Anaesthesia
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Randomized Controlled Trial Clinical Trial Controlled Clinical Trial
The delivery of oxygen by a venturi T piece.
We have evaluated the performance of the Intersurgical 40% Oxygen Recovery T-Kit in ten healthy volunteers. Inspired oxygen and end-tidal carbon dioxide concentrations were measured during normal respiration and with variations in respiratory rate and depth. ⋯ All three modifications increased the inspired oxygen concentration, the longer expiratory limb to 34.6% (p < 0.01) and the altered T piece arrangement to 37.3% (p < 0.01). The highest inspired oxygen concentration of 40.3% (p < 0.01) was obtained by increasing the length of the inspiratory limb.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the recovery characteristics of sevoflurane and halothane in children.
The recovery characteristics of sevoflurane and halothane anaesthesia were compared in 40 children aged 6 months to 6 years undergoing day case surgery. The mean time taken to open eyes after surgery had ended was appreciably and significantly shorter after sevoflurane than after halothane (sevoflurane, mean time (SD) 7 min 52 s (5 min 46 s), halothane, mean time (SD) 15 min 50 s (9 min 2 s), t = 3.32, p = 0.002). ⋯ However, more children were in pain and given analgesia after sevoflurane (p < 0.01) and the mean time to reach the criteria for discharge home was similar in both groups (sevoflurane, mean time (SD) 2 h 9 min (17 min), halothane, mean time (SD) 2 h 4 min (8 min)). There were no major complications in either group.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the induction characteristics of sevoflurane and halothane in children.
The induction characteristics of sevoflurane and halothane were compared in 81 children aged 6 months to 6 years. The mean time taken to achieve loss of eyelash reflex was significantly shorter with sevoflurane than with halothane (sevoflurane, mean time (SD) 1 min 41 s (35 s), halothane, mean time (SD) 2 min 17 s (43 s), t = 4.11, p = < 0.01). ⋯ Effects on heart rate, blood pressure and oxygen saturation during induction were similar for both agents. There were no major complications during induction with either halothane or sevoflurane.
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Surveys conducted in the United Kingdom over the last few years have revealed decreased job satisfaction and increased anxiety and depression in both hospital specialists and general practitioners. Anaesthesia is perceived to be a stressful specialty and there is evidence, albeit patchy, that certain stress-associated conditions are more common in anaesthetists. The 'middle years' seem to be a danger period. ⋯ While outcome studies are numerous much less attention has been paid to the structure and process of anaesthetic practice. Models for studying these aspects have been developed for investigating stress in general practitioners and doctors in training. Even minor degrees of professional impairment may place patients at risk and an investigation into the effects of the specialty on those who practise it is justified.
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A new, rigid intubating fibrescope, the Upsherscope, was evaluated in clinical practice. Intubation was attempted in 200 adult patients and was successful in 191, with a median intubation time of 38 s, range 14-154 s. ⋯ Difficulties were encountered in picking up the epiglottis, in passing the tracheal tube between the vocal cords and with secretions interfering with the view. In two patients known to be difficult to intubate, the Upsherscope was successful in one patient using an awake technique and failed in the other.