Anaesthesia
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Clinical Trial Controlled Clinical Trial
Gastric regurgitation during general anaesthesia in different positions with the laryngeal mask airway.
Ninety patients, divided into three groups of 30, were investigated to determine the incidence of gastric regurgitation during general anaesthesia administered via the laryngeal mask airway in the supine, Trendelenburg and lithotomy positions. Fifteen minutes before induction of anaesthesia each patient swallowed a 75 mg methylene blue capsule. At the end of surgery, the LMA and the oropharynx were inspected for bluish discoloration which was considered to be a sign of gastric regurgitation. No blue dye was detected in the supine group but it was observed in one patient in each of the other two groups.
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One hundred and eighty patients had serum thyrotropin, total triiodothyronine and free thyroxine concentrations measured within 3 h of admission to the Intensive Therapy Unit to assess whether thyroid function tests could predict outcome in critical illness. Overall mortality was 30.6%. Nonsurvivors were older (p = 0.001), and had higher APACHE II scores (p < 0.001) and predicted mortalities (p < 0.001). ⋯ No variable independently predicted death. Total triiodothyronine concentrations were lower in patients who received dopamine before admission to the intensive therapy unit than those who did not (p = 0.008); thyrotropin and free thyroxine concentrations were not influenced by dopamine administration. Serum concentrations of thyrotropin, total triiodothyronine and free thyroxine measured within 3 h of admission to the intensive therapy unit are not predictive of outcome.
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Most paediatric tracheal tubes are marked in centimetres from the tip. In 105 children, nasotracheal tube length was set at the level of the vocal cords such that all 3.0 and 3.5 mm internal diameter tubes were placed with the 3 cm mark at the cords, all 4.0 and 4.5 tubes were set at 4 cm at the cords and all 5.0 and 5.5 tubes were set at 5 cm at the cords. ⋯ Neither bronchial intubation nor accidental extubation occurred in any subject. This is an effective method to determine tracheal tube length which may be used for both oral and nasal intubation.
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We reviewed all the references quoted in Volume 45 (1990) (n = 3967) and half the references quoted in Volume 49 (1994) (n = 2183) of Anaesthesia. The references were numbered sequentially and 100 references from each year were randomly selected. Citations of non-journal articles were omitted leaving 197 citations for careful scrutiny. ⋯ The elements most likely to be inaccurate were, in descending order of frequency, article title, author, and page number. There was no significant difference in the error rate between the 2 years. It is the responsibility of contributors to ensure that all references are carefully checked.
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Based on a new preliminary standard of the 'Comité Européen de Normalisation', the following unidirectional valves were tested with regard to resistance, opening pressure, reverse flow and dislocation: the Dräger inspiratory and expiratory valves, the Engström inspiratory valve, the Ohmeda valve, the Siemens Ventilator 710 inspiratory and expiratory valves, the Siemens Ventilator 900C unidirectional valve of the absorber and the Megamed 700 inspiratory and expiratory valves of the circle system 219 (Megamed 700 CS 219). The following valves fulfilled all Comité Européen de Normalisation requirements: Dräger inspiratory and expiratory valves, Siemens 900 absorber valve and Megamed 700 CS 219 inspiratory valve. The Siemens 710 valve and the Megamed 700 CS 219 expiratory valve did not meet the requirements for flow resistance. ⋯ The requirements for the opening pressure were met by all the valves tested. Valves with the disc in a horizontal position achieved better results than those with the disc in a vertical position. These measurements, showing the differences in the performance of various types of valves confirm the feasibility of the standards proposal.