Anaesthesia and intensive care
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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.
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Anaesth Intensive Care · Jul 2015
Observational StudyElectromagnetic needle tracking during simulated right internal jugular cannulation.
This study used three-dimensional information from Stealth navigation technology during simulated right internal jugular vein cannulation to define the initial needle trajectory taken when using three approaches: landmark (LM), short-axis (SAX) ultrasound and long-axis (LAX) ultrasound. Nineteen volunteers indicated the entry site and needle direction (track) they would use in performing right internal jugular vein cannulation by the three approaches. The likelihood of cannulation success, arterial puncture and needle direction were recorded. ⋯ The use of Stealth technology to provide three-dimensional feedback of the needle path taken during simulated right internal jugular cannulation was considered realistic (16/19) and of benefit for 18 of 19 (95%) respondents. The SAX track was associated with the highest likelihood of successful jugular cannulation and the lowest cross rate of the carotid artery. The simulation model using Stealth was considered to be valuable and realistic by participants despite some limitations.