Anaesthesia and intensive care
-
The possibility of a potential mutagenic or carcinogenic action of chronic exposure to low concentrations of inhalational anaesthetics has been previously studied, with conflicting results. The purpose of this study was to assess whether occupational exposure to waste anaesthetic gases increases genotoxic risk. We examined peripheral lymphocytes from anaesthetists for both sister chromatid exchange (SCE) and for cells with high-frequency SCEs (HFCs). ⋯ This study does not support the existence of an association between occupational exposure to waste anaesthetic gases and an increase in SCEs in lymphocytes. The nature of our anaesthesia practice suggests exposure was likely to be low. It should be noted that some anaesthetic gases produce lesions that can be efficiently repaired in mitogen-stimulated lymphocytes in vitro but not in circulating lymphocytes.
-
Anaesth Intensive Care · Oct 2002
Comparative StudyEffect of age on haemodynamic response to tracheal intubation. A comparison of young, middle-aged and elderly patients.
The effect of age on the haemodynamic response to tracheal intubation was studied. Ninety ASA 1 or 2 patients were divided into three groups of 30 each based on age; ie., young (18-25 years), middle-aged (40-50 years) and elderly (65-80 years). The haemodynamic response after tracheal intubation was observed as percentage change in heart rate and blood pressure compared to the baseline. ⋯ The elderly and young patients showed a significant difference in the diastolic blood pressure response only at one minute post-intubation. The heart rate response was greatest in the middle-aged patients (40%) and least in the elderly (16%). These differences may have clinical significance and should be considered in assessing and performing research into the haemodynamic response to intubation.
-
Anaesth Intensive Care · Oct 2002
Comparative StudyEvaluation of induction doses of propofol: comparison between endstage renal disease and normal renal function patients.
Anaemia, hypoproteinaemia and acidic pH in renal failure patients can alter the pharmacokinetics and pharmacodynamics of anaesthetic agents, resulting in altered dose requirements. We evaluated the induction dose of propofol in adult patients with end-stage renal disease by titrating the hypnotic effect by means of a clinical parameter as well as using a more objective assessment of hypnosis, the Bispectral Index (BIS) monitor. The dose was compared with that for patients with normal renal function. ⋯ Propofol dose required to achieve a BIS of 50 (5) was also higher in end-stage renal disease patients (2.03 (0.4) mg/kg versus 1.39 (0.43) mg/kg in normal renal function patients, P<0.05). There was a significant negative correlation of propofol dose with preoperative haemoglobin concentration. A hyperdynamic circulation in renal failure patients with anaemia may be responsible for the higher propofol dose requirement in this group.
-
Anaesth Intensive Care · Oct 2002
Comparative StudyGum-elastic bougie-guided insertion of the ProSeal laryngeal mask airway: a new technique.
We determined the success rates, cardiovascular responses and airway morbidity for gum-elastic bougie-guided insertion of the ProSeal laryngeal mask airway. One hundred anaesthetized, non-paralyzed adults (ASA 1-2 aged 18 to 80 years) were studied. The ProSeal LMA drainage tube was primed with a well-lubricated 16 French gauge gum-elastic bougie with the curved end proximal and the straight end protruding 30 cm beyond the drainage tube tip. ⋯ Blood staining at removal was not detected on the gum-elastic bougie, but was detected in 3% of ProSeal LMAs. The incidence of sore throat, dysphagia and dysarthria was 21%, 9% and 1% respectively. We conclude that gum-elastic bougie-guided insertion of the ProSeal LMA has a high success rate and is associated with minimal haemodynamic change and a low incidence of trauma.