European journal of anaesthesiology
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Spinal anaesthesia resulted in unblocked segments in a patient who had undergone three previous spinal operations. Scar tissue, which often forms both extra-durally and intra-durally after spinal surgery, was probably the cause of the patchy sensory blockade.
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-dural puncture headache: a comparison of the Sprotte and Yale needles in urological surgery.
One hundred elderly male patients undergoing transurethral surgery were allocated randomly to receive spinal anaesthesia with either a 26 gauge Yale needle or a 24 gauge Sprotte needle. Patients were visited within 48 h by an investigator who was unaware of the needle type used and specific enquiry was made about any headache which was characteristic of dural puncture. ⋯ This represents a highly significant (P < 0.005) reduction in the incidence of postdural puncture headache. The incidence of multiple attempts at dural puncture was also significantly (P < 0.05) reduced to 16% in the Sprotte group compared with 28% in the Yale group.
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We used three methods to determine the onset of rebreathing in the Ohmeda enclosed afferent reservoir breathing system and compared the results with the previously published rebreathing characteristics of this system. Of the methods studied, expiratory limb capnography proved unsuitable for determining the onset of rebreathing in this system. Inspiratory limb capnography and minimum inspired carbon dioxide at the mouth did enable the onset of rebreathing to be determined. However the fresh gas flow:minute volume ratio at which rebreathing occurred as determined by these criteria was less than that determined by the Kain and Nunn criteria and thus offer no clinical advantage over the latter.
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41 patients (ASA I-II) were intubated using a new device for blind oral intubation (Augustine Guide). A group of 33 consecutive patients (Mallampati I and II), was studied for routine intubation. Another group of eight patients (Mallampati III and IV) was selected to study the guide in difficult airway management. ⋯ The Augustine Guide proved to be helpful to intubating patients with an anterior larynx and receding mandible. However, blind oral intubation attempts required a median duration of 65 s (range 35-90 s). Patients with a low Mallampati score did not benefit from the new device.