Anaesthesia
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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.
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Comparative Study
Continuous monitoring of blood PO2 in extracorporeal systems. An in vitro evaluation of a re-usable oxygen electrode.
The technique of intermittent sampling of blood during extracorporeal circulation and in vitro analysis to establish that the blood-gas status of the patient is within acceptable limits has drawbacks which may be overcome by continuous monitoring. An evaluation of an oxygen monitoring system and a comparison with a blood gas analyser have been performed. ⋯ There was no significant difference between the calculated value and the monitor readings but the blood gas analyser results were significantly lower (p less than 0.01) than the calculated values of the tonometered blood. The reasons for this difference and the potential clinical advantages of continuous monitoring are discussed.
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Case Reports
Extensive spread of local anaesthetic solution following subdural insertion of an epidural catheter during labour.
A case is described where a small dose of bupivacaine was accidentally injected into the subdural, extra-arachnoid space resulting in extensive unilateral block and hypotension. The spread of solution was confirmed radiologically.
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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.
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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.