British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Tracheal intubation after induction of anaesthesia with propofol, alfentanil and i.v. lignocaine.
We have assessed tracheal intubating conditions in 60 ASA I or II patients after induction of anaesthesia with propofol 2.5 mg kg-1 and alfentanil 10 or 20 micrograms kg-1 with or without i.v. lignocaine 1 mg kg-1. No neuromuscular blocking agents were administered. ⋯ Intubating conditions were acceptable in 20%, 73%, 73% and 93% of patients in groups 1-4, respectively. Intubating conditions were better and there was less coughing in the lignocaine group.
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We have studied the efficiency of an oesophageal warming device in the prevention of perioperative hypothermia in 22 patients undergoing total hip replacement. Aural canal and skin temperatures (15 sites) were measured before induction of anaesthesia, at the end of surgery and 1 h after recovery and mean body heat was calculated to quantify heat distribution. ⋯ Both groups of patients lost body heat to the same extent (P = 0.34). Thus the oesophageal heat exchanger was ineffective in preventing perioperative hypothermia in a group of patients undergoing total hip replacement.
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Biography Historical Article
John Henry Hill Lewellin: the first etherist in Glasgow.
John Henry Hill Lewellin, a surgeon-dentist, was the first to administer ether in Glasgow, on January 4, 1847. He was born in Calcutta, trained at St Bartholomew's Hospital, qualified M. R. ⋯ He remained there for about 18 months, advertising his dental practice in a high profile manner and, when the time came, he publicized his experience with ether in the local press in an exemplary way. He disappeared from Glasgow in June 1847, and reappeared in Australia 5 years later, practising as a dentist initially, and later as a general medical practitioner in Melbourne until his retirement in 1883. He died in 1886.
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Plasma concentrations of bupivacaine have been measured in 12 patients given bupivacaine through a paravertebral catheter placed under direct vision at thoracotomy. After an initial bolus of 0.5% bupivacaine 20 ml, mean (SEM) Cpmax was 1.45 (0.32) micrograms ml-1 and median (range) tCpmax was 25 (10-60) min. ⋯ No symptoms or signs of toxicity occurred. Separate measurement of R- and S-bupivacaine concentrations demonstrated significantly different concentration-time profiles.
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Randomized Controlled Trial Comparative Study Clinical Trial
Neostigmine and edrophonium antagonism of moderate neuromuscular block induced by pancuronium or tubocurarine.
Edrophonium and neostigmine are anticholinesterase drugs used commonly to antagonize competitive neuromuscular block. Although it has a faster onset of action than neostigmine, edrophonium is unreliable when used to antagonize deep neuromuscular block. We have compared the antagonist characteristics of these two drugs when used to antagonize a moderate degree of pancuronium- or tubocurarine-induced neuromuscular block. ⋯ Adequate recovery was defined as the achievement of a TOF ratio of 0.70 or greater. Only seven of 20 patients who received edrophonium demonstrated adequate recovery 30 min after antagonism. Under the conditions described in this study, edrophonium 0.5 mg kg-1 was less effective as an antagonist than neostigmine 0.05 mg kg-1.