S Afr J Surg
-
Randomized Controlled Trial Clinical Trial
Postoperative management of hypothermia of intra-operative origin--experience with a forced-air convective warming device.
Hypothermia develops during the intra-operative period partly as a result of disordered thermoregulation induced by anaesthesia, and partly because of the nature of the operation or injury and the surgical environment. Both the hypothermic state and the consequences of physiological attempts to return the core temperature to normal, which take place during the postoperative period, are associated with non-beneficial effects. ⋯ This study evaluates the performance of a new device, the forced-air convective warmer, in the management of the postoperative hypothermic state. Results show that the device made a significant difference to the thermal state of a group of hypothermic postoperative patients when compared with a hypothermic control group, but only if used for at least 2 hours after the operation.
-
Historical Article
Ether Day and the first ether anaesthetics in South Africa.
-
Comparative Study
Haemodynamic response to tracheal intubation or laryngeal mask insertion in hypertensive patients.
The haemodynamic response to laryngeal mask insertion and tracheal intubation was studied in 27 hypertensive patients who underwent elective ophthalmic surgery. Both groups received alfentanil 15 micrograms/kg, thiopentone 3-4 mg/kg and vecuronium 0.1 mg/kg and were ventilated with oxygen, nitrous oxide and isoflurane for 3 minutes prior to laryngeal mask insertion or tracheal intubation. ⋯ Heart rate, but not blood pressure, increased above baseline levels in the tracheal intubation group. The anaesthetic technique used blunted the haemodynamic response to tracheal intubation, but completely blocked the response to laryngeal mask insertion.
-
A total of 446 patients with liver trauma were treated over a 10-year period: 295 (66%) had penetrating injuries (204 stab wounds, 91 gunshot wounds) and 151 (34%) blunt trauma. Seventeen patients died during resuscitation before laparotomy. In 344 (80%) of the 429 patients who underwent laparotomy, injuries were managed by simple methods such as temporary packing, diathermy, sutures or vessel ligation. ⋯ Complications occurred in 151 of 392 survivors (38.5%) and correlated with type and severity of the liver injury (31% in stab wounds, 43% in gunshot wounds, 57% in blunt injuries) and the number of associated injuries. As many as 80% of liver injuries can be managed by simple surgical techniques. In major liver injuries perihepatic packing may be life-saving, allowing control of bleeding before a logical sequential strategy is instituted to isolate and repair the injury.
-
A prospective study was undertaken in 40 patients to determine whether suturing of the faucial pillars has any effect in relieving pain and discomfort associated with tonsillectomy. The first 20 patients (5 adults and 15 children) had tonsillectomy without suturing of the faucial pillars. The next 20 patients (3 adults and 17 children) had the anterior and posterior faucial pillars approximated and sutured with 3.0 chromic catgut. ⋯ Approximation of the faucial pillars to cover the raw tonsillar bed after tonsillectomy does not relieve pain. It is disadvantageous in that it produces complications and prolongs the anaesthetic time significantly. Therefore suturing of the faucial pillars is not recommended.