Anaesthesia
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The utilisation of the pre-operative ECG in patients undergoing routine surgery was investigated in 354 adult patients over a 2-week period. Sixty-four percent of patients had an ECG pre-operatively. An ECG was not performed in 17% of patients who, current hospital policy suggests, should have had one. ⋯ In 62% of patients with known cardiac disease, and 44% of patients with strong risk factors for ischaemic heart disease (in the absence of known disease) the ECG was abnormal. This compares with only 7% of patients aged over 50 with no risk factors in whom the ECG was abnormal. These findings suggest that there is room for improvement in the utilisation of the pre-operative ECG, which may have cost implications.
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Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of direct blood pressure measurement at the radial and dorsalis pedis arteries during surgery in the horizontal and reverse Trendelenburg positions.
The differences in simultaneous arterial pressure measurements from the radial and dorsalis pedis arteries were studied in anaesthetised adult patients in either the horizontal or reverse Trendelenburg position. Significantly higher pressures were measured from the dorsalis pedis artery than from the radial artery in both positions, even allowing for the hydrostatic effect on the dorsalis pedis arterial pressure in the non-horizontal group. If the dorsalis pedis artery is to be used to measure direct arterial blood pressure, we recommend that readings be compared with an arm sphygmomanometer to avoid potentially dangerous hypotension being missed.