British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Pattern of change of bronchomotor tone following reversal of neuromuscular blockade. Comparison between atropine and glycopyrrolate.
Specific airways conductance (s. Gaw) was measured using the forced airflow oscillation method, to study the effect of two regimens, commonly used for the reversal of neuromuscular blockade, on bronchomotor tone. Patients who had received neuromuscular blockers and had undergone elective surgery were randomly allocated to receive neostigmine 50 microgram kg-1 given concurrently with either atropine 20 microgram kg-1 (10 patients) or glycopyrrolate 10 microgram kg-1 (10 patients). ⋯ Gaw between the two groups, higher values being found in the atropine group. At 10 min, no significant difference was seen between the groups, although both showed a significant decrease in s. Gaw compared with baseline values (P less than 0.05).
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The effect of carrier gas composition on the output of six anaesthetic vaporizers was studied using oxygen, nitrous oxide, helium and argon as the carrier gases. Vaporizer output was measured with an MGA 200 mass spectrometer and a Riken refractometer and, in addition, the pressure decrease across each vaporizer was determined simultaneously. ⋯ The possible reasons for the changes in steady state output are discussed in relation to the construction of each vaporizer. The addition of nitrous oxide to the carrier gas produced changes of clinical significance only when the vaporizers were used at extreme dial settings and flow rates.
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A ventilator, of new design, is described which has been evaluated on a lung model and in animals. It is simple, versatile, inexpensive and easy to sterilize. A single breathing tube is used in which the respiratory gas is introduced near the patient's airway while a jet in a more distal part of the tube drives the respiratory gas into the patient's lungs. ⋯ It can be used for any age group with any desired respiratory gas, and is suitable for use in the operating theatre and the intensive care unit. As there are no valves in the breathing system, which is open to the atmosphere at all times, complicated systems for synchronizing the machine with spontaneous breathing are not required. PEEP, NEEP, CPAP and IMV are applied easily.
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The rationale, anatomy and technique of transsacral phenol injection are described and the author's results in the treatment of nine patients with intractable perineal pain presented. The technique is recommended as a safe, simple and useful alternative to intrathecal neurolysis in this condition.
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The electrocardiograph (ECG) was recorded continuously in 20 children undergoing adenoidectomy during halothane anaesthesia. Five surface ECG leads and an oesophageal lead were used. In 11 children, there were QRS complexes which had a shape distinctly different from that of the ordinary sinus-evoked beats. ⋯ Although the anomalous QRS complexes were premature, P waves and P-P intervals were unchanged. In some children, there appeared to be ventricular capture beats and fusion beats. Because of this, and in view of evidence gathered from studies in animals, by other authors, we considered it likely that the anomalous beats were ventricular in origin.