Anaesthesia
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We undertook this survey to identify the trend in the published output of original research in anaesthesia emanating from the United Kingdom (UK) in a 10-year period from 1997 to 2006, inclusive. We examined seven major anaesthetic journals for each of the 10 years, and four other specialist journals for the years 1997, 2000, 2003 and 2006. ⋯ We found a highly significant reduction in published research output from the UK in the period under study (% change per year; -5.7 (95% CI -7.4 to -4.0), a trend which was significantly different (p < 0.001) from the trend of changes in research publications worldwide (-1.0% change per year; 95% CI -1.7 to 0.0). We discuss the implications of these findings for UK anaesthesia research strategy.
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Oxygen desaturation during apnoea following anaesthetic induction in obstetrics is hazardous for mother and baby. This study investigated apnoea during pregnancy using computer simulation. The Nottingham Physiology Simulator was configured to replicate normal pregnant physiology. ⋯ We found reduced apnoea tolerance in pregnancy, the median [range] time taken to fall to S(a)O2 < 90% after 99% complete denitrogenation being 4 min 52 s [3:43-6:17] in the pregnant subjects, vs 7 min 25 s [5:49-9:42] in the non-pregnant subjects. The time taken to fall from S(a)O2 90% to 40% was 35 s [32-45] in the pregnant vs 45 s [38-56] in the non-pregnant subjects. Two minutes of pre-oxygenation by tidal breathing provides approximately 3.5-6 min before desaturation to < 90%.
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A new continuous noninvasive blood pressure measurement device, the T-Line Tensymeter TL100 (Tensys Medical Inc., San Diego, CA, USA) which enables avoidance of arterial cannulation has been developed. We compared the values obtained using the T-Line values to simultaneous arterial line measurements in patients undergoing general anaesthesia with induced hypotension. Twenty-five patients, aged 18-70 years, were studied. ⋯ There was virtually no distinguishable error over the course of surgery using the device. In conclusion, the T-Line measurements correlate with arterial measurements during anaesthesia in which there were periods of both normotensive and hypotensive anaesthesia. The T-Line Tensymeter represents a noninvasive alternative to an arterial line in cases when arterial blood sampling is not required.
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The purpose of this bench-top study was to determine the subatmospheric tracheal pressures that could be generated by different sizes of suction catheters when placed into the different sizes of tracheal tubes encountered in adult anaesthetic practice. Five sizes of suction catheter were studied from 8 to 16 Fr and five sizes of tracheal tubes from 5 to 9 mm internal diameter. ⋯ If the size of suction catheter was limited so that the ratio of the outside diameter of the suction catheter to the inside diameter of the tracheal tubes was 0.5 or less, tracheal pressures were not more than 2 mmHg subatmospheric. We were able to recommend sizes of suction catheter to use for each size of tracheal tube.