Anaesthesia
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Patients were questioned pre-operatively to assess the level of their knowledge with regard to anaesthetic qualifications, anaesthesia and the role of anaesthetists. Thirty-five percent did not realise that anaesthetists were qualified doctors and only 25% could mention any duties that anaesthetists might have outside the operating theatre. However, those questioned were better informed about the anaesthetist's role in monitoring the patient during surgery and recovery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intra-ocular pressure changes in patients with glaucoma. Comparison between the laryngeal mask airway and tracheal tube.
We performed a randomised prospective study in 20 patients with glaucoma to examine the effects of tracheal intubation and laryngeal mask insertion on intra-ocular pressure, mean arterial blood pressure and heart rate. After induction of anaesthesia with propofol, intra-ocular pressure decreased significantly below baseline values in both the laryngeal mask and tracheal tube groups. ⋯ In contrast, tracheal intubation was associated with a significant increase in intra-ocular pressure to above baseline values in three out of eight patients. Insertion of the laryngeal mask had minimal effects on mean arterial blood pressure and heart rate, whereas tracheal intubation significantly increased both factors relative to pre-intubation values.
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Randomized Controlled Trial Comparative Study Clinical Trial
Routine pre-oxygenation using a Hudson mask. A comparison with a conventional pre-oxygenation technique.
Two techniques of pre-oxygenation were studied by continuous analysis of respired gases using a mass spectrometer in 10 healthy volunteers. The first was a conventional technique as commonly used in anaesthesia with a Bain system and tightly-fitting anaesthetic face-mask and an oxygen flow of 8 l.min-1. ⋯ This represents a considerable increase in pulmonary oxygen reserve for both techniques. The second technique is not an alternative to conventional pre-oxygenation for emergency anaesthesia, but is a useful and simple method that is acceptable to both patient and anaesthetist in routine cases.
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Comparative Study
Excursions of the cervical spine during tracheal intubation: blind oral intubation compared with direct laryngoscopy.
The most appropriate technique for performing tracheal intubation in patients with cervical spine injury is debatable. Recently, a new device enabling blind oral intubation (Augustine Guide) with the patient's head and neck in the neutral position has been introduced. The aim of this study was to compare the extent of upper cervical spine movement during intubation with this device compared to direct laryngoscopy. ⋯ By evaluating the joints occiput-C3 together as a functional unit, blind oral intubation caused 17 degrees (median) less extension compared to direct laryngoscopy (p < 0.01). The median differences observed for the individual joints were: 7 degrees in occiput-C1 (p < 0.05), 5 degrees in C1-2 (p < 0.01) and 6 degrees in C2-3 (p < 0.01) respectively. Since we assume that intubation-induced excursions of the injured spine are even higher, blind oral intubation might be a safe alternative for airway management in this special group of trauma victims.