Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study
Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children.
Parental presence at induction of anaesthesia is desirable if it makes the child happier and more cooperative. This study evaluated the emotional and behavioural responses of children to being accompanied by a parent at induction of anaesthesia in a paediatric day-care surgical centre. One hundred and thirty-four patients (aged 2-10 yr, ASA physical status I or II) were divided into two groups by day of surgery, to have a parent present at induction of anaesthesia (treatment group), or to be unaccompanied (control group). ⋯ Children in the "calm-treatment," "calm-control" and "anxious-control" subgroups were similarly upset at induction. Children in the "anxious-treatment" subgroup were the most disturbed at induction, and significantly more than those in the "anxious-control" subgroup. Preoperative parental anxiety levels also correlated with the child's fears and behaviour one week after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
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A case of intraoperative awareness during a thoracotomy is described. The patient's recall coincided with an intraoperative period during which a Siemens 900B ventilator and a Siemens 952 isoflurane vaporiser were used. ⋯ This problem eventually was traced to a malfunctioning inlet control valve on the ventilator. This complication may have been prevented if the end-tidal anaesthetic concentration had been monitored intraoperatively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative evaluation of propofol and thiopentone for total intravenous anaesthesia.
Sixty unpremedicated ASA physical status I or II patients scheduled for surgical procedures of intermediate duration (15 to 60 min) were studied to evaluate the safety and efficacy of propofol, to measure recovery times and to compare the return of psychomotor and cognitive function with thiopentone. Patients were randomly allocated into two groups. Anaesthesia was induced and maintained by either propofol (2.0-2.5 mg.kg-1 followed by a continuous infusion 0.1-0.2 mg.kg-1.min-1) or thiopentone (4.0-5.0 mg.kg-1, and infusion rate 0.16-0.32 mg.kg-1.min-1), titrated to patient response. ⋯ Psychomotor and cognitive function returned earlier with propofol and fewer side effects were noted. At 24 hr there was no distinguishable difference between groups. Propofol is a safe anaesthetic agent with the potential for early patient discharge and street fitness after outpatient procedures.
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The rate of blood contamination of IV tubings used in anaesthesia practice was investigated. Only IV tubings started in the operating room were studied. First, 300 tubings of three different types were tested at the three distal injection sites. ⋯ This rate decreases as the distance from the IV catheter increases. The use of the third site fixed at a level equal to or above the IV catheter carries a lower risk of contamination. Changing the needle alone is a useless procedure to prevent cross-contamination.
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In order to determine correlations between electromyographic (EMG), mecanomyographic (MMG) and clinical criteria of adequate recovery from neuromuscular blockade with vecuronium, seven young healthy conscious volunteers were given subparalysing doses of vecuronium. During recovery from neuromuscular blockade, vital capacity, negative inspiratory pressure, peak expiratory flow rate and five-second head lift were assessed. ⋯ We found that all subjects maintained head lift for five seconds at EMG T4T1 of 0.70, and they achieved normal respiratory tests at EMG T4/T1 of 0.90. The MMG T4/T1 needed for the subjects to perform normal respiratory tests was found to be 0.50, at which time six of the seven subjects were able to perform adequately the head lift test.