Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 1993
Evaluation of safety procedures in anaesthesia and intensive care.
A study was conducted to determine the ability of junior anaesthetists to check the anaesthetic machine, demonstrate a knowledge of a multifunction monitor and a defibrillator, and know the hospital fire drill. The subjects were 38 junior anaesthetists working in a large multi-disciplinary teaching hospital. 45% were able to check the anaesthetic machine according to the guidelines of the Australian and New Zealand College of Anaesthetists, and 16% had a complete working knowledge of the monitor. ⋯ Only one subject had a working knowledge of the fire drill; excluding knowledge of the fire drill only 3 subjects (8%) satisfactorily completed all aspects of the assessment. As a result of this study structured checking routines are being introduced into anaesthetic teaching and practice and a similar multi-center study of specialist anaesthetists is being planned.
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Anaesth Intensive Care · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of caudal epidural bupivacaine with adrenaline and bupivacaine with adrenaline and pethidine for operative and postoperative analgesia in infants and children.
This study compares the effectiveness of two drug combinations--(a) bupivacaine with adrenaline and (b) bupivacaine with adrenaline and pethidine--on operative and postoperative pain relief when administered by the caudal route in infants and children. A randomised controlled trial was conducted on fifty children below the age of twelve years: 25 children were randomly allocated to each group. ⋯ Though the group with pethidine had a longer duration of analgesia and sedation, the very high incidence of vomiting and delay in urination observed in this group would preclude the use of pethidine routinely. No respiratory depression was seen in either group.
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Anaesth Intensive Care · Aug 1993
Comparative StudyEnd-tidal oxygen measurement compared with patient factor assessment for determining preoxygenation time.
Time to adequate preoxygenation was assessed in 200 elective surgical patients, using measurement of end-tidal oxygen concentration. A variety of patient factors were assessed as to their ability to predict the time required to preoxygenate a patient. Of the 200 patients, 23 (11.5%) were unable to be adequately preoxygenated; most of these cases were due to a poor mask fit. ⋯ Although a regression equation could be constructed to calculate time required for preoxygenation, the wide standard errors of the coefficients preclude a clinically useful predictive equation. We thus found that we could not accurately predict time required for preoxygenation and that a routine three minutes preoxygenation may not be sufficient for many patients. However, the measurement of end-tidal oxygen concentration is a very useful method of determining the end-point for preoxygenation.
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Anaesth Intensive Care · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia after caesarean section with intramuscular ketorolac or pethidine.
We compared, in a double-blind randomised study, intramuscular ketorolac 30 mg (n = 49) and intramuscular pethidine 75 mg (n = 51) for analgesia after elective caesarean section under general anaesthesia. Anaesthesia was induced with thiopentone and suxamethonium and maintained with atracurium, nitrous oxide and isoflurane. Intravenous fentanyl 100 micrograms was given after delivery of the neonate. ⋯ However, four patients in the ketorolac group and six patients in the pethidine group requested no further analgesia within 24 hours. Pain VAS and overall assessment of analgesia was similar between groups, although more side-effects (nausea, dizziness) were noted in the pethidine group. Ketorolac 30 mg and pethidine 75 mg provided similar but variable quality of analgesia after caesarean section.