British journal of anaesthesia
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The time from the end of surgery to the administration of the first post-operative analgesic has been measured in 86 patients following brachial plexus block with bupivacaine, lignocaine, nepivacaine or prilocaine. A signficant increase in time occurred with bupivacaine; the combination of regional and general anesthesia significantly increased the time when compared with general anaesthesia in the same patient. In children, the use of regional anaesthesia almost removed the need for analgesia after surgery.
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Clinical Trial Controlled Clinical Trial
Intra-ocular pressure changes during halothane and enflurance anaesthesia.
We have measured intra-ocular pressure (i.o.p.) in 20 patients anaesthetized with halothane or enflurance (0.6 MAC in oxygen) for repair of trauma to the eye. The changes in i.o.p. with halothane 0.5% were unpredictable, whereas enflurance 1% reduced intra-ocular tension consistently in all the patients studied. Enflurane is recommended as a possible alternative anaesthetic for surgery on the open eye.
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Comparative Study
A comparison of the cardiorespiratory effects of continuous positive airway pressure breathing and continuous positive pressure ventilation in dogs.
Five patterns of ventilation have been compared in dogs: (1) spontaneous ventilation at ambient pressure (SV); (2) intermittent positive pressure ventilation (IPPV); (3) spontaneous ventilation at 0.98 kPa positive airway pressure, delivered from a non-rebreathing circuit incorporating a 5-litre reservoir bag and fresh-gas flow of twice the minute volume (CPAP (bag)); (4) spontaneous ventilation at 0.98 kPa positive airway pressure, with the reservoir bag replaced by a weighted bellows (CPAP (bellows)) and (5) IPPV with 0.98 kPa positive end-expiratory pressure (CPPV). CPAP significantly decreased the rate of respiration compared with SV. ⋯ There were no significant changes in mean systemic arterial pressure, cardiac output, PaO2, PaCO2, CaO2, (CaO2-CVO2), PAO2-PAO2) or pulmonary venous admixture. Under the conditions of this study oxygen transport was not altered by positive airway pressure ventilation.
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Biography Historical Article
Dr Nooth and his apparatus. The role of carbon dioxide in medicine in the late eighteenth century.
The two earliest inhalers devised for the administration of ether anaesthesia in the U. K. (Hooper's and Squire's apparatus) both incorporated the bottom part of a Nooth's apparatus. This, which was once a household object, is now remembered only as a footnote in one or two specialist histories, and Nooth himself, who was a most distinguished and respected medical man in his day, is almost completely forgotten. Yet there are many aspects of Nooth's life that are of great interest, and his apparatus was one of the very first to be designed to produce, for medicinal purposes, what may inclusively be called carbonated waters; and, surprisingly, there are strong links of coincidence between the histories of artificial mineral waters and of anesthesia, and the personalia involved in each.