Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1985
Historical ArticleThe introduction of local anaesthesia in Australia, January 19, 1885.
Medical journals in Australia between 1856 and 1884 were wont to publish many references to forms of local anaesthesia, probably because this form of pain relief was of assistance to lone practitioners in isolated country towns. Some of these methods are described, as is the first use of cocaine by A. S. ⋯ T. Rudall on January 19, 1885. As in journals elsewhere there followed a spate of articles reporting various aspects of cocaine and its usage, including an abortive attempt to find an alternative agent.
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Anaesth Intensive Care · Feb 1985
Indications for and complications of temporary transvenous cardiac pacing.
A prospective survey was conducted of the indications for and complications of 153 temporary transvenous cardiac pacing lead insertions in 148 patients. Pacing for bradyarrhythmias or potential bradyarrhythmias (Group I) accounted for 105 insertions, wide complex tachycardia (Group II) 17, and narrow complex tachycardia (Group III) 31 pacing electrode insertions respectively. The infraclavicular subclavian vein approach was used in 73%. ⋯ A complication occurred in 27 (18%) of 153 lead insertions, 11 (7%) were serious. No complication resulted in the death of a patient. Temporary transvenous pacing is safe and effective for the treatment of bradyarrhythmias and certain tachyarrhythmias.
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Anaesth Intensive Care · Nov 1984
Randomized Controlled Trial Clinical TrialEvaluation of the transcutaneous electrical nerve stimulator for postoperative analgesia following cardiac surgery.
The effectiveness of transcutaneous electrical nerve stimulation (TENS) in postoperative pain relief was assessed in this prospective randomised controlled study of 31 patients during the first 72 hours after cardiac surgery. Fourteen patients were given functioning TENS units, and seventeen patients were given non-functioning units. Postoperative pulmonary function tests, analgesic requirements and the incidence of atelectasis were compared in the two groups. ⋯ The forced vital capacity (FVC) was significantly larger with functioning TENS units on the second postoperative day, but there were no other significant differences in forced expiratory volume in one second (FEV1) or forced vital capacity (FVC) values between the two groups. A questionnaire given to patients assessing their opinions of the effectiveness of the TENS unit for analgesia showed a placebo effect in some patients with non-functioning units. In summary, this study suggests that TENS may be of benefit in postoperative pain relief after cardiac surgery, especially on the second postoperative day.
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Anaesth Intensive Care · Nov 1984
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of morphine and buprenorphine for analgesia after abdominal surgery.
Eighty fit adults having elective abdominal hysterectomy or cholecystectomy received buprenorphine or morphine intravenously at the start of peritoneal closure, in a randomised double-blind trial. The anaesthetic sequence precluded the use of other narcotic analgesics. Pain scores were lower in patients who received buprenorphine, as were the cumulative numbers of patients withdrawn from the trial at each interval because of pain, statistical significance being achieved at all intervals from one to seven hours after administration. ⋯ One patient with protracted drowsiness and slow respiratory rate after buprenorphine received naloxone. No serious side-effects were noted. Buprenorphine 4-6 micrograms/kg provided adequate postoperative analgesia of greater duration than could be achieved with morphine, and the potency of buprenorphine when administered in this way was at least 33 times that of morphine.
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Anaesth Intensive Care · Nov 1984
The influence on foetal outcome of maternal carbon dioxide tension at caesarean section under general anaesthesia.
The influence on foetal outcome of maternal PCO2 at caesarean section under general anaesthesia was assessed in 27 "clinically acceptable ideal patients" as defined by Crawford. A standard anaesthetic technique was employed which utilised left lateral tilt and an F1O2 of 0.5. ⋯ No relationship was found between clinically measured parameters of foetal outcome and maternal end-tidal PCO2. The relevant literature is reviewed.