British journal of anaesthesia
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We studied 60 children undergoing neurosurgical procedures in the sitting position. Routine monitoring included ECG, pulse oximetry, invasive arterial pressure, in particular mean arterial pressure (MAP), and right atrial pressure (RAP). Children were allocated to two groups. ⋯ Inflation of the MAST suit induced a dramatic increase in RAP and JBVP, reinforced by addition of PEEP. There was a strong positive relationship between RAP and JBVP. There were no deleterious side effects or differences between the two groups in peroperative blood product requirements or surgical general conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
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We have studied in 12 healthy male volunteers the effects of three different body positions (10 degrees head-down tilt, horizontal supine and supine with 50-cm leg elevation from the hip) on the spectral components of heart rate and finger plethysmographic amplitude variability. We have demonstrated the absence of any statistically significant difference in any measure of variability in the time of frequency domain for both of these measures between the three positions. We conclude that neither leg elevation nor 10 degrees head-down tilt is associated with any significant alteration in the dominant parasympathetic cardiac control in comparison with the resting supine position.
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Historical Article
A brief historical review of non-anaesthetic causes of fires and explosions in the operating room.
Fires and explosions have occurred in the operating theatre for many years. Flammable inhalation anaesthetic agents were responsible for many incidents in the past, but these are no longer available in many countries. Other causes of fires and explosions still exist in the operating theatre and, from time to time, result in serious and occasionally fatal injury. ⋯ Adhesive skin drapes have resulted recently in two tragic deaths. The increasing use of laser therapy, particularly in ear, nose and throat surgery, and in oral surgery, has brought about a renewed awareness of the risk of fire. The relevant factors which should be borne in mind and the precautions which should be adopted when laser therapy is to be used in the airway are discussed.
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We describe a miniature electrochemically driven, wrist-worn infusion pump. Generation of gas by an electrolytic reaction compresses a reservoir containing medication and provides a predictable and controllable infusion rate. ⋯ This portable system, using a novel motive force, has advantages of convenience over larger systems and has sophisticated features not present in existing small systems. It has potential as a routine PCA device and it may have uses in other situations requiring convenient infusion or intermittent injection in an ambulatory setting.