Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 2005
ReviewAnaesthesia for neurosurgery in the sitting position: a practical approach.
Neurosurgery in the sitting position offers advantages for certain operations. However, the approach is associated with potential complications, in particular venous air embolism. As the venous pressure at wound level is usually negative, air can be entrained. ⋯ Other particular concerns to the anaesthetist are airway management, avoidance of pressure injuries, and the risk of pneumocephalus, oral trauma, and quadriplegia. Newer anaesthetic agents have made the choice of anaesthetic technique easier. An appreciation of the implications of neurosurgery in the sitting position can make the procedure safer
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Anaesth Intensive Care · Jun 2005
Historical ArticleAnaesthesia in Hong Kong and the Faculty of Anaesthetists: 25 years of co-operation.
The development of anaesthetic services in Hong Kong started about five years after the Faculty of Anaesthetists, RACS, was founded. A nucleus of trained anaesthetists there sought assistance from the Faculty to establish adequate training posts and courses of instruction, and hence to provide consultants with an internationally accepted qualification. This paper describes the major features of the early decades of this development.
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Anaesth Intensive Care · Jun 2005
Assessment of internal diameter and cross-sectional area of right internal jugular vein pre-induction and post-intubation.
This prospective observational study compared the internal diameter and cross-sectional area of the right internal jugular vein pre-induction and post-initiation of positive pressure ventilation. Twenty patients undergoing coronary artery bypass surgery were studied. ⋯ There was a statistically significant increase in both measurements post-intubation. This study suggests that it may be easier and safer to perform cannulation of RIJV after institution of intermittent positive pressure ventilation in patients in the modified Trendelenburg position.
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Anaesth Intensive Care · Jun 2005
Biography Historical ArticleNorman R. James F.F.A.R.A.C.S., a pioneer of high quality anaesthesia in Australia.
Dr Norman R. James was a multi-talented, highly accomplished clinician, teacher and innovator broadly recognized on three continents. In the United Kingdom, he served in London's Emergency Medical Service during World War II and was dubbed "England's foremost exponent of regional anaesthesia". ⋯ T. "Pepper" Jenkins, the charismatic founder of anesthesiology at the University of Texas Southwestern Medical School, recruited him to Dallas in 1960, where he taught the art and science of anesthesiology at Parkland Memorial Hospital until his retirement in 1974. He died in 1987 and is buried in Winnsboro, Texas. A brief story of his life and career follows.
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Prospective data was collected on 58 patients having neurosurgery in the sitting position in one institution. The incidence of venous air embolism was 43% (25/58), of which the majority were small or moderate in size. ⋯ There was no mortality or serious morbidity. With a proper understanding of the pathophysiology of venous air embolism and the use of sensitive monitoring, anaesthesia for sitting position neurosurgery can be provided safely.