Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 1988
Inspired oxygen and nitrous oxide concentrations in volunteers during nitrous oxide sedation with a Hudson mask.
Ten volunteers were given varying ratios of oxygen and nitrous oxide at 4, 6 and 8 litres per minute using a Hudson mask delivery system. Maximum and minimum inspired oxygen concentrations, maximum inspired nitrous oxide concentrations and end tidal carbon dioxide concentrations were measured using the Datex Cardiocap CCI-104 monitor. ⋯ When nitrous oxide sedation is used clinically, nitrous oxide must be used with consideration of safe oxygen levels. This study did not detect unsafe pharyngeal oxygen levels in the ratios investigated, where the maximum delivered nitrous oxide concentration was 75%.
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The Final Examination for Fellowship of the Faculty of Anaesthetists, Royal Australasian College of Surgeons has been functioning since 1956. A description of its development and an analysis carried out on the examinations in 1969 and 1970 are contained in the paper by Fisk et al. ⋯ Recent development within the Faculty is described to indicate the influence these events have had upon the training and examination of candidates for the Fellowship, and statistical data is provided to illustrate the effectiveness of the examination process. Recommendations include possible directions that could be taken to enhance both the training and examination of candidates for the Fellowship examination in the future.
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Anaesth Intensive Care · Aug 1988
Comparative Study Clinical Trial Controlled Clinical TrialCardiovascular effects of sedative infusions of propofol and midazolam after spinal anaesthesia.
The cardiovascular effects of intravenous sedation were studied in fifty patients after spinal anaesthesia for lower limb or pelvic surgery. Twenty patients received propofol (mean dosage 74 (SD 4) micrograms/kg/min for 0-20 minutes and 51 (SD 7) micrograms/kg/min for 20-40 minutes), twenty received midazolam (35 micrograms/kg + 2.54 (SD 0.2) micrograms/kg/min for 0-20 minutes and 1.35 (SD 0.2) micrograms/kg/min for 20-40 minutes) and ten patients received saline infusion only. The forearm vasoconstriction in response to the spinal anaesthesia was measured by strain gauge plethysmography. ⋯ In the control group, however, forearm vasoconstriction increased during 40 minutes in theatre (P less than 0.05). Recovery from propofol was far more rapid than after midazolam and was virtually complete in ten minutes. This was reflected by an increase in blood pressure and in forearm vasoconstriction in the recovery period.
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Anaesth Intensive Care · Aug 1988
Anaesthesia for extracorporeal shockwave lithotripsy at the Victorian Lithotripsy Service--the first 300 patients.
A prospective survey was undertaken of the anaesthesia for the first 300 patients at the Victorian Lithotripsy Service. The majority (71.7%) were not hospitalised on site, including four quadriplegics and two ASA grade IV patients. Two hundred and eighty-three (94.3%) patients received continuous lumbar epidural anaesthesia, sixteen (5.3%) received general anaesthesia and one received a spinal anaesthetic. ⋯ There was a 90% patient follow-up rate and the most common postoperative complication was backache (101 patients, 37.4%). The problems of anaesthesia for extracorporeal shockwave lithotripsy are discussed. Epidural anaesthesia offers a number of advantages for this procedure and proved very suitable for the majority of patients.
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Anaesth Intensive Care · Aug 1988
Epidermolysis bullosa--a review of 15 years' experience, including experience with combined general and regional anaesthetic techniques.
Eight patients with epidermolysis bullosa received a total of 60 anaesthetics for 67 procedures over the fifteen-year period 1972 to 1986. On twenty-three occasions patients were intubated. On thirteen occasions general anaesthesia was supplemented by regional blockade, involving a total of thirty-four local anaesthetic blocks. Complications from intubation were minimal and none were seen related to regional blockade.