Canadian Anaesthetists' Society journal
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One hundred Nigerian patients presenting for emergency caesarian section were interviewed within the first 24 hours post-operatively. The purpose was to determine the incidence of awareness and dreams. ⋯ The incidence of awareness was 4% while the incidence of dreaming was 17%. Most (94%) of the patients said they dreamed only occasionally at home and of these, 15% claimed they dreamed more frequently when pregnant than when not pregnant.
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A formula is derived for maintaining normocapnia during controlled ventilation using a circle system without carbon dioxide absorption. In a series of 70 patients, unselected in terms of age, sex, obesity, ASA status, body position during operation, type of anaesthetic administered or type of circle system used, it was found that a total fresh gas flow of 50 ml/kg body weight/min and a minute ventilation of 120 to 150 ml/kg body weight at a rate of 10 to 12/min achieved normocapnia. For moderate hypocapnia a total fresh gas flow of 60 ml/kg body weight/min and a minute ventilation of 120 ml/kg at a rate of 10-12/min is suggested.
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Comparative Study
Comparison of etidocaine and lidocaine for obstetrical analgesia.
Etidocaine, a relatively new local anaesthetic agent, is compared with lidocaine for use in epidural anaesthesia for vaginal delivery. The parameters compared were quality of anaesthesia, dose of drug, onset and regression of sensory blockade, complete degree of motor blockade, effect on maternal blood pressure, and foetal Apgar scores at one and five minutes. The major differences between the drugs are the lower percentage of satisfactory anaesthesia with etidocaine, the much greater variability in the time of onset of complete sensory block with etidocaine as compared to lidocaine, the more profound motor block with etidocaine, and the slightly longer duration of action of this drug. It is concluded that etidocaine has no real place in epidural anaesthesia for obstetrics.
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Over the past three years the inflation-catheter technique (ICT) of controlled ventilation during general anaesthesia has proved a safe and useful method for use with laryngoscopy and other trans-oral endoscopies (most notably flexible fiberoptic bronchoscopy). The ICT allows full control of the patient's airway for the anaesthetist and exceptionally good exposure for the surgeon. In this technique ventilation of the patient is accomplished by intermittent high flow (10 ml/kg/sec) inflation of the lungs through a small (2 to 6 mm diameter) plastic orotracheal catheter. ⋯ The Inflation Catheter Technique is readily adaptable for patients ranging from large adults to small babies by variation of catheter sizes. It can be used safely with nitrous oxide-oxygen as the ventilating gas(i.e., Bird N2O/O2 Blender) since air entrainment is not a feature. It is also readily adaptable for use with mechanical ventilation (i.e., Wolf Injectomat).