Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2020
ReviewAnaesthesia for ophthalmic procedures in patients with thyroid eye disease.
Thyroid eye disease is an autoimmune inflammatory disorder of the orbit in adults. It causes inflammation, expansion and fibrosis of orbital fat, muscles and the lacrimal gland, leading to facial disfigurement, functional disability and, in severe cases, blindness. Overall, approximately 20% of affected patients need some form of surgical intervention requiring anaesthesia. ⋯ In addition, the contralateral eye should be checked and, if necessary, protected against corneal exposure. Retrobulbar, peribulbar and sub-Tenon's blocks are best avoided. Topical anaesthesia has been used for some strabismus correction surgery but its use is limited to motivated and cooperative patients only.
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Anaesth Intensive Care · Nov 2020
Anarcha, Betsey, Lucy, and the women whose names were not recorded: The legacy of J Marion Sims.
In April 2018, a statue commemorating J Marion Sims was removed from Central Park, New York, and relocated to Green-Wood Cemetery in Brooklyn, where he is buried. In 1849, Sims developed a repeatable surgical solution for obstetric fistula, a debilitating condition caused by prolonged, obstructed labour, which damages the vaginal wall, resulting in permanent leakage via the vagina from either the bowel or bladder and sometimes both. Initially, Sims appears worthy of widespread adulation. ⋯ One of these women, Anarcha, was operated on at least 30 times without the use of anaesthesia over a four-year period, despite the availability of anaesthesia for the majority of the experimentation period. Over 170 years later, Sims' story retains its relevance because it represents a clear point at which race, gender and class intersect with medicine. This paper will use Sims' own account to drive the narrative, then examine matters of agency, ethics and consent that come from it, to show that his work, and subsequent renown, were only possible because of the inherent violence of chattel slavery and other systemic forms of oppression.
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The administration of chloroform by John Snow to Queen Victoria to provide analgesia for the delivery of her children was a pivotal moment in the development of anaesthesia. It has long been thought that this was the only occasion she had experienced anaesthesia but examination of her diaries shows this to be untrue.
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Anaesth Intensive Care · Nov 2020
Paper trails: History of the first Australian paper on ether anaesthesia.
In September 1847, David John Thomas read a paper on etherisation at a monthly meeting of the Port Phillip Medical Association. Thomas' paper is the earliest known presentation of a paper on etherisation in the Australian colonies. ⋯ The original manuscript was acquired at an unknown date by the Medical Society of Victoria. Although a full transcript of the manuscript was published in 1933, the original manuscript of Dr Thomas remained unknown to anaesthesia historians and is now held by the Medical History Museum, University of Melbourne.
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Anaesth Intensive Care · Nov 2020
Dr Himson Tamur Mulas, the first national specialist anaesthetist in Papua New Guinea.
Dr Himson Tamur Mulas was born on the Gazelle Peninsula of East New Britain, New Guinea, on 13 March 1934. After finishing his schooling, he was selected to go to Fiji to undertake a medical course at Fiji Central Medical School in 1953, returning to New Guinea in 1958. He successfully completed residency posts and after a period of training in anaesthesia in Port Moresby, was sent to the Alfred Hospital in Melbourne, Australia, in 1966-1967 to further his anaesthetic career. ⋯ He left public hospital anaesthetic practice in 1980. He is recognised as the first New Guinean to be a specialist anaesthetist. He died on 28 July 2000 aged 66 years.