Annals of the Royal College of Surgeons of England
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Methods available for the relief of postoperative pain are reviewed. The use of intermittent injections of morphine is likely to remain the established method and suggestions are made for its more effective use. Newer methods are discussed in terms of their expense and the effects on medical and nursing workload. It is suggested that nurses trained in pain relief methods could greatly improve the relief of pain following operation.
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Ann R Coll Surg Engl · Jul 1982
Respiratory failure after chest injury: the development of effective treatment.
The development of methods of treatment of severe chest injury over the years is reviewed and the contribution made by the introduction of intensive care units is assessed. A comparative analysis of the results of treatment in large series of patients reported during the period 1946-78 shows that, despite the risk of complications, the addition of artificial ventilation to conservative methods of treatment reduces mortality in patients with respiratory failure associated with chest trauma.
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A study was carried out in vitro to determine the minimum intracuff pressure needed to produce no-leak ventilation and prevent aspiration in Portex Profile and Searle Medical Sensiv endotracheal tubes. The mean pressures required to produced no-leak ventilation were 4.16 and 1.06 kPa respectively and the mean pressures at which aspiration occurred were 2.93 and 0.54 kPa respectively. The implications of these findings are discussed and recommendations are made regarding cuff specifications.
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Developments in anaesthesia for intracranial surgery over the past 35 years are illustrated by a comparison of personal practice in 1943-45 and in 1977-79, with some reference to techniques developed during the intervening years.