Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 1989
Comparative StudyPostoperative analgesia in neonates: an Australia-wide survey.
An Australia-wide survey of the use of postoperative analgesia in neonates has been conducted. A high overall use of analgesia has been recorded with 75% of respondents prescribing an opioid. ⋯ The general attitude is that analgesia is desirable but a fear of respiratory depression inhibits its use, particularly in non-ventilated neonates and after more minor surgery. It is suggested that a wider use of regional anaesthesia techniques may reduce this problem.
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Anaesth Intensive Care · Nov 1989
Acid aspiration prophylaxis in Australian obstetric hospitals--a survey.
During 1987 a confidential survey of all hospitals in Australia providing obstetric services was undertaken to determine the antacid medications used routinely as prophylaxis against acid aspiration pneumonitis. Of the 567 hospitals surveyed, 379 (67%) responded. Of these, 243 hospitals provide an obstetric service which includes caesarean section, and 67% of these perform less than 500 deliveries per annum. ⋯ Results were similar in the emergency caesarean section group. The use of cimetidine or ranitidine was uncommon in all groups. Results of this survey suggest marked differences in attitudes towards acid aspiration prophylaxis between Australian and British obstetric anaesthetic practices.
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Anaesth Intensive Care · Nov 1989
The influence of CO2 production and physiological deadspace on end-tidal CO2 during controlled ventilation: a study using a mechanical model.
A mechanical lung model was used to investigate the effect of varying carbon dioxide production and deadspace on the end-tidal carbon dioxide levels achieved during mechanical ventilation when using the Bain, Humphrey ADE, and circle systems. Both factors had significant influence on end-tidal carbon dioxide concentration and could result in values in excess of those considered acceptable in clinical practice. The implications of the results are discussed.
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Perioperative pulse oximetry was performed on one hundred consecutive abdominal surgical patients to audit our management of perioperative oxygenation. Oximetry was performed preoperatively, in the recovery room, and daily in the ward until discharge or the sixth postoperative day, with prescribed oxygen therapy continuing during measurement. ⋯ In this group of patients, clinical assessment of oxygenation and the need for oxygen therapy was inadequate. Intermittent oximetry is rapidly and simply performed, and by detecting patients with arterial haemoglobin desaturation, could improve oxygen prescribing in the perioperative period.
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Anaesth Intensive Care · Nov 1989
A method for implementing programmed infusion of thiopentone and methohexitone with a simple infusion pump.
We have tabulated the series of steps in infusion rate required to maintain constant arterial levels of thiopentone and methohexitone. The tables are based on multiexponential equations for infusion rate, derived from plasma drug efflux studies. ⋯ The tables provide rates suitable for delivery by a standard syringe pump to achieve and maintain an arterial concentration of 10 mg/l of thiopentone and 5 mg/l of methohexitone. Other desired drug concentrations can be derived from the table by simple multiplication.