Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1993
Comparative StudyOne hundred sciatic nerve blocks: a comparison of localisation techniques.
One hundred sciatic nerve blocks performed for surgery related to lower limb vascular disease were prospectively audited with respect to the techniques used for sciatic nerve localisation and the success rates achieved. Utilising a 22 gauge Quincke point needle, sciatic nerve localisation was performed by initially searching for paraesthesia, followed by the use of a low powered peripheral nerve stimulator. ⋯ A positive response to the nerve stimulator was achieved in 95 cases of which 87 went on to have successful blocks. Our findings suggest that either eliciting paraesthesia or a positive response to the peripheral nerve stimulator carries a high correlation with subsequent successful block, but that the use of the nerve stimulator provides a more consistent and reliable technique for nerve localisation.
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Anaesth Intensive Care · Feb 1993
Insertion of the laryngeal mask airway--a prospective study of four techniques.
The standard insertion technique (ST 0) for laryngeal mask airway insertion was compared to three alternative techniques in 120 patients. The alternative techniques included insertion using the standard approach, but with the cuff either semi-inflated (ST 0.5) or fully inflated (ST 1.0), and a non-standard approach using a back-to-front technique (like a Guedel airway) and with the cuff fully deflated (T 180). ⋯ Insertion with the LMA back-to-front with the cuff deflated produced similar fibreoptic and functional results to the standard technique. In 23%, however, there was some residual rotation of 25-90% to the coronal plane.
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Anaesth Intensive Care · Feb 1993
Noninvasive monitoring of tidal volume with an extensometer: laboratory and clinical studies.
The extensometer or "rubbery ruler" (RR) is a new torso transducer with potential application in the field of respiratory pattern analysis. This paper determines whether the RR can measure tidal volume over a clinically useful time frame following spirometric calibration. ⋯ Clinical testing in a variety of patients demonstrated that 96.6% of derived spirometric values were contained within an error range of +15.2% to -16.9% of spirometrically measured tidal volume and that accuracy did not change over a period of one hour. These results are encouraging and suggest that this device merits further investigation.
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Anaesth Intensive Care · Feb 1993
Complement (C3, C4) and C-reactive protein responses to cardiopulmonary bypass and protamine administration.
Complement activation has been deemed responsible for the damaging effects of cardiopulmonary bypass (CPB) in patients undergoing open heart surgery. We studied C3, C4 and C-reactive protein (CRP) in 22 patients undergoing CPB. In Group 1 (11 patients), protamine was given intravenously and in Group 2 (11 patients), via the aortic root after CPB. ⋯ In both groups, C3 levels gradually returned toward baseline within 24 hours but C4 levels were still lower than baseline 24 hours postoperatively. CPB and protamine administration did not cause any significant changes in CRP levels, but CRP increased abruptly 24 hours after operation. Although activation of complement system during CPB is expected to invoke an acute phase response, we conclude that this period is not long enough to induce an increased production of CRP in response to tissue injury or inflammation.
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Anaesth Intensive Care · Feb 1993
Biography Historical ArticleCattlin's bag and Clover's facepiece for nitrous oxide anaesthesia.