Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 1998
Contamination of propofol infusions in the intensive care unit: incidence and clinical significance.
Epidemics of bacteraemia and wound infection have been associated with the infusion of bacterially contaminated propofol administered during anaesthesia. We conducted an observational study to determine the incidence and clinical significance of administration of potentially contaminated propofol to patients in an ICU setting. ⋯ There were no episodes of clinical infection or colonization which could be attributed to the administration of contaminated propofol. During the routine use of propofol to provide sedation in ICU patients the risk of nosocomial infection secondary to contamination of propofol is extremely low.
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Anaesth Intensive Care · Apr 1998
Case ReportsCentral nervous system toxicity attributable to epidural ropivacaine hydrochloride.
Ropivacaine, a new local anaesthetic agent, has been demonstrated to have less potential than bupivacaine for central nervous system toxicity on the basis of human and animal studies. We report a case of a convulsion secondary to presumed inadvertent intravascular injection of 20 mg of ropivacaine in a 44 kg patient during an epidural for chronic pain. There were minimal signs of cardiovascular toxicity.
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Anaesth Intensive Care · Apr 1998
Case ReportsOxygen contamination of the nitrous oxide pipeline supply.
Midogas (CIG Australia) nitrous oxide/oxygen blenders are commonly used in delivery wards in Australia. In this case report we describe an incident where a small hole in the diaphragm of the oxygen failure alarm in a Midogas nitrous oxide/oxygen blender led to retrograde flow of oxygen contaminating the nitrous oxide pipeline supply to the operating theatres and the delivery ward. ⋯ However, if the oxygen pipeline pressure had been lower than the nitrous oxide pipeline pressure, the contamination would have been reversed, potentially resulting in a hypoxic mixture being delivered to many patients. Suggestions are made as to a method of prevention of this problem.
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Anaesth Intensive Care · Apr 1998
Letter Clinical TrialNebulized 10% lignocaine for awake fibreoptic intubation.
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Anaesth Intensive Care · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialPatient evaluation and comparison of the recovery profile between propofol and thiopentone as induction agents in day surgery.
The patient's subjective perception of the quality of his/her recovery after day case anaesthesia with propofol or thiopentone as induction agents is still controversial. The authors investigated the perception and quality of awakening after anaesthesia during the recovery period and at 24 hours and 72 hours, in outpatients undergoing anaesthesia induced either with propofol or thiopentone and maintained with a volatile anaesthetic. In a double-blind study in adults undergoing knee arthroscopy in a day surgery unit, propofol and thiopentone were compared as induction agents in 60 randomized outpatients. ⋯ In the propofol group, patients awoke more rapidly (9.2 +/- 5.8 vs 12.3 +/- 5.8 min) (P < 0.05); however, the CFFT measurements did not show any significant difference between the groups, except at time = 0 min, when 17 patients in the propofol group were able to perform the test versus only 10 patients in the thiopentone group (P < 0.05). At 4, 24, and 72 hours postoperatively, the authors were unable to detect any difference between the two groups. Except for early recovery, there were no differences between the intermediate and late recovery profiles, when propofol or thiopentone was used as the anaesthetic induction agent in day surgery.