Anaesthesia and intensive care
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The aim of this study was to determine the incidence of true local anaesthetic allergy in patients with an alleged history of local anaesthetic allergy and whether subsequent exposure to local anaesthetics is safe. Two hundred and eight patients with a history of allergy to local anaesthesia were referred over a twenty-year period to our Anaesthetic Allergy Clinic. In this open study, intradermal testing was performed in three patients and progressive challenge in 202 patients. ⋯ In all but one patient local anaesthesia has been given uneventfully subsequently. A history of allergy to local anaesthesia is unlikely to be genuine and local anaesthetic allergy is rare. In most instances LA allergy can be excluded from the history and the safety of LA verified by progressive challenge.
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Anaesth Intensive Care · Dec 1997
Letter Randomized Controlled Trial Clinical TrialSpinal morphine for caesarean section.
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Anaesth Intensive Care · Dec 1997
Case ReportsHypoglossal neuropraxia following endotracheal intubation.
A case of hypoglossal nerve neuropraxia following elective drainage of bilateral chronic subdural haematomas is described. We postulate that the cause of neuropraxia was inadvertent extubation of the trachea with the cuff inflated, leading to compression and stretch of the nerve against the greater horn of the hyoid bone. The literature on cranial nerve palsies following endotracheal intubation is reviewed.
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Anaesth Intensive Care · Dec 1997
Case ReportsSystemic levels of 6-keto-prostaglandin F1 alpha following administration of inhaled aerosolized prostacyclin.
A case is described where systemic levels of prostacyclin metabolite were measured during inhaled aerosolized prostacyclin (IAP) therapy for severe hypoxaemia in a patient with the acute respiratory distress syndrome. Comparable levels of prostacyclin metabolite have been associated with a marked platelet aggregation defect in vitro. A platelet aggregation defect was also demonstrated in vivo in this patient. Haemodynamic and gas exchange data during the IAP therapy are described.