bluuebunny/crossref_metadata_2025_split huggingface dataset:
Propofol infusion and auditory evoked potentials
Authors: SAVOIA G. , ESPOSITO C. , BELFIORE F. , AMANTEA B. , CUOCOLO R. 
Published: February 2007

SummaryThe effects of propofol on auditory evoked potentials (brainstem and middle latency responses) were recorded in six patients. Two different infusion rates were used, 54 and 108 μg/kg/minute. Effects on brainstem responses were not found. Regression of amplitude and latency of middle latency auditory potentials were dose related (p < 0.01).
The effect of fentanyl on propofol requirements for day case anaesthesia
Authors: Thomas V. L. , Sutton D. N. , Saunders D. A. 
Published: February 2007

SummaryFifty women of ASA grade 1 or 2 scheduled to undergo minor gynaecological procedures were allocated randomly to two groups. Group A received fentanyl 100 μg intravenously before induction; group B received no sedative or analgesie drugs. Anaesthesia was induced with propofol intravenously and maintained using 67% nitrous oxide in oxygen with incremental doses of propofol. Induction lime and dose were significantly less and mean arterial pressure decreased significantly lower in Group A. These differences were, however, small and the ranges of values were large. The incidence of side effects and subjective assessment of quality of anaesthesia were similar in both groups. Fentanyl did not confer any practical advantage when used with propofol in the techniques described above.
Comparison of a total intravenous anaesthetic technique using a propofol infusion, with an inhalational technique using enflurane for day case surgery
Authors: Price M. L. , Walmsley A. , Swaine C. , Ponte J. 
Published: February 2007

SummaryA total intravenous anaesthetic technique with a propofol infusion for maintenance of anaesthesia was compared with an inhalational technique that used oxygen, nitrous oxide and enflurane in 98 unpremedicated patients who presented for day case surgery. Overall quality of anaesthesia during induction and maintenance was comparable in both groups. Quality of maintenance of anaesthesia in the propofol group was improved by an increase of the initial infusion rate from 12 to 15 mg/kg/hour. There was a larger decrease in arterial blood pressure after induction in the propofol group but no difference in blood pressure between the groups during maintenance. Recovery times and scores using the Steward scoring system were not significantly different. Nausea and vomiting were slightly less frequent in the propofol group.
Anaesthesia for extracorporeal shock‐wave lithotripsy. A comparison of propofol and methohexitone infusions during high frequency jet ventilation
Authors: Harries A. , Bagley G. , Lim M. 
Published: February 2007

SummaryA continuous infusion of propofol 2.(1–2.5 mg/kg for induction followed by 9 mg/kg/hour for the first 30 minutes and 6 mg/kg/hour thereafter, was compared with methohexitone 1.5 mg/kg for induction followed by 4.8 mg/kg/hour thereafter for maintenance of anaesthesia in a randomised study of 40 patients who underwent extracorporeal shock‐wave lithotripsy using high frequency jet ventilation (HFJV). Systolic blood pressure was significantly lower in the propofol group after induction of anaesthesia, tracheal intubation, placement in the semirecumbent position in the hoist, bath immersion and after 5, 10 and 30 minutes of treatment. Diastolic blood pressure was significantly lower in the propofol group after intubation, placement in the hoist, bath immersion and after 5, 10 and 15 minutes of treatment. Heart rate was significantly lower in the propofol group after induction, intubation, placement in the hoist and bath immersion. There was no significant difference in the quality of induction between the two groups. Quality of maintenance of anaesthesia was judged to be poor in six out of 20 patients who received methohexitone compared with one out of 20 who received propofol but this difference did not reach statistical significance. There was no significant difference between the recovery times for the two groups but six out of 20 patients who received methohexitone were fudged to have a poor recovery from anaesthesia compared with none in the propofol group (p < 0.05). Propofol was associated with excellent induction, maintenance and recovery characteristics but it had a propensity to produce greater decreases in blood pressure, which were most marked when the patient was placed in the semirecumbent position in the hoist.
Premedication with temazepam in minor surgery
Authors: RATCLIFF A. , INDALO A. A. , BRADSHAW E. G. , RYE R. M. 
Published: February 2007

SummaryFourteen patients received oral premedication of temazepam in soft gelatin capsules before minor surgery. The plasma concentrations of temazepam and its sedative, anxiolytic and amnesic effects were measured for 24 hours. Absorption was rapid and peak concentrations occurred 49 minutes after administration. Clinical effects were evident at 30 minutes and persisted for about 4 hours. The decline in plasma concentration was biexponential with a distribution half‐life of 1.24 hours. The end of the distribution phase coincided approximately with the termination of its clinical effects. A relationship between plasma concentration and effect was observed: concentrations above 300 ng/ml produced measurable changes in tests of mental function. Patients had recovered fully from the effects of temazepam after 24 hours. This dose of temazepam is reliable and efective as premedication before surgery.
Spinal arteriovenous fistula
Authors: SGHIRLANZONI A. , GEMMA M. , PAREYSON D. , CIMINO C. , BOIARDI A. 
Published: February 2007

SummaryA 62‐year‐old male suddenly developed a severe paraparesis after epidural anaesthesia. He recovered gradually over the next few months. He had an acute relapse one year later and a selective spinal angiography showed a dural T8 arteriovenous fistula with large draining veins. Intravascular embolisation of the fistula produced immediate and sustained clinical improvement. The mechanism commonly held responsible for neurological disturbances in spinal dural arteriovenous fistulas is cord hypoxia secondary to venous hypertension. The 20‐ml of local anaesthetic solution injected into a narrow spinal canal with osteophytosis may have caused further venous engorgement, cord hypoxia and acute neurological deficit.
The M1 air crash
Authors: COAD N. R. , JONES M. J. , BYRNE A. J. , PEPPERMAN M. L. 
Published: February 2007

SummaryThe M1 air crash provided an enormous challenge to the anaesthetic and intensive care services of the hospitals which admitted the survivors, many of whom had serious injuries. This account describes some of the problems which were encountered in two of the hospitals, details the workload imposed on the anaesthetists and the staff of the Intensive Therapy Units and identifies factors which, if improved, might advance the management of multiple casualties admitted from the scene of a major disaster.
Cardiovascular effects of fibrescope‐guided nasotracheal intubation
Authors: SMITH J. E. , MACKENZTE A. A. , SANGHERA S. S. , Scott‐Knight V. C. E. 
Published: February 2007

SummaryThe cardiovascular effects of fibrescope‐guided nasotracheal intubation were compared to those of a control group of patients who were intubated using the Macintosh laryngoscope. The 60 patients studied received a standard anaesthetic technique which included a muscle relaxant and were allocated randomly to one of two groups immediately before tracheal intubation. Systolic and diastolic arterial pressures in the fibreoptic group were significantly lower than in the control group during the first minute after intubation. The maximum increase in diastolic pressure was significantly lower in the fibreoptic group. The heart rate in the fibreoptic group was significantly higher than in the control group during all five minutes after intubation. The maximum increase in hearl rate was significantly higher in the fibreoptic group. The cardiovascular responses to fibreoptic nasotracheal intubation under general anaesthesia should not cause undue concern in fit patients, but appropriate measures should be taken to prevent excessive tachycardia in compromised patients.
Transtracheal illumination for optimal tracheal tube placement
Authors: MEHTA S. 
Published: February 2007

SummaryThe tracheas of 420 adult patients were intubated using the tip of a lighted stylet placed inside the lumen of the tracheal tube, just proximal to the tube cuff. The maximum point of transillumination was visible just distal to the cricoid cartilage; with proper cuff positioning. The lighted stylet was also introduced into the oesophagus to see whether transoesophageal illumination could be demonstrated. The intensity of transillumination was measured using a grading system. The distance between the bevel end of the tracheal tube and the carina was determined with a fibreoptic bronchoscope. Tracheal transillumination was graded as excellent in 81% of patients and as good in 19%, when the overhead lights were dimmed and cricoid pressure was applied. Transoesophageal illumination could not be demonstrated in any patient. The mean distance between the tip of the tracheal tube and the carina varied between 3.7 and 4 cm. Transtracheal illumination is a simple, effective and reliable method that can be used during intubation for the recognition of optimal tube placement.
Anaesthesia for patients with mitochondrial myopathy
Authors: BURNS A. M. , SHELLY M. P. 
Published: February 2007

SummaryThe anaesthetic management for an infant with mitochondrial encephalomyopathy due to fumarase deficiency is described. Mitochondrial myopathies may produce skeletal and cardiac muscle abnormalities, central nervous system effects and metabolic problems. The solutions to the anaesthetic problems posed by these patients are discussed.
Propofol infusion for sedation in outpatient oral surgery
Authors: VALTONEN M. , SALONEN M. , FORSSELL H. , SCHEININ M. , VIINÄMAKI O. 
Published: February 2007

SummaryAn infusion of propofol was compared with intravenous boluses of diazepam as sedation for minor oral surgery under local anaesthesia in 12 healthy patients who had elective bilateral surgical extraction of lower third molars; the patients served as their own controls. Plasma catecholamine, vasopressin and cortisol concentrations were determined from repeated blood samples. The total administered dose of propofol was 3.93 (SD 1.34) mg/kg and of diazepam 0.28 (SD 0.07) mg/kg. No cardiovascular depression or airway problems occurred. Other side effects were also rare but some discomfort on injection was frequent with propofol. Recovery times were faster after propofol than after diazepam as assessed by the Maddox wing and visual analogue scales. Propofol also provided better amnesia compared to diazepam at the time of the extraction of the teeth. Eight of the 12 patients subjectively preferred propofol sedation. There was no hormonal stress response in either group.
Effect of intravenous cimetidine on lignocaine disposition during extradural Caesarean section
Authors: FLYNN R. J. , MOORE J. , COLLIER P. S. , HOWARD P. J. 
Published: February 2007

SummaryWe studied whether an intravenous bolus of cimetidine altered the disposition of extradurally administered lignocaine in the parturient. Mothers who requested extradural analgesia for elective Caesarean section were randomly pretreated with either cimetidine 200 mg intravenously (n = 5) or no H2‐receptor antagonist (n = 5). No difference was found between peak plasma lignocaine levels or area under the plasma concentration/time curve between the two groups after administration of 6 mg/kg lignocaine 2% with adrenaline 1:200 000. There was no evidence for an effect of a single intravenous dose of cimetidine on lignocaine disposition in the obstetric patient. In addition, the extradural administration of 6 mg/kg lignocaine produces plasma levels well below toxic levels.
Alteration of maternal posture and its immediate effect on epidural pressure
Authors: JOHNSTON G. M. , RODGERS R. C. , TUNSTALL M. E. 
Published: February 2007

SummaryA study was undertaken to investigate the changes in pressure inside the epidural space in parturients in the first stage of labour. The purpose was to see whether acute local pressure changes in the epidural space were consistent with the hypothesis that there is physical movement of cerebrospinal fluid with certain changes in maternal posture. Pressure changes were measured via the epidural catheter through which continuous infusion epidural analgesia was administered, using a pressure transducer kept at the level of the lumbar spine. The mothers moved through a series of postures that rejected those expected during the course of labour and delivery. The pressure within the catheter was recorded during these manoeuvres. The pressure changes which were found, taken in conjunction with the associated investigations of others, are consistent with the hypothesis.
Comparison of continuous spinal and continuous epidural anaesthesia for lower limb surgery in elderly patients A retrospective study
Authors: Sutter P.‐A. , Gamulin Z. , Forster A. 
Published: February 2007

SummaryThis retrospective study compared continuous spinal anaesthesia with continuous epidural anaesthesia for lower limb orthopaedic surgery in the elderly. The anaesthetic records of 457 patients who received continuous spinal anaesthesia and 274 who received continuous epidural anaesthesia over a 5‐year period were analysed. The patients who had continuous spinal anaesthesia were at a higher anaesthetic risk (ASA 3—4, 76% as compared with 37%, p < 0.001), but the incidence of failures was significantly lower (1.7%, as compared with 9%,p<0.001) and fewer patients showed a decrease in mean arterial pressure of more than30%(44%, ascomparedwith 65%,p < 0.001)and(or)receivedvasopressors(65%, as compared with 77%, p < 0.01). Ourdata show continuous spinal anaesthesia to be more reliable and to provide better cardiovascular stability.
Total intravenous anaesthesia for laparoscopy
Authors: Bailie R. , Craig G. , Restall J. 
Published: February 2007

SummaryTwo techniques of total intravenous anaesthesia for laparoscopy were compared in 80 patients. Group 1 received alfentanil, propofol and vecuronium, and Group 2 alfentanil, midazolam, ketamine and vecuronium. Haemodynamic stability after induction and the pressor response to tracheal intubation were signcantly different. There was no significant difference in recovery times between the two groups and little difference in other postoperative sequelae.
Forum Paediatric anaesthesia in a district general hospital
Authors: Bowhay A. R. , Morgan‐Hughes J. O. 
Published: February 2007

SummaryOver 4000 general anaesthetics were administered during 1987 to children under the age of 13 years in the Norwich Health District. We have reviewed the 2938 anaesthetics performed in the Norfork and Norwich Hospital. Five hundred and fifty‐eight(19%) were undertaken in children aged less than 3 years; 24 of these were neonates. The implications of this workload are discussed, with reference to the more appropriate use of consultants with previous paediatric anaesthetic training, the training of junior staff and the policy for transfer of patients to specialised centres.
Propofol‐induced anaesthesia
Authors: SANDERS L. D. , ISAAC P. A. , YEOMANS W. A. , CLYBURN P. A. , ROSEN M. , ROBINSON J. O. 
Published: February 2007

SummaryPostoperative psychomotor and cognitive recovery were assessed after anaesthesia induced by either propofol or thiopentone, and maintained with nitrous oxide and halothane in 40 unpremedicated dental patients. Performance was shown to be impaired one hour postoperatively for the whole sample in hand–ye coordination (p < 0.001), reaction time (p < 0.001) and digit span (p < 0.05). There was evidence of impairment at 3 hours postoperatively in reaction time (p < 0.05) and ataxia (p < 0.01). Performance also deteriorated in the dexterity and aiming tasks. Patients reported significantly less clumsiness by 24 hours in blurred vision and shivering (p < 0.05) and by 48 hours less coughing (p < 0.05). However, there was no significant difference between groups. No evidence showed that recovery in the propofol group was faster, so it was concluded that induction with propofol offered no advantage when anaesthesia is maintained with nitrous oxide and halothane for the periods of time reported in this study.
Alfentanil requirement in Crohn's disease
Authors: GESINK‐VAN DER VEER B. J. , BURM A. G. L. , HENNIS P. J. , BOVILL J. G. 
Published: February 2007

SummaryThe dose requirement of alfentanil as a supplement to nitrous oxide anaesthesia was studied in 13 patients with Crohn's disease and seven control patients all of whom underwent laparotomy. Alfentanil was administered as a variable rate infusion with supplemental bolus injections titrated to the patient's needs. The alfentanil requirement was independent of the duration of surgery and was significantly higher in patients with Crohn's disease than in control patients. The results indicate that Crohn's disease alters the dose requirement of alfentanil.
Tracheal dilatation followed by stenosis in Mounier–Kuhn syndrome
Authors: MESSAHEL F.M. 
Published: February 2007

SummaryA patient with previously undiagnosed Mounier–Kuhn syndrome (tracheobronchomegaly) was admitted with a head injury after a fall. The trachea was intubated with an oral tracheal tube with high‐volume low‐pressure cuff. The intracuff pressure was within the normal safe range recommended by the manufacturer. However, the patient developed tracheal dilatation on the second day after intubation. The trachea was extubated on the 15th day, and it was noticed 48 hours later that the patient was developing a tracheal stenosis at the site of the previous dilatation. The stenosis was so severe that the patient underwent resection‐anastomosis surgery of his stenotic tracheal segment 2 months after extubation. It may be preferable in patients with Mounier–Kuhn syndrome who require mechanical ventilation to intubate the trachea with an uncuffed tube and to pack the throat to decrease the chances of gas leak and inhalation.
Bradycardia in patients receiving atracurium or vecuronium in conditions of low vagal stimulation
Authors: COZANITIS D. A. , LINDGREN L. , ROSENBERG P. H. 
Published: February 2007

SummaryFour groups of 20 patients each received either vecuronium or atracurium together with either glycopyrronium or saline, and underwent anaesthesia free of vagolytic drugs, and surgery devoid of vagal activity. Determinations of plasma histamine concentrations were made to examine the possible correlation between these levels and changes in heart rate and blood pressure as well as a possible relationship with skin reactions after the administration of the relaxants. Patients who received vecuronium without the anticholinergic drug, glycopyrronium, showed a greater tendency towards bradycardia (though not statistically significant) than those given atracurium. More cutaneous reactions were observed with patients who received atracurium than in those with vecuronium, but there was no correlation with plasma histamine concentrations of either relaxant group. There was no correlation either between histamine concentrations and heart rate or blood pressure associated with atracurium. The incidence of bradycardia with either relaxant is low if the anaesthetic technique and the surgery are devoid of vagal activity.
The value of postoperative chest radiology after major abdominal surgery
Authors: COOPER M. H. , PRIMROSE J. N. 
Published: February 2007

SummaryA prospective study was carried out in which a chest radiograph was performed routinely on the third postoperative day on 35 consecutive patients who had elective abdominal surgery. The aim was to determine whether clinical symptoms and signs could be correlated with the radiographic appearances and whether the routine use of such an X ray could detect serious chest pathology before clinical signs developed. Thirteen patients (37%) had radiological evidence of complications and all had symptoms and (or) signs which suggested postoperative chest pathology. The 22 patients (63%) who had no radiological abnormality, could be subdivided clinically into those who were normal (29%) and those who had symptoms and (or) signs (34%). There was no significant difference between the groups in terms of previous surgery, sex, smoking, nature of surgical incision, age or duration of anaesthesia. There was a poor correlation between the diagnosis of the chest abnormality detected clinically and the diagnosis suggested by the radiographs. These findings suggest that a routine postoperative chest X ray is unnecessary in the absence of clinically detectable chest pathology.
Epidural anaesthesia and spinal arachnoiditis
Authors: SGHIRLANZONI A. , MARAZZI R. , PAREYSON D. , OLIVIERI A. , BRACCHI M. 
Published: February 2007

SummarySix patients were referred to our hospital with spinal arachnoiditis after epidural anaesthesia performed one month to 3 years before the onset of symptoms. None had had previous lumbar surgery or trauma, intraspinal haemorrhage, infections or other known causative factors of arachnoiditis. All the patients were free of neurological symptoms before epidural anaesthesia and only two had transient distress in the period immediately following the procedure. The clinical signs and symptoms of spinal arachnoiditis were severe and in every case the diagnosis was confirmed by myelography. Three patients were confined to a wheelchair after 3 years of follow‐up. To our knowledge, the anaesthetic procedures were performed according to standard methods. Arachnoiditis seems to be due to the epidural injection of foreign substances, and may be related to anaesthetic–vasoconstrictor solution or contaminants.
Haemodynamic responses to nicardipine in humans anaesthetised with halothane
Authors: RAY D. C. , DRUMMOND G. B. 
Published: February 2007

SummaryThe haemodynamic effects of an infusion of nicardipine were studied noninvasively before, during and after halothane anaesthesia in man, using a simple technique to achieve constant plasma drug concentrations. Eighty patients were randomly allocated to receive an intravenous infusion of either nicardipine or normal saline. Systolic and diastolic arterial pressures were significantly lower and heart rate significantly higher throughout the infusion than before infusion (p < 0.001, all variables) in those patients who received nicardipine. The hypotension induced by nicardipine was not affected by induction of anaesthesia; halothane significantly reduced the nicardipine‐induced tachycardia (p < 0.001). Nicardipine caused no cardiac rhythm disorders. This technique for the intravenous administration of nicardipine achieves appropriate stable plasma concentrations, is devoid of severe haemodynamic disturbance and appears to be safe to use during halothane anaesthesia in patients with normal left ventricular function.
Peri‐operative management of severe thyrotoxicosis with esmolol
Authors: VIJAYAKUMAR H. R. , THOMAS W. O. , FERRARA J. J. 
Published: February 2007

SummaryA case of severe thyrotoxicosis with cardiac decompensation is reported. Use of propranolol was followed by cardiovascular collapse. Esmolol, the beta‐1 adrenoceptor blocking agent was successfully used to control the thyrotoxic state. A discussion of possible advantages of esmolol is provided.
Hypertrophic obstructive cardiomyopathy in combination with a prolapsing mitral valve
Authors: BELL M.D. , GOODCHILD C.S. 
Published: February 2007

SummaryThe anaesthetic management of a 27‐year‐old woman who presented for surgical correction of hypertrophic obstructive cardiomyopathy and mitral valve prolapse is described. The rationale for using propofol in a total intravenous anaesthetic technique is discussed.