Anaesthesia and intensive care
-
Anaesth Intensive Care · May 1991
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of two-lung high frequency positive pressure ventilation and one-lung ventilation plus 5 cm H2O non-ventilated lung CPAP, in patients undergoing anaesthesia for oesophagectomy.
A randomised prospective controlled study was conducted during a one-year period on patients scheduled for oesophagectomy via a right thoracotomy approach. Twenty-two patients received one-lung ventilation (OLV group) and twenty patients received high frequency positive pressure ventilation (HFPPV group). ⋯ The mean peak inspiratory pressure and average mean airway pressure were significantly lower in the HFPPV group 28.8 (SD 7.7) and 7.2 (SD 2.4) cm H2O respectively, compared with the OLV group, 40.0 (SD 9.9) and 11.9 (SD 4.9) cm H2O (P less than 0.05). Two-lung high frequency positive pressure ventilation has some advantages over one-lung ventilation during the thoracotomy phase of oesophagectomy because it is easy to administer, does not significantly compromise the surgical exposure and is associated with fewer severe undesirable physiological disturbances.
-
Anaesth Intensive Care · May 1991
Randomized Controlled Trial Comparative Study Clinical TrialArterial desaturation during induction in healthy adults: should preoxygenation be a routine?
We studied the haemoglobin saturation of one hundred healthy patients equally divided into two groups. Group 1 patients received three minutes of preoxygenation prior to thiopentone induction followed by inhalational anaesthetics. ⋯ None of the patients in Group 1 showed any arterial oxygen desaturation during the five minutes of the induction period, whereas 21 patients in Group 2 showed definite desaturation (P less than 0.005), of which fifteen patients had a saturation of 90% or less (P less than 0.005) and six had a saturation of 85% or less. Since those were healthy patients and the anaesthetics were given by experienced anaesthetists, we concluded that some form of preoxygenation should be used in all patients receiving general anaesthesia.
-
Anaesth Intensive Care · May 1991
Randomized Controlled Trial Clinical TrialThe influence of epidural pethidine on shivering during lower segment caesarean section under epidural anaesthesia.
A prospective study of 94 patients undergoing elective lower segment caesarean section under epidural anaesthesia was performed in order to determine the incidence of shivering and the influence of epidural pethidine. Epidural anaesthesia was established with bupivacaine 0.5% with adrenaline, with or without additional lignocaine 2% with adrenaline, to total 20-25 ml. With the injection of epidural local anaesthesia an extra 5 ml of solution was administered into the epidural space--pethidine 25 mg preservative-free, in normal saline, or normal saline alone. ⋯ The difference was highly significant (P less than 0.01). There was no significant difference in the incidence of maternal nausea, vomiting, drowsiness or pruritus, or neonatal Apgar scores. Cord blood samples were assayed for pethidine, revealing low or absent pethidine concentrations.
-
The use of epidural fentanyl by patient-controlled analgesia (PCA) may be a useful method of providing high-quality postoperative analgesia on the general surgical ward. The successful use of this technique requires an infusion pump with specific characteristics. Three Provider 5500, newly-developed, battery-powered PCA pumps, were tested to determine their accuracy, threshold of occlusion alarm limits and stored volume characteristics. ⋯ This problem did not occur with the addition of an epidural catheter and filter. This device has features which make it suitable for the safe delivery of epidural PCA. Care, however, needs to be taken on changing cartridges to prevent accidental administration of a drug bolus to the patient.