Anaesthesia
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Review Case Reports
Pre-eclampsia in a parturient with a history of myocardial infarction. A case report and literature review.
A mother with pre-eclamptic toxaemia and severe coronary artery disease was managed with epidural analgesia accompanied by invasive cardiovascular monitoring. Caesarean section was carried out uneventfully using the epidural. The literature is reviewed.
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This survey reviews the structure and content of all anaesthetic record charts in use in the 40 hospitals of the Yorkshire Regional Health Authority in the light of previous recommendations. Twenty-two different anaesthetic charts were used by 290 anaesthetists in this region. ⋯ Fourteen of the 22 charts omitted important headings concerned with patient identification and eight charts did not provide a record of the whole perioperative period. Some comprehensive forms are in use, chiefly in smaller hospitals, but there have been few changes in design in the last 10 years despite increasing medicolegal awareness.
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A case is described of an extensive block and hypotension which occurred after inadvertent dural puncture and subsequent epidural injection of bupivacaine. The subarachnoid spread of solution from the extradural space was confirmed radiologically.
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A patient is described who has received nine anaesthetics, the last three since he was confirmed as susceptible to malignant hyperthermia. The ninth anaesthetic illustrates the prophylactic therapy and management in detail. Certain aspects of the problem are discussed.
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An experimental study of the Oxford Miniature Vaporizer in combination with a paediatric resuscitation bag has demonstrated efficient halothane vaporization at small tidal volumes. This technique will be appropriate in paediatric anaesthesia with the Triservice apparatus.