Anaesthesia
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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.
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The use of ketamine anaesthesia is described for the transport from home to hospital of patients in severe pain secondary to malignant disease. The technique is simple and highly effective and introduces a new role for anaesthetists and pain relief specialists.
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We asked 20 anaesthetists and seven operating department assistants to check three anaesthetic machines 'doctored' to contain errors of varying seriousness, and recorded their performances. Two weeks later we asked the same group to repeat the test. On the second occasion they followed a visual aid and filled in a questionnaire about the test. ⋯ The visual aid was most useful at increasing the detection rate of machine leaks. Of the participants, 60% considered that the visual aid was helpful and 74% thought that such an aid should be available in our theatre complex. Sixty-six percent of those questioned felt that a formal check list would be of use.