Anaesthesia and intensive care
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There have been several reports of propofol becoming extrinsically contaminated with bacteria. These reports have usually related to infusions or delays in administration after the ampoule has been opened. This observational study was performed to examine bacterial contamination of propofol during usual practice in the operating theatres of a single large hospital group. ⋯ This common clinical practice, especially in paediatric anaesthesia, does not comply with the manufacturer's recommendations. The clinical significance of the bacterial contamination detected is not clear. It is recommended that propofol should be handled in an aseptic fashion and measures taken to minimize the risk of bacterial contamination.
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Anaesth Intensive Care · Oct 1999
Supplementary oxygen and the laryngeal mask airway--evaluation of a heat-and-moisture exchanger.
Heat-and-moisture exchangers (HMEs) are routinely used in anaesthesia for the humidification and warming of inspired gases. The use of the Laryngeal Mask Airway (LMA) is widespread, and many anaesthetists choose to leave it in situ until the patient regains consciousness. ⋯ At an oxygen flow rate of 4 l.min-1, the HME provided a mean end-tidal oxygen concentration of 36.2% (+/- 6.2), which compares favourably to other previously described devices. The HME thus represents a convenient, effective and economical means of oxygen supplementation via the LMA.
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Anaesth Intensive Care · Oct 1999
The haemodynamic effects of propofol in combination with ephedrine in elderly patients (ASA groups 3 and 4).
The marked vasodilator and negative inotropic effects of propofol are disadvantages in frail elderly patients. We investigated the safety and efficacy of adding different doses of ephedrine to propofol in order to obtund the hypotensive response. ⋯ However, marked tachycardia associated with the use of ephedrine in combination with propofol occurred in the majority of patients, occasionally reaching high levels in individual patients. Due to the risk of this tachycardia inducing myocardial ischemia, we would not recommend the use in elderly patients of any of the ephedrine/propofol/mixtures studied.