Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 1978
Intravenous ketamine anaesthesia for major abdominal surgery--an assessment of a technique and the influence of ataractic drugs on the psychomimetic effects of ketamine.
Eighty-two patients presenting for major abdominal surgery were divided into five groups, and received intravenous ketamine, muscle relaxation and controlled ventilation with oxygen-enriched air. For maintenance of anaesthesia patients were given a single intravenous dose of either droperidol 5 mg, diazepam 5 mg, promethazine 25 mg, flunitrazepam 0.5 mg or lorazepam 2 mg, followed by incremental doses of ketamine. Flunitrazepam and lorazepam were the adjuvants associated with the lowest incidence of dreaming and emergence phenomena; postanaesthetic sequelae occurred most frequently with both ketamine/diazepam and ketamine/droperidol anaesthesia. However, the differences between the five groups failed to reach statistical significance.
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Anaesth Intensive Care · Aug 1978
Case ReportsProlonged curarisation in the presence of renal impairment.
Prolonged curarisation in the presence of renal failure occurred in six cases where pancuronium was used, and one case where alcuronium was used. The cases are presented with a brief review of the literature. Pancuronium must be used with great caution if postoperative reversal problems are to be avoided. Greater use of adjuvants will reduce requirements and may eliminate the problems encountered in renal failure.
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Anaesth Intensive Care · Aug 1978
Arterial blood gas analysis: potential errors due to the addition of heparin.
The effect of sodium heparin on the determination of the major arterial blood gas parameters was studied. The addition of heparin produced errors in all three parameters tested, i.e. ⋯ Small but statistically significant errors were also produced in PO2 and pH by this heparin concentration. The clinical implications of these findings are discussed and certain measures outlined to avoid such errors.
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Blood levels of lignocaine and bupivacaine were measured in children following caudal, subcutaneous and tracheal administration. The highest peak levels were in children under 3 years following tracheal spray but all blood levels were below accepted toxic adult levels for anaesthetised patients. No toxic manifestations were seen.
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Anaesth Intensive Care · Aug 1978
Continuous lumbar plexus block--analgesia for femoral neck fractures.
In a series of 21 patients with fractures of the neck of the femur, continuous lumbar plexus block provided effective pain relief in 17 cases. The technique for continuous lumbar plexus block is described. The technique has advantages over conventional methods of analgesia.