British journal of anaesthesia
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The molecular basis of i.v. general anaesthetic activity was investigated using comparative molecular field analysis (CoMFA). ⋯ A single activity model can be formulated for i.v. general anaesthetics and preliminary pharmacophoric maps derived, which describe the molecular basis of their in vivo potency.
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It has been suggested that obstetric epidurals lead to chronic adhesive arachnoiditis (CAA). CAA is a nebulous disease entity with much confusion over its symptomatology. ⋯ Using these criteria, there is evidence to show that epidural or subarachnoid placement of some contrast media, preservatives and possibly vasoconstrictors, may lead to CAA. No evidence was found that the preservative-free, low concentration bupivacaine with opioid mixtures or plain bupivacaine currently used in labour lead to CAA.
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Randomized Controlled Trial Clinical Trial
No effect of cardiopulmonary bypass on hypnosis in patients anaesthetized with propofol and alfentanil.
The effect of cardiopulmonary bypass (CPB) on the level of anaesthetic depth has not been studied previously in a randomized way. ⋯ CPB does not affect propofol requirements or immediate postoperative recovery compared with the off-pump technique.
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Clinical Trial Controlled Clinical Trial
Mid-latency auditory evoked response during propofol and alfentanil anaesthesia.
Propofol has been shown to affect the mid-latency auditory evoked response (MLAER) in a dose-dependant manner. Few studies have investigated the addition of alfentanil. Myogenic responses, such as the post-auricular responses (PAR), can confound the MLAER but there has been little investigation as to which electrode site reduces this interference. ⋯ Addition of alfentanil lowers the propofol infusion rate required to produce unconsciousness and the Nb latency that predicts it. The better of the two sites to reduce the incidence of PAR is the vertex-inion electrode site.
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Methicillin resistant Staphylococcus aureus (MRSA) is endemic within many hospitals worldwide. Critically ill patients on intensive care units have increased risk factors making them especially prone to nosocomially acquired infections. This review addresses the current situation regarding the evolution of MRSA and the techniques for identifying and epidemiologically typing it. It discusses specific risk factors, the morbidity and mortality associated with critically ill patients, and possibilities for future antibiotic treatments.