Anaesthesia and intensive care
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Naltrexone implants are used as an abstinence therapy for patients with opioid, amphetamine and alcohol abuse. This study was designed to assess the implications of this therapy in patients presenting for anaesthesia for removal of these implants. We conducted a retrospective case-note review of 37 patients undergoing removal of naltrexone implants in the period 2001 to 2008 at Sir Charles Gairdner Hospital. ⋯ The majority of patients were discharged home by the first postoperative day. Anaesthesia for the removal of naltrexone implants was associated with a wide range of opioid analgesia requirements and a high incidence of pain postoperatively. Concern regarding increasing opioid sensitivity after removal of implants does not seem to preclude use of generous opioid analgesia in this group of patients.
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Anaesth Intensive Care · Sep 2011
A New Zealand based cohort study of anaesthetic trainees' career outcomes compared with previously expressed intentions.
Predicting workforce requirements is a difficult but necessary part of health resource planning. A 'snapshot' workforce survey undertaken in 2002 examined issues that New Zealand anaesthesia trainees expected would influence their choice of future workplace. We have restudied the same cohort to see if that workforce survey was a good predictor of outcome. ⋯ Our study shows that stated career intentions in a group do not predict the actual group outcomes. We suggest that 'snapshot' studies examining workforce intentions are of little value for workforce planning. However we believe an ongoing program matching career aspirations against career outcomes would be a useful tool in workforce planning.
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Anaesth Intensive Care · Sep 2011
Case ReportsComputed tomography changes of alveoli and airway collapse after laryngospasm.
An eight-month-old girl underwent a computed axial tomographic study of the chest and neck for investigation of expiratory stridor. Following the scout scan, severe laryngospasm developed. While no cause for the laryngospasm was found, the computed axial tomographic chest study showed marked changes in the lungs consistent with absorption atelectasis which we postulate occurred secondary to laryngospasm.
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Anaesth Intensive Care · Sep 2011
Case ReportsAnaesthetic management of emergency caesarean section in a patient with seizures and likely raised intracranial pressure due to tuberculous meningitis.
We report the anaesthetic management of a term pregnant woman with active tuberculous meningitis, who had experienced seizures, had signs of raised intracranial pressure and required emergency caesarean section. Peripartum anaesthetic management of a patient with tuberculous meningitis is a rare event.