Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 2005
Biography Historical ArticleVivian Richard Ebsary, A.M. biomedical engineer, inventor, philanthropist.
Vivian Ebsary was an inventor, designer and manufacturer of varied pieces of medical equipment, particularly those involving pumps. These included hypothermia machines and the heart-lung cardiopulmonary bypass machines used in Australian and New Zealand hospitals from the mid 1950s until well into the 1970s. Ebsary also designed and manufactured anaesthetic machines, a hyperbaric unit, scoliosis implant equipment, a chairlift and many other devices for use in the general community. This paper presents an overview of his life's involvement with medicine and medical technology in Australia.
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Anaesth Intensive Care · Jun 2005
ReviewAnaesthesia for neurosurgery in the sitting position: a practical approach.
Neurosurgery in the sitting position offers advantages for certain operations. However, the approach is associated with potential complications, in particular venous air embolism. As the venous pressure at wound level is usually negative, air can be entrained. ⋯ Other particular concerns to the anaesthetist are airway management, avoidance of pressure injuries, and the risk of pneumocephalus, oral trauma, and quadriplegia. Newer anaesthetic agents have made the choice of anaesthetic technique easier. An appreciation of the implications of neurosurgery in the sitting position can make the procedure safer
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Anaesth Intensive Care · Jun 2005
Comparative StudyEffect of newer anaesthetics on duration of stay in postanaesthesia care unit in patients undergoing major abdominal surgery.
Newer anaesthetic agents, such as remifentanil and sevoflurane, are more expensive than conventional anaesthetics, such as isoflurane and fentanyl. However, newer anaesthetics might outweigh their higher acquisition costs by reducing length of stay in the postanaesthesia care unit and thereby reducing personnel costs. We retrospectively investigated the influence of newer anaesthetics on time to eligibility for discharge from the postanaesthesia care unit in consecutive patients undergoing major abdominal surgery. ⋯ In the sevoflurane/fentanyl group, time to eligibility for discharge from the unit showed a tendency to be increased (P = 0.08), however these patients were significantly older compared to the other groups. Sevoflurane and remifentanil did not appear to reduce time to eligibility to discharge from the postanaesthesia care unit in our patients undergoing major abdominal surgery compared to isoflurane and fentanyl. This study highlighted the necessity for carefully planned transition from remifentanil to other longer-acting analgesia in our patients.
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Prospective data was collected on 58 patients having neurosurgery in the sitting position in one institution. The incidence of venous air embolism was 43% (25/58), of which the majority were small or moderate in size. ⋯ There was no mortality or serious morbidity. With a proper understanding of the pathophysiology of venous air embolism and the use of sensitive monitoring, anaesthesia for sitting position neurosurgery can be provided safely.
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Anaesth Intensive Care · Jun 2005
Biography Historical ArticleThe Marrett apparatus: is hospital anaesthetic equipment compatible with field use?
Major Rex Marrett in 1945 was commissioned to design an anaesthetic apparatus for field use to replace the Field Pattern Boyle's apparatus in use during the Second World War. His design was both elegant and avant garde and was capable of being used with all agents and circuitry then in current use. ⋯ The equipment and its later developments are described. Eventually the desire for knowing volatile agent concentrations led to its decline with production ceasing in 1976.