denervation, might be the underlying mechanism of the prolonged hypotension. Treatment was conservative; however, the use of tricyclic antidepressants and sympathomimetic amines to restore the blood pressure to a normal level can be considered with appropriate caution.
The Triservice anaesthetic apparatus
Authors: Kocan M. 
Published: February 2007

SummarySixty male patients undergoing limb surgery were anaesthetised using a drawover technique with the Triservice apparatus. They were randomly allocated to receive trichloroethylene and one of three other volatile agents (halothane, enflurane or isoflurane) after thiopentone induction. Signs of inadequate anaesthesia were noted. The incidence of such signs was not significantly different in the three groups. Similarly, no qualitative difference could be demonstrated in the immediate recovery, but the recovery time was significantly shorter with enflurane.
Unintentional dural puncture. A survey of recognition and management
Authors: Okell R.W. , Sprigge J.S. 
Published: February 2007

SummaryA survey of the recognition and management of 21 unintentional dural punctures that occurred in a series of 3500 obstetric epidurals is presented. In seven cases, dural puncture was not recognised at the time of occurrence and two patients may have subsequently received mixed epidural and subarachnoid analgesia. In two patients with dural puncture in whom air had been used to locate the epidural space, cerebrospinal fluid did not drip from the hub of the needle. A test dose did not reveal incorrect catheter placement in seven patients. The provision of an epidural infusion of Hartmann's solution for 24 hours, together with bed rest, appeared to delay the onset of dural puncture headache rather than prevent it entirely. Blood patching was required only in five of the 21 patients but was entirely successful. The implications of these observations in relationship to obstetric epidural practice are discussed.
Hepatotoxicity and death following two enflurane anaesthetics
Authors: PAULL J. D. , FORTUNE D. W. 
Published: February 2007

SummaryA 67‐year‐old woman died with massive fatty change in the liver 41 hours after her second enflurane anaesthetic in 28 days. The clinical features of five previously reported similar deaths are summarised. Possible mechanisms of the hepatotoxicity are reviewed briefly.
Retrograde intubation
Authors: COOPER C. M. S. , MURRAY‐WILSON A. 
Published: February 2007

SummaryAn infant with Goldenhar's syndrome is presented in whom two‐stage plastic surgery was undertaken. The first operation, at the age of 5 months, necessitated a retrograde technique for tracheal intubation while in the second, at 10 months of age, conventional intubation was possible. The discussion highlights those refinements that promote a successful outcome when retrograde intubation is indicated, particularly in infants.
Transient hearing loss following spinal anaesthesia
Authors: WANG L. P. , FOG J. , BOVE M. 
Published: February 2007

SummaryAudiograms were performed pre‐operatively in 14 patients scheduled for transurethral resection of the prostate under spinal anaesthesia and again 2 days postoperatively. Six of the 14 patients showed a minor reduction of hearing in the low frequency range. Follow‐up audiograms showed full recovery after 1–7 months. No significant hearing loss was found in 12 patients who underwent the same procedure with epidural anaesthesia.
Hypolgcaemic encephalopathy following surgery on phaeochromocytoma
Authors: CHANNA A. B. , MOFTI A. B. , TAYLOR G. W. , MEKKI M. O. , SHEIKH M. H. 
Published: February 2007

SummarySevere hypoglycaemia as a complication of excision of a phaeochromocytoma has been reported seven times in the world literature. The eighth case, reported here, is unusual for the severity of the hypoglycaemic neurological damage which persisted for 10 weeks before ultimate recovery.
Displacement of a minitracheotomy tube during high frequency jet ventilation
Authors: RAVALIA A. , STOCKWELL M. A. 
Published: February 2007

SummaryA patient required respiratory support with jet ventilation via a minitracheotomy tube 2 days after right upper lobectomy. After initial improvement, the patient's condition deteriorated because of migration of the minitracheotomy tube out of the larynx. This complication has not been described previously. A number of possible causative factors and remedies are discussed.
Arterial oxygen desaturation during postoperative transportation: the influence of operation site
Authors: Meiklejohn B. H. , Smith G. , Elling A. E. , Hindocha N. 
Published: February 2007

SummaryArterial oxygen saturation in 132 patients was measured using a Biox IV oximeter with an ear probe, during transfer from theatre to recovery room following a variety of surgical procedures. Oxygen saturation decreased to 85% or less in 21.9% of patients and to 90% or less in 61.4%. No predictive factors were identified. It is recommended that supplementary oxygen be given to all patients in the immediate postoperative period, including the period of transit to the recovery room.
Nalbuphine for obstetric analgesia
Authors: FRANK M. , McATEER E. J. , CATTERMOLE R. , LOUGHNAN B. , STAFFORD L. B. , HITCHCOCK A. M. 
Published: February 2007

SummaryA double‐blind, randomised study of 60 patients who received intravenous increments of nalbuphine 3 mg or pethidine 15 mg by patient‐controlled analgesia during the first stage of labour, was carried out. Pain intensity, sedation, uterine contractions, maternal cardioventilatory variables and fetal heart rate were recorded as well as any side effects. Apgar scores, time to sustained respiration and resuscitative measures required for the neonate were noted at delivery. Modified neonatal neurobehavioural studies and a retrospective assessment of maternal analgesia, satisfaction and tolerance were also carried out. Group mean values of pain scores of nalbuphine‐medicated primiparous women were statistically significantly lower than those of pethidine‐medicated patients (p < 0.01). Other assessments did not demonstrate a statistical significance between the two groups.
Peak intratracheal pressure during controlled ventilation in infants and children
Authors: SYNNOTT A. , WREN W. S. , DAVENPORT J. 
Published: February 2007

SummaryThe mathematical relationship between peak ventilator breathing system pressure displayed on the digital meter of the Siemens SV900C ventilator, and peak intratracheal pressure measured at the distal end of the tracheal tube, was defined and incorporated into a computer program. The mean difference between peak airway pressure calculated by the computer and directly measured peak intratracheal pressure was 0.02 kPa (SD 0.10) in 18 infants and children. The mean difference between ventilator breathing system pressure and intratracheal pressure in the same group was 0.82 kPa (SD 0.91). Bench tests established that the decrease in peak pressure displayed by the ventilator (from 1.36 to 0.38 kPa) while inspiratory lime was increased from 20 to 80% of the respiratory period, concealed an increase (from 0.2 to 0.38 kPa) in intratracheal pressure which occurs during this process; and that the large increase in pressure displayed by the ventilator (from 0.3 to 6 kPa) while respiratory frequency was increased from 20 to 120 breaths I minute, concealed a small increase in peak intratracheal pressure (0.2–0.3 kPa) which occurs during this process. These changes were accurately predicted by the computer program. The increase in intratracheal pressure associated with prolonged inspiratory times explains the high incidence of baro‐trauma which has recently been associated with this procedure in infants.
Fatal disseminated intravascular coagulation following a monoamine oxidase inhibitor/tricyclic interaction
Authors: TACKLEY R. M. , TREGASKIS B. 
Published: February 2007

SummaryIn spite of intensive therapy, an otherwise fit 34‐year‐old man died following the hyperpyrexial reaction to an interaction between tranylcypromine and clomipramine. There was no evidence of drug overdose, but severe disseminated intravascular coagulation developed which proved fatal.
Carcinoid syndrome and intravenous cyproheptadine
Authors: SOLARES G. , BLANCO E. , PULGAR S. , DIAGO C. , RAMOS F. 
Published: February 2007

SummaryThe anaesthetic management of a patient with the carcinoid syndrome is reported. Important cardiovascular complications occurred immediately after tracheal intubation and during manipulation of metastases. Hypertensive crises were controlled with intravenous cyproheptadine, although hypotension and drowsiness were observed due to its use.
Diclofenac sodium for post‐tonsillectomy pain in children
Authors: WATTERS C. H. , PATTERSON C. C. , MATHEWS H. M. L. , CAMPBELL W. 
Published: February 2007

SummaryDiclofenac sodium was assessed as an analgesic for postoperative pain following paediatric tonsillectomy in a randomised double blind trial. In a comparison made with both a pethidine and a control group diclofenac was shown to be an effective analgesic. No significant difference in analgesic efficacy was demonstrated between the two drugs, although patients who received diclofenac tended to be less drowsy postoperatively than those who received pethidine. There were no significant differences between the two drugs in respect of time to awaken from anaesthesia or incidence of postoperative vomiting.
Propofol induction and maintenance with nitrous oxide in paediatric outpatient dental anaesthesia
Authors: PUTTICK N. , ROSEN M. 
Published: February 2007

SummaryIntravenous induction of anaesthesia with propofol (3.5 mg/kg) and maintenance boluses (I mg/kg), with 30% oxygen and 70% nitrous oxide, were compared with intravenous thiopentone induction (5 mg/kg) followed by 30% oxygen and 70% nitrous oxide, supplemented with 2 to 3% halothane in children aged 2–11 years who underwent dental extractions. Both techniques were found to he acceptable in clinical practice. Recovery from anaesthesia was assessed by the time taken to reach clinically‐defined milestones. Times to open eyes, give name, stand unaided, and time to discharge were all 3 to 7 minutes shorter in those who had the propofol technique compared with those who had thiopentone‐halothane (p < 0.05). These indices of recovery were more sensitive than the Steward score.
Plasma bupivacaine concentrations during caudal analgesia and ilioinguinal‐iliohypogastric nerve block in children
Authors: STOW P. J. , SCOTT A. , PHILLIPS A. , WHITE J. B. 
Published: February 2007

SummaryPlasma bupivacaine concentrations were measured in 27 children aged 3 ‐7 years who received one of two analgesic regimens for herniotomy or orchidopexy. Analgesia was provided either by caudal epidural bupivacaine 0.2% 2 mg/kg (n = 14) or by ilioinguinal‐iliohypogastric nerve block with bupivacaine 0.5% 1.25 mg/kg (n = 13). Mean (SD) peak venous bupivacaine concentrations were 0.57 (0.17) μg/ml and 0.79 (0.38) μg/ml respectively. Time to peak plasma concentrations were 29.6 (7.9) and 22.3 (10.9) minutes respectively. These concentrations are well below the potentially toxic level of 4.0 μg/ml, but suggest that uptake of bupivacaine is more rapid after ilioinguinal iliohypogastric nerve block than during caudal analgesia.
A survey of anaesthetic charts
Authors: Bembridge M. , Bembridge J. L. 
Published: February 2007

SummaryThis survey reviews the structure and content of all anaesthetic record charts in use in the 40 hospitals of the Yorkshire Regional Health Authority in the light of previous recommendations. Twenty‐two different anaesthetic charts were used by 290 anaesthetists in this region. Some of the charts did not meet the ideal standard for size (A4) and the majority had no colour coding. Fourteen of the 22 charts omitted important headings concerned with patient identification and eight charts did not provide a record of the whole perioperative period. Some comprehensive forms are in use, chiefly in smaller hospitals, but there have been few changes in design in the last 10 years despite increasing medicolegal awareness.
Premeditation with oral slow release morphine in dental anaesthesia. A comparison with temazepam
Authors: Richmond M. N. , Daum R. E. O. 
Published: February 2007

SummaryOral slow release morphine 30 mg and temazepam 30 mg given as premedication 2 hours before operation were compared in 62 patients who underwent extraction of four third molar teeth in a randomised double‐blind trial. There was no significant difference in pre‐operative sedation; the majority were mildly or moderately sedated. Patients in the morphine group woke up significantly faster and had significantly reduced requirements for analgesics after operation.
Fibreoptic intubation in Klippel‐Feil syndrome
Authors: DAUM R. E. O. , JONES D. J. 
Published: February 2007

SummaryA patient with Klippel‐Feil syndrome who underwent abdominal surgery is presented and the anomaly reviewed. The anatomical abnormality and potentially unstable neck provide a potentially difficult tracheal intubation which was undertaken using an awake fibreoptic technique. The role of the fibrescope and the advantage of pre‐operative assessment of the difficult airway are discussed.
A new technique for sleeve resection and major bronchial resection using twin catheters and high frequency jet ventilation
Authors: McKINNEY M. , COPPEL D. L. , GIBBONS J. R. , COSGROVE J. 
Published: February 2007

SummaryA new anaesthetic technique that uses two catheters combined with high frequency jet ventilation for sleeve resection of the major bronchus and carina is described. The advantages and disadvantages are discussed and compared with other techniques.
An evaluation of the Stihler 1FT 200 blood warmer
Authors: WALTERS S. E. , WOOD C. , MORGAN M. 
Published: February 2007

SummaryThe performance of the Stihler IFT 200 blood warmer was evaluated at flow rates from 25 to 150 mil minute and compared with that of the Hetotherm and Fenwal warmers. The Fenwal proved to be an efficient apparatus at all flow rates but the performance of the Hetotherm fell off slightly at higher flow rates. The Stihler IFT 200 did not meet requirements for use in the operating room.
The influence of anaesthetic technique on metabolism of oral morphine
Authors: SHELLY M. P. , TAYLOR B. L. , QUINN K. G. , PARK G. R. 
Published: February 2007

SummaryThe pharmacokinetics of oral controlled release morphine were studied in 10 patients to investigate the effect of two different anaesthetic techniques on its absorption and metabolism. Five patients received general anaesthesia with neuromuscular blockade; the remainder received lumbar epidural analgesia with general anaesthesia but without neuromuscular blocking agents. Blood samples were collected throughout the peri‐operative period for estimation of plasma morphine concentration using two radio immunoassay techniques, one specific for morphine, the other less specific and crossreacting with morphine glucuronides. Plasma morphine concentrations with the specific method were similar for the two groups of patients but there was a statistically significant difference between the two groups with the less specific method at 30 and 45 minutes after induction of anaesthesia. This difference was because of the varying concentrations of morphine metabolites and may reflect the change in splanchnic blood flow produced by lumbar epidural analgesia.