British journal of anaesthesia
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Comparative Study
Effectiveness of preoxygenation in morbidly obese patients.
The time taken for the oxygen saturation (SpO2) to decrease to 90% after preoxygenation was studied in six morbidly obese patients and six matched controls of normal weight. During apnoea the obese patients maintained Spo2 greater than 90% for 196 (SD 80) s (range 55-208 s), compared with 595 (SD 142) s (range 430-825 s) in the control group (P less than 0.001). One patient in the obese group had desaturation before the onset of complete relaxation and tracheal intubation, without complications. Bedside lung function tests were not significantly different between groups and cannot be used as a predictor of the effectiveness of preoxygenation.
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Case Reports
Repair of traumatic transection of the thoracic aorta: esmolol for intraoperative control of arterial pressure.
We report the intraoperative use of esmolol for control of arterial pressure during repair of a traumatic transection of the descending thoracic aorta. A mean infusion rate of esmolol 50.5 micrograms kg-1 min-1 resulted in a decrease in mean arterial pressure to 63 mm Hg and heart rate to 99 beat min-1 and was associated with excellent surgical conditions. The infusion rate of esmolol was titrated easily against mean arterial pressure, which increased rapidly on discontinuing its infusion. Control of arterial pressure with esmolol was comparable to that achieved with sodium nitroprusside, but without the reflex tachycardia or decrease in Pao2 associated with the latter agent.
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We describe the performance of the pneuPAC hyperbaric variant HB, a ventilator designed for use in a one-man hyperbaric chamber. The ventilator delivered minute volumes of 11-23 litre at 1 atm abs to 7.6-16 litre at 2.5 atm abs. The delivered minute volume may be controlled easily from outside the chamber by manipulation of the ventilator rate, 11.5-31 b.p.m.
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Randomized Controlled Trial Comparative Study Clinical Trial
Gastric emptying and small bowel transit in male volunteers after i.m. ketorolac and morphine.
Ten male volunteers were studied in a randomized, double-blind crossover trial. Each received ketorolac tromethamine 30 mg and morphine sulphate 10 mg i.m. at an interval of 2 weeks. After a standard radiolabelled meal, gastric emptying half-time (GE) and small intestinal transit time (SIT) were measured using a gamma camera. ⋯ Mean GE, SIT and TFF were significantly prolonged by morphine compared with ketorolac (P less than 0.03); ETH was prolonged also, but the difference was not significant. There were no significant correlations between SIT, ETH and TFF. Most subjects reported adverse effects after morphine, but only one after ketorolac.