Anaesthesia
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Comparative Study
A comparison of three methods of axillary brachial plexus anaesthesia.
One hundred patients scheduled for elective outpatient hand surgery had blockade of the axillary brachial plexus by one of three techniques; insertion of a catheter into the brachial plexus sheath (n = 25), use of paraesthesia (n = 50) or use of the nerve stimulator (n = 25) to localise the plexus. Only two patients required general anaesthesia for the planned surgery. ⋯ The more nerves detected in the paraesthesia and the nerve stimulator groups before injection of local anaesthetic the higher the success rate of the block. We advocate use of the nerve stimulator technique in view of the possible risk of neurological damage associated with paraesthesia and the technical difficulties with the catheter technique, for routine brachial plexus blockade.
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A case of meningitis after obstetric spinal anaesthesia is reported. The possible aetiological causes of postspinal meningitis are discussed and the difficulty in differentiation between aseptic and bacterial meningitis noted. Ways to reduce the risk of bacterial contamination of cerebrospinal fluid are mentioned. The patient in this case made a full recovery, but the use of spinal anaesthesia in these patients is open to question.
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There is no standard colour code for intravenous cannulae in the United Kingdom. A questionnaire was sent to the manufacturers to compile a table of available cannulae, and to assess their views and plans with regard to colour coding. Present moves to establish an international standard are outlined. A simple colour coding standard is proposed.
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Comment Letter Comparative Study
Epidural or general anaesthesia for caesarean section?