Anaesthesia and intensive care
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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.
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Anaesth Intensive Care · Jun 2005
Biography Historical ArticleHubert Ingham Clements: a pioneer of Australian anaesthesia.
Hubert Ingham Clements was an inventor, designer and engineer who manufactured many pieces of apparatus for use in the scientific and medical practice, particularly in the field of anaesthesia from 1917 when he designed and manufactured suction pumps and anaesthetic machines. His products were ingenious, light and portable where desirable, but sturdy, extraordinarily reliable, of low maintenance and high performance. His contribution to the specialty of anaesthesia is acknowledged.
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Anaesth Intensive Care · Jun 2005
Comparative StudyEffect of newer anaesthetics on duration of stay in postanaesthesia care unit in patients undergoing major abdominal surgery.
Newer anaesthetic agents, such as remifentanil and sevoflurane, are more expensive than conventional anaesthetics, such as isoflurane and fentanyl. However, newer anaesthetics might outweigh their higher acquisition costs by reducing length of stay in the postanaesthesia care unit and thereby reducing personnel costs. We retrospectively investigated the influence of newer anaesthetics on time to eligibility for discharge from the postanaesthesia care unit in consecutive patients undergoing major abdominal surgery. ⋯ In the sevoflurane/fentanyl group, time to eligibility for discharge from the unit showed a tendency to be increased (P = 0.08), however these patients were significantly older compared to the other groups. Sevoflurane and remifentanil did not appear to reduce time to eligibility to discharge from the postanaesthesia care unit in our patients undergoing major abdominal surgery compared to isoflurane and fentanyl. This study highlighted the necessity for carefully planned transition from remifentanil to other longer-acting analgesia in our patients.