Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2015
Historical ArticlePain relief in childbirth: changing historical and feminist perspectives.
Pain during human childbirth is ubiquitous and severe. Opium and its derivatives constitute the oldest effective method of pain relief and have been used in childbirth for several thousand years, along with numerous folk medicines and remedies. Interference with childbirth pain has always been criticised by doctors and clergy. ⋯ They popularised the use of 'twilight sleep', a combination of morphine and scopolamine, which fell into disrepute as its adverse effects became known. From the 1960s, as epidural analgesia became more popular, a second wave of feminists took the opposite position, calling for a return to non-medicalised, female-controlled, 'natural' childbirth and, in some cases, valorising the importance of the pain experience as empowering for women. However, from the 1990s, a third wave of feminist thought has begun to emerge, revalidating a woman's right to choose a 'technological', pain-free birth, rather than a 'natural' one, and regarding this as a legitimate feminist position.
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Anaesth Intensive Care · Jul 2015
Historical ArticlePioneers of laryngoscopy: indirect, direct and video laryngoscopy.
Airway management is one of the core skills of the anaesthetist and various techniques of airway management have developed over many years. Initially, the only view of the glottis that could be obtained was an indirect view (indirect laryngoscopy). ⋯ Currently, in the early 21st century, there has been a return to indirect laryngoscopy via videolaryngoscopy using a videolaryngoscope. The aim of this paper is to give a historical overview of the development of both direct and indirect laryngoscopy.
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Anaesth Intensive Care · Jul 2015
Biography Historical ArticleBecoming a physician anaesthetist-difficulties encountered for half a century.
William T. G. Morton was not the first to use ether or nitrous oxide as an anaesthetic. ⋯ Some were prolific writers and helped spread the use of anaesthesia. However, attracting physicians to this new discipline proved difficult and there were segments of the medical establishment and society who were unwilling to accept this most significant advancement. In this article, we examine the reasons why many physicians and patients resisted the use of anaesthesia.
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Anaesth Intensive Care · Jul 2015
Sevoflurane for analgesia-testing a modified vaporiser for delivery.
The Diamedica Sevoflurane Inhaler (Diamedica UK Ltd, Bratton Fleming, UK) (DSI) is a breathing system which includes a modification of an existing vaporiser (Diamedica Draw-over Vaporiser, Diamedica UK Ltd, Bratton Fleming, UK), to enable the delivery of 0.8% sevoflurane. Previous studies have suggested that self-administered sevoflurane at sub-anaesthetic concentration can provide useful pain relief during the first stage of labour and that it may be more effective than Entonox. Further research and potential clinical use have been impeded by the lack of a practical delivery system. ⋯ The results from testing this revised version are also described. Mean sevoflurane output from the DSI-2 was found to be within a clinically acceptable range at the minute volumes tested (0.78% to 0.88%) and ambient temperatures tested (0.69% to 0.9%). Based upon these results, the authors propose to undertake further studies of sevoflurane analgesia using the DSI-2.