Anaesthesia
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During transcervical endometrial resection the uterine cavity is irrigated under pressure with 1.5% glycine solution. This solution may be absorbed, with consequent fluid and electrolyte shifts. ⋯ In five cases this decrease was > 10 mmol.l-1. Hyponatraemia is a potential risk with this procedure.
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Randomized Controlled Trial Clinical Trial
The effects of 2% lignocaine gel on incidence of retching with the use of the laryngeal mask airway.
This randomised, single-blind study investigated the incidence of retching during emergence from general anaesthesia with a laryngeal mask airway in place. Eighty four patients, ASA grade 1 and 2, aged 15 to 60 years, were randomly divided into two groups. Each patient received fentanyl 1 microgram.kg-1 and propofol 2 mg.kg-1 for induction. ⋯ The patients were allowed to wake up at the end of surgery with the laryngeal mask airway in place while a blinded observer observed for retching. The age, sex, weight and duration of surgery were similar in both groups. The test group had a significantly lower incidence of retching on emergence from general anaesthesia with the laryngeal mask airway in place (p < 0.005, Chi-squared test).
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Protein S is a nonenzymatic and vitamin K-dependent cofactor of activated protein C. Without protein S, the anticoagulant function of protein C is almost depleted and thrombotic events occur. We report a parturient with hereditary protein S deficiency in whom the risk of thromboembolism was further complicated by pregnancy and who required emergency Caesarean section for fetal distress.
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Dr Nathan Cooley Keep (1800-1875) was a Boston dentist and doctor who carried our pioneering work in both dentistry and anaesthesia. He worked with William Morton before the first public demonstration of ether anaesthesia, formed the world's first anaesthetic partnership with Morton but parted company with him and later opposed Morton's claim to be the sole inventor of ether anaesthesia.
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The American Society of Anesthesiologists' (ASA) Physical Status Classification was tested for consistency of use by anaesthetists. A postal questionnaire was sent to 113 anaesthetists of varying experience working in the Northern Region of England. They were asked to allot ASA grades to 10 hypothetical patients. ⋯ In no case was there complete agreement on ASA grade, and in only one case were responses restricted to two of the five possible grades. In one case there was a significant difference in answers between anaesthetists with the FRCA (or equivalent) qualification, and those without. So much variation was observed between individual anaesthetist's assessments when describing common clinical problems that the ASA grade alone cannot be considered to satisfactorily describe the physical status of a patient.