Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Mar 1983
The functional and morphological effects of duodeno-gastric reflux and their relation to peptic ulceration.
The functional and morphological effects of duodeno-gastric reflux have been studied in the dog. Reflux causes hypersecretion of acid to pentagastrin and a hypergastrinaemic response to a standard meal, associated with antral gland hyperplasia. It is suggested that these changes are mediated by suppressed somatostatin activity, and that they may play an important part in the pathogenesis of peptic ulceration.
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Following the introduction of muscle relaxants into anaesthesia there became recognised a state in which patients may be aware of their surroundings but unable to communicate their plight. This state of awareness is more likely to occur during light inhalational or total intravenous anaesthesia. Detection of awareness is difficult and several methods have been described. ⋯ Awareness can occur without patient recall and may be due to equipment failure or anaesthetic failure. The former is avoidable and the latter ought to be. Recommendations have been made regarding the use of premedicant drugs and volatile anaesthetic agents to reduce the incidence of awareness.