British journal of anaesthesia
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We studied the size 4 laryngeal mask airway (LMA) to test the hypothesis that oropharyngeal leak pressure and fibreoptic position improves with increasing cuff volume. After LMA insertion, 50 anaesthetized adult patients had the cuff inflated in 5-ml increments to 40 ml. ⋯ Gastric insufflation was detected more frequently when the cuff volume exceeded 20 ml. We conclude that inflation of the size 4 LMA to the maximum recommended volume provides suboptimal conditions and that this value should be reduced from 30 to 20 ml.
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The influence of aging on the pharmacodynamics of anaesthetic agents in the central nervous system remains poorly understood. As alpha-aminobutyric acid (GABA)-mediated neurotransmission appears to be an important target for anaesthetics in the brain, we hypothesized that aging could alter the sensitivity of the GABA carrier to anaesthetics. We have examined the effects of etomidate and propofol on the uptake of [3H]-GABA (5 min, 37 degrees C) into striatal synaptosomes of rats aged 2, 18 and 24 months. ⋯ Aging increased IC50 values for these anaesthetics. Nipecotic acid was unaffected. These data suggest that aging selectively alters the action of etomidate and propofol in the mammalian CNS.
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One hundred and six former or current flexible trainees in anaesthesia responded to a questionnaire evaluating their part-time training (a response rate of 71%). They were compared with a group of 32 flexible trainees in obstetrics and gynaecology. ⋯ Nearly all those who had finished their training were working as consultants (54% of the whole group); 4% had either retired, become a clinical assistant or a locum consultant. The remainder (42%) were senior registrars.