Anaesthesia and intensive care
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Anaesth Intensive Care · May 1983
Comparative StudyA comparison of methods of cardiac output measurement.
Cardiac output measurements determined by dye dilution, iced-injectate thermodilution and room temperature thermodilution were compared in man in order to assess the random error of each method and to examine the systematic error of both thermodilution methods in comparison with dye dilution. Results showed that random error was greatest with room temperature thermodilution and least using iced thermodilution. Iced thermodilution correlated well with dye dilution, tending to overestimate cardiac output only at low flows. Room temperature thermodilution, however, overestimated cardiac output by up to 25% in the clinically important range and more so at low cardiac output.
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Gastric pH values were studied prior to, and up to, ninety minutes after an intravenous injection of cimetidine 200 mg given before general anaesthesia, in twenty surgical patients, all with a gastric pH less than 3.5. At thirty, sixty and ninety minutes, sixteen, eighteen and twenty patients had a gastric pH greater than 3.5 respectively. In conclusion, the results of the present study indicate that cimetidine 200 mg given intravenously 90 minutes before surgery will reduce the hazard of chemical pneumonitis should stomach content be aspirated.
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Anaesth Intensive Care · Feb 1983
Case ReportsThe management of headache following accidental dural puncture in obstetric patients.
The progress and management of fifty-eight obstetric patients who received an accidental dural puncture is described. Headache attributable to dural puncture occurred in 85% of patients managed conservatively. Epidural infusion or repeat epidural bolus injections of saline after delivery reduced the incidence to 65%. ⋯ The pathophysiology and treatment of dural puncture headache is reviewed. Reduction of pressure differential across the dural puncture site is most useful in the first 24-48 hours. Persistent and severe headache occurring after this should be treated with blood patch.
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Anaesth Intensive Care · Feb 1983
Femoral nerve block--the anatomical basis for a single injection technique.
A technique for blocking the femoral nerve using a single needle placement is described. It depends on an appreciation of the anatomy and the need to feel loss of resistance twice as two fascial layers are penetrated during insertion of the needle just lateral to the femoral artery. A single injection of bupivacaine 0.35-0.5 per cent of at least 0.3 ml/kg will produce a satisfactory block.