Anaesthesia and intensive care
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Anaesth Intensive Care · May 1991
Randomized Controlled Trial Comparative Study Clinical TrialArterial desaturation during induction in healthy adults: should preoxygenation be a routine?
We studied the haemoglobin saturation of one hundred healthy patients equally divided into two groups. Group 1 patients received three minutes of preoxygenation prior to thiopentone induction followed by inhalational anaesthetics. ⋯ None of the patients in Group 1 showed any arterial oxygen desaturation during the five minutes of the induction period, whereas 21 patients in Group 2 showed definite desaturation (P less than 0.005), of which fifteen patients had a saturation of 90% or less (P less than 0.005) and six had a saturation of 85% or less. Since those were healthy patients and the anaesthetics were given by experienced anaesthetists, we concluded that some form of preoxygenation should be used in all patients receiving general anaesthesia.
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The use of epidural fentanyl by patient-controlled analgesia (PCA) may be a useful method of providing high-quality postoperative analgesia on the general surgical ward. The successful use of this technique requires an infusion pump with specific characteristics. Three Provider 5500, newly-developed, battery-powered PCA pumps, were tested to determine their accuracy, threshold of occlusion alarm limits and stored volume characteristics. ⋯ This problem did not occur with the addition of an epidural catheter and filter. This device has features which make it suitable for the safe delivery of epidural PCA. Care, however, needs to be taken on changing cartridges to prevent accidental administration of a drug bolus to the patient.
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Anaesth Intensive Care · May 1991
Comparative StudyIntraoperative assessment of the Lawrence 3000 Doppler Cardiac Output Monitor.
Transoesophageal Doppler cardiac output measurement was evaluated against the thermodilution method in eleven patients undergoing elective cardiac surgery. A total of 106 pairs of Doppler and thermodilution values were obtained. Cardiac output was measured over a range of 2.3 l.min-1. to 11.51 l.min-1. ⋯ Standard deviction was 1.8 l.min-1. This is a significant difference. It is concluded that these techniques do not agree when measuring cardiac outputs.
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An adaptor has been devised which, when fitted between the handle and the blade of a standard Macintosh design laryngoscope, allows the angle to be adjusted to several clinically useful positions. An appropriate angle can be easily found either for introduction of the blade, laryngoscopy or exploration of the pharynx through a simple mechanism operated by the hand holding the laryngoscope.