Canadian journal of anaesthesia = Journal canadien d'anesthésie
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A formal on-site survey of all anaesthetizing locations in the Province of Manitoba was initiated in the Spring of 1988. Serious deficiencies of anaesthetic equipment previously noted on random survey were confirmed. Recognizing a need for improved standards for delivery of anaesthetic services through safe, functional anaesthetic equipment, the province undertook to fund the upgrading of all anaesthetic gas delivery systems under its jurisdiction. ⋯ After careful assessment 92 machines were replaced, 66 machines were upgraded and 45 machines were deleted from further service. Although the maintenance and upgrading of medical equipment is the individual health care facility's responsibility, substantial benefit was recognized by a provincial approach. The authors recommend a similar approach for other Canadian provinces.
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This is a report of our experience with a portable anaesthesia system that was developed for use under field conditions, when compressed gas supplies are limited. We first assembled and bench-tested a low-pressure plenum system, based upon the Farman entrainer. The entrainer required a low flow of compressed gas, O2 at 1-2 L.min-1, and generated a low-pressure mixture of O2 and air which was directed through an Oxford miniature vaporizer, a non-return valve, and a widebore T-piece circuit. ⋯ The system was very economical, using 1-2 L.min-1 O2 and 20-25 ml.hr-1 liquid halothane to produce a FGF of 6-10 L.min-1, an FIO2 of 0.33, and FIhal of 1-1.5 per cent. We have demonstrated that this is a versatile, safe, and economical system, compatible with the practice of modern inhalational anaesthesia under field conditions. It can be readily assembled from commercially available components.
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The aim of this project was to develop a portable anaesthesia system that was compatible with modern anaesthesia practice under field conditions, when compressed gas supplies are limited. We assembled and evaluated a low-pressure plenum system, based upon the Farman entrainer, which was adaptable to spontaneous, assisted or intermittent positive pressure ventilation (IPPV). The entrainer was tested using a low flow of compressed gas, O2 at 1-3 L.min-1. ⋯ With a wide bore T-piece the air/O2 entrainment ratio was 6:1, and the F1O2 was 0.3. When circuit resistance was higher, e.g., with the Bain circuit, air entrainment and FGF were reduced, but F1O2 was higher. Because it offered the lowest resistance, the T-piece circuit was selected for a clinical trial.
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The purpose of this study was to determine the pharmacokinetic properties of the local anaesthetic ropivacaine used with or without epinephrine for brachial plexus block. Seventeen ASA physical status I or II adult patients undergoing elective orthopaedic surgery received a single injection of 33 ml ropivacaine for subclavian perivascular block and 5 ml to block the intercostobrachial nerve in the axilla. One group (n = 8) received 0.5 per cent ropivacaine without epinephrine (190 mg) and the other (n = 9) received 0.5 per cent ropivacaine with epinephrine 1:200,000 (190 mg). ⋯ The terminal phase of the individual plasma concentration-time curves showed a varying and sometimes slow decline possibly indicating a sustained systemic uptake of ropivacaine from the brachial plexus. No central nervous system or cardiovascular symptoms attributed to systemic plasma concentrations of the drug were observed, with the dose (1.90-3.28 mg.kg-1) of ropivacaine used. It is concluded that the addition of epinephrine does not alter the pharmacokinetic properties of ropivacaine when used for subclavian perivascular brachial plexus block.