Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the reinforced laryngeal mask airway and tracheal intubation for nasal surgery.
Airway maintenance and protection during anaesthesia and recovery provided by the reinforced laryngeal mask airway was compared with the sequential use of a tracheal tube followed by the Guedel airway in 66 patients having anaesthesia for nasal surgery. One patient was withdrawn from the laryngeal mask group because the airway was difficult to position. All patients had an oropharyngeal pack inserted and Moffett's solution instilled into the nasal cavities. ⋯ Contamination of the lower airway occurred in only five patients. During recovery from anaesthesia the laryngeal mask and Guedel airway were well tolerated by most patients, but only the mask laryngeal provided an unobstructed airway in all patients. The laryngeal mask protects the larynx from contamination during and after operation until the return of the patient's own protective reflexes.
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The purpose of this study was to determine current UK anaesthetic practice regarding the use of regional anaesthesia in the management of patients with placenta praevia presenting for Caesarean section. We asked the members of the Obstetric Anaesthetists Association to complete a postal questionnaire in which a range of clinical situations involving varying degrees of placenta praevia were presented. ⋯ A wide variety of clinical practice was demonstrated. Anaesthetists with two or more obstetric sessions were more willing to use regional anaesthesia for Caesarean section in the presence of placenta praevia in both elective and emergency situations associated with haemorrhage.
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Open-chest cardiac massage in humans to treat chloroform syncope was first performed by Niehans in Berne and Langenbuch in Berlin in the late 1880s. Closed-chest cardiac massage in humans was advocated by Koenig and Maass in Göttingen in the last two decades of the 19th century. The closed technique was used in Central Europe for several decades to treat chloroform syncope.
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Randomized Controlled Trial Clinical Trial Retracted Publication
The effect of the anticoagulation regimen on endothelial-related coagulation in cardiac surgery patients.
Heparin is still the most commonly used anticoagulant in cardiac surgery necessitating cardiopulmonary bypass. In recent years, endothelial-related coagulation (e.g. thrombomodulin/protein C-system) has enlarged our knowledge of the regulation of haemostasis. In a controlled randomised study, the influence of different regimens of anticoagulation on the thrombomodulin/protein C-system was studied. ⋯ Thrombin/antithrombin III plasma concentrations increased most in groups 1 (to 69 (14) micrograms.l-1 after bypass) and 2 (to 48 (7) micrograms.l-1 after bypass), whereas they remained significantly lower in groups 3 and 4. The thrombomodulin/protein C-system was not significantly influenced by the regimen of anticoagulation. Administration of 'high-dose' heparin was associated with the highest blood loss, which could not be related to endothelial-associated coagulation.