Anaesthesia
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Randomized Controlled Trial Clinical Trial
Etomidate in a new solvent. A clinical evaluation.
The introduction of polyethylene glycol as a solvent for etomidate appears to markedly reduce the incidence of pain on injection while maintaining the previously demonstrated advantageous features of cardiovascular stability and rapid recovery.
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Biography Historical Article
Clover's portable regulating ether inhaler (1877). A notable one hundredth anniversary.
The 100th anniversary of the first description of the 'portable regulating ether-inhaler' by Joseph T. Clover (1825-1882) is recalled. The importance of this piece of apparatus in the development of British anaesthesia is considered and the techniques of its use are outlined. Clover's personal portable inhaler is described and illustrated.
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Biography Historical Article
Frederic Hewitt lecture 1977. Anaesthesia as a career.
The contribution of Frederic Hewitt (1855-1916) to the development of the specialty of anaesthesia is acknowledged and his reasons for becoming an anaesthetist explored. Three hundred and forty-nine replies to a questionnaire on professional philosophy, status and training sent to 676 anaesthetists who joined the Association of Anaesthetists of Great Britain and Ireland during the years 1972-1975 are assessed. The factors which influence a medical practitioner to take up anaesthesia and find satisfaction in its practice are explored in the light of these replies and suggestions are made with regard to the future of the specialty.
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Randomized Controlled Trial Comparative Study Clinical Trial
Etomidate in electroconvulsive therapy. A within-patient comparison with alphaxalone/alphadalone.
In a group of 31 patients undergoing electroconvulsive therapy, there was no significant difference between the times of return of eyelash reflex, swallowing and respiration following a single induction dose of 0.2 mg/kg of etomidate as compared with an induction dose of 0.036 ml/kg of alphaxalone/alphadalone. The incidence of involuntary movements and increased muscle tone was significantly greater after etomidate than following alphaxalone/alphadalone; but the involuntary movements were never marked. The overall incidence of pain on injection was 15% after etomidate. There was a low incidence of venous sequelae following either drug.
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A case is reported of the successful resuscitation of a 6-year-old child after 25 minutes' immersion in water at 4 degrees C. The difficulties of evaluating vital functions at low body temperatures, with the accompanying danger of fatal misjudgment, are pointed out. It is concluded that low body temperatures indicate that a considerably longer resuscitation procedure than normal should be undertaken, particularly in children, and that if the body temperature is above 30 degrees C rewarming ought not to take place before satisfactory oxygenation and an efficient circulation have been established.