bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of midazolam and diazepam for intravenous sedation in dentistry
Authors: Aun C. , Flynn P. J. , Richards J. , Major E. 
Published: February 2007

SummaryIn a randomised cross‐over trial, midazolam, a new water soluble benzodiazepine was compared with the conventional diazepam preparation (Valium) in 34 patients aged 16—45 years who were undergoing outpatient conservation dentistry. Midazolam hydrochloride (0.17 mg/kg) was virtually free of venous complications and showed advantages over diazepam (0.32 mg/kg) in providing a faster onset of action, higher incidence of amnesia and more rapid recovery. Midazolam produced a higher incidence of respiratory side effects: hiccough (17.6% compared with 2.9%), brief apnoea following induction (11.8% compared with 5.8%), and airway obstruction during maintenance (8.8%, compared with 0%). These may be related to the greater potency of midazolam as suggested by the smaller total dose required. Cardiovascular changes and operating conditions were similar.
An assessment of the Humphrey ADE anaesthetic system in the Mapleson A mode during spontaneous ventilation
Authors: Dixon J. , Chakrabarti M. K. , Morgan M. 
Published: February 2007

SummaryThe Humphrey ADE anaesthetic breathing system in the Mapleson A mode has been compared with the Magill system in spontaneously breathing conscious volunteers and anaesthetised patients. In the latter, rebreathing occurred at a significantly lower fresh gas flow with the ADE system than when the Magill system was used (mean 45.6 ml/kg/minute und 56.5 ml/kg/minute respectively). There was no significant difference between the fresh gas flow at which rebreathing orcurred in conscious volunteers.
Intensive care patients in district hospitals. A case for transfer?
Authors: Lavery G. G. , Donnelly P. B. , Dundee J. W. 
Published: February 2007

SummaryPatients, admitted and primarily treated in a rural hospital, who required varying periods of intensive care management have been reviewed. The criteria for transfer of such patients 10 more specialised units and the hazards associated with ambulance travel are discussed. We describe measures to reduce these hazards and also a scheme for more uniform documentation and follow‐up of such cases by the unaesthetist involved in primary care.
Postoperative analgesia for Caesarean section using epidural methadone
Authors: Beeby Diana , MacIntosh K.C. , Bailey M. , Welch D.B. 
Published: February 2007

SummaryA prospective randomised double blind study was carried out to compare the use of epidural methadone, morphine and bupivacaine for pain relief after Caesarean section. The results indicate that methadone is the most effective agent with few side effects. Subsequently this method was used routinely for postoperative analgesia in all patients undergoing Caesarean section. A retrospective study of 178 patients having this method of analgesia was carried out and indicated that epidural methadone is an effective and safe method of postoperative pain relief.
Anaesthetic management during repair of tracheo‐oesophageal fistula
Authors: CHAN C. S. 
Published: February 2007

SummaryA flexible fibreoptic laryngoscope was used to facilitate the passage of a long polyvinyl chloride tracheal tube into the left main bronchus during repair of a tracheo‐oesophageal fistula situated near the carina in a patient in whom intubation with a double‐lumen endobronchial tube was difficult. Close monitoring of neuromuscular transmission using a peripheral nerve stimulator also contributed to the successful unaesthetic management of this patient.
Anaesthetic carrier gases
Authors: MANN M. S. , WOODSFORD P. V. , JONES R. M. 
Published: February 2007

SummaryThe effects of three different anaesthetic carrier gases on middle‐ear pressure in the operative and postoperative periods was assessed. Patients receiving oxygen and oxygen‐enriched air did not have significant changes in middle‐ear pressure. The changes associated with the use of nitrous oxide as the carrier gas were reversed with return of pharyngeal reflexes or after prolonged inhalation of 100% oxygen. In patients undergoing middle‐ear surgery or those with pre‐existing middle‐ear disease, we suggest that oxygen‐enriched air is the anaesthetic carrier gas of choice.
High‐frequency jet ventilation for tracheal surgery
Authors: ROGERS R. C. , GIBBONS J. , COSGROVE J. , COPPEL D. L. 
Published: February 2007

SummaryThe anaesthetic requirements for tracheal resection include a clear airway, adequate ventilation and good surgical access. Many techniques have been described, none of which is entirely satisfactory. This case reports on the use of high‐frequency jet ventilation with 10Fg catheter combined with muscle relaxants and intravenous anaesthesia in a patient with tracheal stenosis.
Ischaemia following selfadministered intra‐arterial injection of methylphenidate and diamorphine
Authors: CORSER G. , MASEY S. , JACOB G. , KERNOFF P. , BROWNE D. 
Published: February 2007

SummaryA patient presented with a painful, oedematous, cyanosed hand having injected a solution of diamorphine and methylphenidate into his radial artery. Treatment was started with heparin and vasodilators. Benefit from this was limited and a course of intra‐arterial urokinase was instituted. This gave almost total resolution of the injury. The mechanisms producing ischaemia following intra‐arterial injection of drugs of abuse and possible treatment are discussed.
Blocking the circulatory responses to tracheal intubation
Authors: KAY B. , HEALY T. E. J. , BOLDER P. M. 
Published: February 2007

SummaryThe effects of three drug administration programmes on the haemodynamic responses to tracheal intubation have been compared. Thirty patients received thiopentone 4 mg/kg. Ninety seconds later, following the injection of either saline, nalbuphine 0.3 mg/kg or fentanyl 5μg/kg, suxamethonium 1.5 mg/kg was given. The pressor response to tracheal intubation which occurred after saline was reduced after nalbuphine (p < 0.05) but a tachycardia still occurred. In contrast, neither an increase in blood pressure nor heart rate occurred in those patients given fentanyl. It is concluded that nalbuphine 0.3 mg/kg is only partially efective in reducing the cardiovascular responses to laryngoscopy and tracheal intubation.
Evaluation of the IVAC 560 volumetric pump
Authors: HUTCHINSON A. , YEOMAN P. M. , BYRNE A. J. 
Published: February 2007

SummaryThe performance of a new combined infusion pump and central venous pressure monitor, the IV AC 560, has been evaluated in laboratory and clinical studies. The pump performed accurately and reliably, and the pressure readings obtained from the pump correlated well with conventional methods of pressure measurement, although they lost accuracy when using 50% dextrose at higher venous pressures.
Respiratory complications following cardiac surgery
Authors: GOULD F. K. , FREEMAN R. , BROWN M. A. 
Published: February 2007

SummarySputum specimens were received for microbiological examination from 110 patients following open heart surgery. The isolation of Haemophilus influenzae occurred significantly more often in those patients who had pre‐existing chest disease, but was not associated with postoperative chest problems. There was a significant association between pre‐operative heart failure and subsequent severe pulmonary complications.
Excessive dose requirements of local anaesthetic for epidural analgesia
Authors: KUMAR C. M. , DENNISON B. , LAWLER P. G. P. 
Published: February 2007

SummaryOn two separate occasions, a 78‐year‐old obese man suffering from congestive cardiac failure and peripheral vascular disease, required epidural anaesthesia for surgery to his leg. The dosage requirement on the first occasion was large and much greater than on the second occasion. Reasons for the difference in dosage are discussed. We suggest an epidural catheter should be inserted 3 cm into the epidural space.
Assessment and modification of pain on induction with propofol (Diprivan)
Authors: McCulloch M.J. , Lees N.W. 
Published: February 2007

SummaryAssessment of pain on injection of the emulsified formulation of di‐isopropylphenol (propofol, ‘Diprivan’) was undertaken in 120 unpremedicated patients and comparison made with thiopentone. A high incidence of pain (37.5%) was found using dorsal hand veins, but use of forearm veins showed only a 2.5% incidence of pain. The use of intravenous lignocaine immediately before propofol injection only partially reduced the incidence of pain using dorsal hand veins (17.5%). A degree of cardiorespiratory depression accompanied induction but the incidence of other side effects was low.
Epidural blood patch using a catheter. Diagnosis of an unrecognised dural tap
Authors: Shah J.L. , Veness A.M. 
Published: February 2007

SummaryTwenty five patients were treated with an epidural blood patch for persistent headache, following a known or suspected dural puncture. Fifteen to 20 ml blood was injected into the epidural space through a catheter inserted one space away from the dural puncture. The catheter technique was useful in confirming the clinical diagnosis of previously unrecognised dural tap in six patients with severe headache. It was possible to perform the blood patch single‐handed.
Opitz‐Frias syndrome
Authors: BOLSIN S. N. , GILLBE C. 
Published: February 2007

SummaryThe unaesthetic management is described of a nine‐month‐old male for surgical palliation of the the functional abnormalities associated with Opitz‐Frias syndrome. Features of this syndrome of interest to anaesthetists include recurrent pulmonary aspiration of intestinal contents, achalasia of the oesophagus, subglottic stenosis, hypertelorism, micrognathia and a high arched palate. No previous reports of anaesthesia for patients uith this condition have been identified.
Anaesthetic management in Moya‐moya disease
Authors: BINGHAM R. M. , WILKINSON D. J. 
Published: February 2007

SummaryA case of Moya‐moya disease requiring anaesthesia for both investigation and attempted surgical correction is presented. The influence of the anaesthetic technique on the abnormal cerebral vasculature, with particular reference to induced hypocapnia, is discussed. Guidelines for a safe method of anaesthesia in this group of patients are suggested.
Adverse effects of suxamethonium*
Authors: BUDD A. , SCOTT R. F. P. , BLOGG C. E. , GOAT V. A. 
Published: February 2007

SummaryOne hundred patients were allocated randomly to pretreatment with atracurium 2.5 mg. atracurium 5 mg, fazadinium 3,75 mg or saline 3 minutes before the injection of suxamethonium. The effect upon neuromuscular conduction was studied by recording the mechanical response of the adductor pollicis muscle to indirect stimulation of the ulnar nerve using repeated 2 Hz train of four stimuli. Blood samples were taken at intervals for the measurement of serum potassium. There was no significant difference in the incidence of postoperative muscle pains between the groups in the first 72 hours following anaesthesia. The use of the larger pretreatment dose of atracurium resulted in clinically significant neuromuscular blockade in three of the subjects. Minimal changes in serum potassium occurred in all patients but there was no statistical difference between the groups.
The estimation of midazolam, a water‐soluble benzodiazepine by gas liquid chromatography
Authors: HOWARD P. J. , McCLEAN E. , DUNDEE J. W. 
Published: February 2007

SummaryA simple, reliable and reproducible method for the estimation of midazolam in plasma samples is described. This involves extraction with benzene and estimation by gas‐liquid chromatography using diazepam as the internal standard. Reproducibility was good and the extraction from plasma was 94% efjcient.
Anaesthesia for suction termination of pregnancy
Authors: West Sheila L. , Moore C. A. , Gillard M. , Browne P. D. 
Published: February 2007

SummaryThe effect of three anaesihetic techniques on blood loss and intra‐uterine pressure changes in response io Syntocinon were siudied in patients undergoing routine first trimester suciion termination of pregnancy. All patients received a standard premedicaiion, a bolus dose of fentanyl, intravenous induction of anaesthesia and maintenance with nitrous oxide and oxygen plus either iniravenous supplementation or 0.5% halothane. Intra‐uterine pressure was related to ihe anaesthetic technique used although blood loss was unrelaied either to anaesthetic technique or to intra‐uterine pressure changes.
The depth of the lumbar epidural space from the skin
Authors: Harrison G.R. , Clowes N.W.B. 
Published: February 2007

SummaryThe depth of the epidural space at different intervertebral interspaces was measured in 1000 parturients. Overall the median distance from the skin to the epidural space was 4.7 cm. but this varied with the lumbar interspace at which it was measured, being greatest at the third (L3‐4) interspace (4.93 cm) and least at the first (L1‐2) interspace (4.23 cm). The clinical significance of these findings is discussed.
Epidural fentanyl in labour
Authors: VELLA LOUISE M. , WILLATTS D. G. , KNOTT CHRISTINE , LINTIN D. J. , JUSTINS D. M. , REYNOLDS FELICITY 
Published: February 2007

SummaryIn a randomised double‐blind trial in the first stage of labour, 20 patients given fentanyl 80 μg in the epidural test dose of bupivacaine, were compared with 20 patients receiving an intravenous infusion designed to produce comparable plasma fentanyl concentrations, at the same time as their epidural test dose. Despite slightly higher plasma fentanyl concentrations in the intravenous, fentanyl group, epidura1, fentanyl produced analgesia which was more complete, more rapid in onset and slightly longer lasting. Supplementary doses of bupivacaine were needed to produce analgesia in 75% of the inlravenous and 30% of the epidural fentanyl group. It is clear that epidural, fentanyl produces satisfactory pain relief when added to the epidural test dose, but that the presence of fentanyl in the systemic circulation makes a negligible contribution to analgesia.
Neuromuscular blockade in dystrophia myotonica with atracurium besylate
Authors: BOHEIMER N. , HARRIS J. W. , WARD S. 
Published: February 2007

SummaryThe anaesthetic management of a young woman with dystrophia myotonica is described. The use of atracurium and monitoring of neuromuscular block allowed suxamethonium and neostigmine to be avoided, and thereby to reduce the risk of myotonic contractions. No adverse sequelae were observed.
Postoperative apnoea and latent myasthenia gravis
Authors: WOJCIECHOWSKI A. P. J. , HANNING C. D. , POHL J. E. F. 
Published: February 2007

SummaryWe report a case of alcuronium induced postoperative apnoea due to latent myasthenia gravis in a patient with no other clinical manfestations of the disease at presentation. Acetylcholine receptor antibody estimation was used to confirm the diagnosis.
Transdermal hyoscine and postoperative nausea and vomiting
Authors: UPPINGTON J. , DUNNET J. , BLOGG C. E. 
Published: February 2007

SummaryForty‐two patients, undergoing major gynaecological surgery, were randomly allocated to have a patch applied to the skin behind one ear, containing either hyoscine or placebo. They were followed up at 24‐hour significant (p < 0.01) reduction in nausea and vomiting in the first 24 hours postoperatively, but no difference thereafter. There was an increased incidence of visual disturbance in the hyoscine group at 48 hours. but no other differences in the side effects studied at any other time. However, despite receiving hyoscine there was still a high incidence (68%) of severe nausea and vomiting.
Phenelzine poisoning
Authors: BREHENY F. X. , DOBB G. J. , CLARKE G. M. 
Published: February 2007

SummaryA 46‐year‐old female with severe phenelzine poisoning was managed successfully by alpha blockade and fluid loading, with the aid of invasive haemodynamic monitoring. The pathophysiology was documented, showing elevated plasma and urinary catecholamines, cardiovascular abnormalities and a contracted blood volume. Most of these changes were reversed following treatment.
Cryoanalgesia for pain after herniorrhaphy
Authors: Khiroya R.C. , Davenport H.T. , Jones J.G. 
Published: February 2007

SummaryThe effect of freezing the ilioinguinal nerve on postoperative pain relief was examined in a double blind study in 36 patients undergoing herniorrhaphy. randomly allocated into two groups. Patients in the experimental group had their ilioinguinal nerves frozen during surgery and were compared with the patients in the control group who did nor have cryoanalgesia. Pain relief was assessed overa 48‐hour period in three ways, namely the linear analogue pain scale, peak expiratory flow rates and the amount of analgesic drugs required by patients in the two groups. We conclude that cryoanalgesia of the ilioinguinal nerve alone does not produce significant early post herniorrhaphy pain relief.
One‐lung ventilation
Authors: Obara H. , Tanaka O. , Hoshino Y. , Kaetsu H. , Maekawa N. , Iwai S. 
Published: February 2007

SummaryWe applied positive end expiratory pressure to the nondependent, nonventilated lung, or both non‐dependent and dependent, ventilated lung during one lung anaesthesia, and compared the results to those obtained by other techniques, such as increasing the inspired oxygen concentration in the dependent lung, or insuffating with oxygen using positive end expiratory pressure in the nondependent lung. Our study suggests that arterial oxygenation and intrapulmonary shunt can be lessened during one lung ventilation by continuous oxygen insufflation of the nondependent lung at 0.98 kPa positive end expiratory pressure while the dependent lung is ventilated with 0.49 kPa positive end expiratory pressure.
Cervical epidural anaesthesia in carotid artery surgery
Authors: KAINUMA M. , SHIMADA Y. , MATSUURA M. 
Published: February 2007

SummaryThe successful anaesthetic management using a cervical epidural technique is reported in three patients undergoing carotid artery surgery. Adequate analgesia was obtained in all cases and the adequacy of cerebral blood flow was easily judged by the patient's state of consciousness. Cervical epidural anaesthesia could be a safe and reasonable technique for the management of patients who need carotid artery surgery.
Effects of atracurium on intracranial pressure in man
Authors: Unni V.K.N. , Gray W.J. , Young H.S.A. 
Published: February 2007

SummaryIntravenous administration of 0.6 mg/kg of atracurium 10 nine patients did not produce any significant change in intracranial, mean arterial or cerebral perfusion pressures. In another three patients, anaesthesia was induced with thiopentone 5 mg/kg after muscle relaxation with atracurium I mg/kg. Intracranial pressure was below pre‐induction levels in two patients whose tracheas were intubated 90 seconds after atracurium. The vocal cords were not fully relaxed at 90 seconds in the third patient. Intubation at 150 seconds in this patient was associated with a rise in intracranial pressure above pre‐induction values.
Plasma cholinesterase changes during the puerperium
Authors: ROBSON N. , ROBERTSON I. , WHITTAKER MARY 
Published: February 2007

SummaryChanges in plasma cholinesterase activity during the puerperium were studied in 16 women who received epidural analgesia for labour followed by vaginal delivery, and in five women who underwent elective Caesarean section under epidural analgesia. A consistent fall in cholinesterase activity was demonstrated during the first 2 to 3 days post partum. followed by a rise to approximately normal nonpregnant values by the end of the puerperium. An additional patient who manifested prolonged paralysis following an emergency Caesarean section under general anaesthesia, including a suxamethonium infusion, was also studied. Possible mechanisms by which the transient decrease in cholinesterase activity is produced, and its clinical significance, are discussed.
Meptazinol versus pethidine for postoperative pain relief in children
Authors: RIDLEY S. A. , MATTHEWS N. C. , DIXON J. 
Published: February 2007

SummaryA double‐blind, randomised, clinical trial was undertaken comparing intramuscular meptazinol (1 mg/kg) with intramuscular pethidine (1 mg/kg)for the relief of post‐tonsillectomy pain, in 100 children under 15 years of age. Pethidine provided better analgesia in those patients who were awake after 30 minutes, but thereafter no statistically significant differences between the degree of pain relief could be detected. Meptazinol caused less sedation than pethidine, in that significantly more patients were awake after 40 minutes in the meptazinol group. The incidence of nausea and vomiting was similar in patients of both groups.
The Nellcor N‐101 pulse oximeter
Authors: TYTLER J. A. , SEELEY H. F. 
Published: February 2007

SummaryThe accuracy of the Nellcor N‐101 pulse oximeter has been evaluated in adult patients receiving general anaesthesia or intensive care. Readings obtained noninvasively with this instrument were compared with measurements made on arterial blood using a Radiometer OSM2 oximeter. The pulse oximeter was easy to use and within the range tested (70–100 percent saturation of haemoglobin with oxygen) the readings were within I digit of the values obtained by in vitro measurement.
Ketanserin and the cardiovascular system
Authors: GRIFFITHS H. B. A. , WHITWAM J. G. 
Published: February 2007

SummaryThe effect of 10 mg of ketanserin on the pressor responses to noradrenaline, phenylephrine and angiotensin II in 19 patients during cardiopulmonary bypass was observed. The results were compatible with the previously reported evidence that ketanserin, in addition to its antagonism of serotonin, causes alpha, adrenoceptor blockade.
Ketanserin and the cardiovascular system
Authors: GRIFFITHS H. B. A. , WHITWAM J. G. 
Published: February 2007

SummaryA double‐blind study was performed on 19 patients undergoing myocardial revascularisation. Routine anaesthetic and cardiopulmonary bypass procedures were used. Nine patients received ketanserin by continuous infusion and ten received an equal infusion rate of placebo. Arterial blood pressure was controlled with sodium nitroprusside. The ketanserin group had a signijicantly higher cardiac index and a lower peripheral vascular resistance during the first 2 hours after bypass.
Pupil response to alfentanil and fentanyl
Authors: ASBURY A. J. 
Published: February 2007

SummaryThe pupillary response to alfentanil, fentanyl and a saline placebo was measured in patients anaesthetised in a standard manner with halothane, to determine whether the pupil diameters changed in a way which could be distinguished from background activity. Measurements were made to the nearest 0.1 mm using a purpose‐built pupillometer. The response to the drugs can be clearly distinguished from the background activity seen in the placebo group. The time courses of constriction caused by the two drugs are significantly different from the placebo group responses. The time to maximum to response with alfentanil is 4 minutes compared with 8 minutes for fentanyl. Both drugs produced at least 35% reduction in mean pupil diameter compared with the placebo group. The duration of the response to alfentanil was 25 minutes, whereas the fentanyl response lasted more than one hour.
Plasma morphine levels produced by continuous infusion in children
Authors: Bray R.J. , Beeton C. , Hinton W. , Seviour J.A. 
Published: February 2007

SummaryBlood samples were taken from six children aged between I0 months and 15 years. at intervals over a period of 40 hours while they were receiving continuous morphine infusions. The plasma morphine values obtained showed similar and consistent levels 15–30 minutes after starting the infusions.