British journal of anaesthesia
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The mortality associated with 240 483 anaesthetics administered over 10 years at Groote Schuur Hospital, Cape Town, is reported. The frequency of death to which anaesthesia contributed was 0.22 per 1000 anaesthetics (compared with 0.33 per 1000 in the previous 10 years). These deaths were responsible for 2.2% of the total mortality from surgery. Two-thirds of the "anaesthetic" deaths were attributable to (in order of frequency): (a) hypovolaemia; (b) respiratory inadequacy following myoneural blockade; (c) complications of tracheal intubation; (d) inadequate postoperative care and supervision.
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The scavenging of gases from anaesthetic circuits may present hazards to the patient. The negative pressure relief valve prevents the generation of subatmospheric pressures in the circuit as a result of a discrepancy between the fresh gas flow and the gas evacuation rate. ⋯ Six different valves were studied. Two membrane valves came nearest to fulfilling the ideal requirements.
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A Doppler ultrasound bloodflow detector was used to localize the third division of the subclavian artery, rendering the supraclavicular approach to the brachial plexus safer and highly successful.