Anaesthesia
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A new method to distinguish oesophageal from tracheal intubation using an end-tidal carbon dioxide detector was evaluated. In a prospective study on 50 healthy adult patients, the end-tidal carbon dioxide detector was reliably used to detect initial oesophageal intubation in 22 cases, and then to confirm tracheal intubation in all 50 patients. We conclude from this study that the end-tidal carbon dioxide detector is a reliable, rapid and easy method for the detection of oesophageal intubation.
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Caesarean section was performed under spinal anaesthesia in 55 women using a 25-gauge diamond-tipped needle and in a further 55 mothers with a 24-gauge Sprotte needle. Eight patients (14.5%) developed a headache in the former group, five of whom required a blood patch. There were no headaches reported in the Sprotte group.
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Case Reports
Intrathecal diamorphine during laparotomy in a patient with advanced multiple sclerosis.
A patient with advanced multiple sclerosis was successfully managed for a sigmoid colectomy using spinal anaesthesia. Effective postoperative analgesia was achieved with intrathecal diamorphine administered through an indwelling intrathecal catheter, and wound infiltration with 0.25% bupivacaine.