Annals of the Royal College of Surgeons of England
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A questionnaire was sent to 302 qualified nurses in an attempt to elicit their current practice of administering postoperative analgesics, knowledge of the drugs, opinions regarding prescribing habits and comments on how pain control could be improved; 211 nurses replied (70% response). Knowledge was good but practice poor in that 56% give less than six doses postoperatively and the majority of nurses do not give analgesics until the patient is in pain; 66% thought the amount of analgesic given was a poor indication of pain experienced; 62% felt that prescribing by doctors was inconsistent and 90% thought it could be improved. ⋯ The nurses wished for more involvement in pain management and for more education of patients preoperatively. A selection of comments is included and possible simple methods for improving pain control are discussed.
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Ann R Coll Surg Engl · Jan 1985
Percutaneous cervical cordotomy: results and complications in a recent series of 100 patients.
One hundred and twenty-two percutaneous cervical cordotomies were performed in 100 patients. Of these, 95 suffered from pain associated with malignant disease. ⋯ The results and complications observed in this recent series are discussed in relation to our previous and other authors' experience. For selected patients with cancer pain, percutaneous cordotomy is the most effective operative method available at the present time.
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Ann R Coll Surg Engl · Nov 1984
The provision of junior anaesthetic staff for the intensive care unit of a district general hospital: a workable solution?
The problems of staffing an ICU in a District General Hospital at junior level are discussed. The needs of the Unit, the junior staff and the Anaesthetic Department and possible ways of reconciling these are outlined. A system of providing cover using pairs of junior anaesthetists is described in detail. This has been successfully in operation for 18 months and its merits are discussed.
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Although the incidence of cuff induced tracheal damage has been considerably reduced by judicious use of tracheal tubes with large-volume, low-pressure cuffs, aspiration continues to be a major problem. A study was conducted to determine the maximum hydrostatic pressure that can be produced by a column of liquid above the tracheal cuff. ⋯ The maximum vertical and horizontal distance between the upper central incisor teeth and suprasternal notch was 9 cm and 21 cm respectively. The implication of these findings are discussed and it is suggested that a fixed intracuff pressure in the range of 2.5 to 3kPa should be used to obtain an optimal tracheal seal.
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Ann R Coll Surg Engl · Sep 1984
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of anti-emetics in association with intrathecal diamorphine.
Intrathecal diamorphine is associated with a high incidence of emetic symptoms. Six anti-emetic drugs representing various chemical groups were given in random order to patients undergoing total hip replacement and who had received intrathecal diamorphine 0.5-1.0 mg. The phenothiazines, perphenazine and prochlorperazine, were more effective than the others. It is suggested that this might be a useful model for the evaluation of new anti-emetics.