Anaesthesia
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Case Reports
Post-partum intracranial subdural haematoma. A possible complication of epidural analgesia.
A case is reported of bilateral chronic subdural haematomas in a 29-year-old woman 1 month after childbirth under attempted epidural analgesia. The possible link between leakage of cerebrospinal fluid through a hole in the lumbar theca and the later development of an intracranial chronic subdural haematoma is discussed, with a review of eleven previous reported cases.
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A case of hearing deficit following nitrous oxide anaesthesia is reported. The mechanism and time course of nitrous oxide-induced intratympanic pressure changes are described and contrasted with the effects of non-nitrous oxide anaesthesia. The rate of increase is about 10 mm H20/min. The possibility that nitrous oxide may cause displacement of tympanic membrane grafts both outwards and inwards, or disrupt the reconstructed middle ear conducting mechanism, is raised again.
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Biography Historical Article
From Clover to computer. Towards programmed anaesthesia?
The control of depth of anaesthesia has been viewed as a control-system problem the solution of which can involve both feedback and feedforward techniques. The nature of the problem in Clover's day and the solutions he found have been examined. A similar analysis has been made in respect of the modern anaesthetist. Finally, the way in which computers may aid the anaesthetist in his task has been illustrated by reference to various attempts reported from around the world and, in particular, by describing the development in Cardiff of a system which should produce, in the brain of the patient, any tension of an inhaled anaesthetic which the anaesthetist chooses to specify.
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Cardiac arrest due to electrocution occurred in a young obstetric patient undergoing laparotomy. The patient subsequently died despite initial resuscitation. The cause was traced to an inappropriate and faulty switch in the base of the operating table; the circuit was completed by the ECG monitor which was of the direct earth type.