Anaesthesia
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Randomized Controlled Trial Clinical Trial
Posture and epidural catheter insertion. The relationship between skill, experience and maternal posture on the outcome of epidural catheter insertion.
This study was undertaken to investigate the outcome of epidural catheter insertion in the sitting or lateral position in mothers during labour. An initial prospective randomised study period (144 patients) suggested that the sitting position offered some superiority over the lateral in terms of technical ease of insertion. It was concluded, by minimising the subjective aspects in a follow-up, prospective nonrandomised study period (152 patients), that the determining factor lies in the skill and experience of the anaesthetist. There was no significant difference in complication rates or maternal discomfort between the two positions in either study period.
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The Level 1 blood warmer series comprises three infusion sets and two blood warmers of different power outputs. All systems were found to be extremely efficient, with the larger 500 series capable of warming the equivalent of 80 units of blood an hour almost to body temperature.
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We investigated the occurrence of gas embolism during Caesarean section using a Doppler ultrasound probe and found that it occurs between uterine incision and delivery. Embolism is less common during general anaesthesia than has been reported during regional anaesthesia. Both ruptured membranes and a protracted uterine incision to delivery interval predispose to embolism.
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As anaesthetists have become more aware of malignant hyperthermia the mortality rate has fallen, but concommitantly the number of dubious and aborted cases has increased. All probands who developed a suspected malignant hyperthermia reaction during anaesthesia and subsequently underwent muscle biopsy were classified according to the clinical presentation. ⋯ Certain clinical features were found to be of more value as predictors than others; these included a high creative kinase and myoglobinuria. The accuracy of prediction depends on a clear contemporaneous description of the clinical events.