Anaesthesia
-
Biography Historical Article
The Macintosh laryngoscope. A historical note on its clinical and commercial development.
It is 40 years since Sir Robert Macintosh discovered the principle of indirect elevation of the epiglottis and developed the laryngoscope which bears his name. The author celebrates the anniversary of this revolution in intubation with some notes on the early commercial history of the instrument and a description of a Longworth version made about 1945.
-
A jet injector was used to perform intercostal nerve block as a method of intra-operative and postoperative pain relief at cholecystectomy, using a concentrated solution of local analgesic. This method was shown to be as successful as the conventional needle technique. The risk of pneumothorax, and the problems of the local analgesic solution used are discussed.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Non-parenteral postoperative analgesia. A comparison of sublingual buprenorphine and morphine sulphate (slow release) tablets.
Sixty-nine patients undergoing upper and lower abdominal surgery were studied after operation to compare the analgesic effects of sublingual buprenorphine (0.4 mg) and slow release morphine sulphate tablets (MST, 20 mg) given 6 hourly in a double-blind, double-dummy trial. Both MST and buprenorphine produced satisfactory postoperative analgesia but the linear analogue pain scores were significantly lower on the second post operative day with MST.
-
A case of respiratory failure following postoperative intercostal nerve blockade is described. A possible mechanism is postulated and the evidence in favour of intercostal blockade in patients with chronic airways disease is questioned. The need for caution when managing such patients with regional blockade is emphasised.
-
Randomized Controlled Trial Clinical Trial
Reduction of gastric acid secretion. The efficacy of pre-anaesthetic oral cimetidine in children.
Cimetidine 10 mg/kg orally was given at varying times from 60 to 240 minutes pre-operatively to 100 healthy children between the ages of 6 months and 14 years. Cimetidine proved to be most effective when given between 120 and 180 minutes before the induction of anaesthesia. ⋯ In these patients the mean (SD) half-life of cimetidine was 138 (18) minutes. The reduction of gastric juice volume and acidity produced by 10 mg/kg oral cimetidine given 120-180 minutes prior to induction of anaesthesia has important clinical implications.