British journal of anaesthesia
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Case Reports
Airway management in a case of neck impalement: use of the oesophageal tracheal combitube airway.
A patient presented with neck impalement after a traffic accident. Respiratory arrest demanded immediate tracheal intubation, which was impossible as a wooden splinter had partially obstructed the pharynx and prevented laryngoscopy. An oesophageal tracheal Combitube airway was inserted successfully and the patient's lungs were ventilated adequately until tracheotomy was performed.
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Comparative Study
Voltage fields surrounding needles used in regional anaesthesia.
Using a bench model, we have studied the voltage fields surrounding both insulated and uninsulated needles used in regional anaesthesia. The findings were compared with earlier computer predictions which suggested that the fields would be markedly different for the two types of needle. The results confirm that the fields differ markedly and suggest that the use of insulated needles may not necessarily improve the accuracy of nerve location and that uninsulated needles may be more appropriate.
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We have investigated the pharmacological basis of CNS excitation that occurs in association with general anaesthesia in mice. Propofol produced sustained clonic movements during anaesthesia. Methohexitone produced intermittent non-rhythmic jerking during anaesthesia. ⋯ Bicuculline did not affect either behaviour or EEG with any of the anaesthetic drugs. Our data show that methohexitone and propofol produced CNS excitation, while pentobarbitone and ethanol did not. We propose that the pharmacological basis of this excitation may be glycine antagonism occurring in subcortical structures.