Anaesthesia
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A twin-tube breathing system for inhalational anaesthesia in dental surgery is described. The system is a modification of a parallel Mapleson 'A' breathing system and is suitable for use with continuous flow anaesthetic machines. ⋯ The system is suitable for children and adults, easy to use and efficient. The expiratory valve is located remote from the face and the system is suitable for scavenging by active, assisted or passive systems.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pre-oxygenation: the Hudson mask as an alternative technique.
The use of a simple oxygen facemask (Hudson) with high oxygen inflow (48 l.min-1) was investigated as a technique for pre-oxygenation, comparing it with the Magill system (oxygen flow: 100 ml.kg-1.min-1). One hundred and thirty-eight patients scheduled for elective gynaecological and orthopaedic surgery were studied: group 1, Hudson mask and group 2, Magill system (ASA 1-2, n = 107); group 3, Hudson mask and group 4, Magill system (ASA 3, n = 30). Pre-oxygenation was assessed by measuring the times to 97%, 95% and 93% arterial desaturation (finger pulse oximetry) following 3 min of pre-oxygenation. The times taken to achieve these end-points in all the study groups suggest that the Hudson mask offers an alternative technique for pre-oxygenation.
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Comparative Study
Vital capacity breath technique for rapid anaesthetic induction: comparison of sevoflurane and isoflurane.
This study compares vital capacity rapid inhalational induction of anaesthesia with sevoflurane and isoflurane. Forty-six volunteers undergoing the procedure had one of the two agents: 25 had sevoflurane and 21 isoflurane. Subjects were unpremedicated and breathed approximately 1.7 MAC equivalents of either vapour. ⋯ There were fewer induction complications in the sevoflurane group. Subjects in the sevoflurane group found the induction of anaesthesia more pleasant and were more willing to undergo it again compared to subjects in the isoflurane group. We conclude that sevoflurane is superior to isoflurane in vital capacity rapid inhalational induction of anaesthesia, particularly in instances where premedication should be avoided.
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Audiograms were performed pre-operatively and 2 days postoperatively in 48 patients given spinal anaesthesia for transurethral resection of the prostate. Hearing levels were examined at 1000 Hz and below. ⋯ The mean hearing level was more reduced in the Quincke group. The shape of the tip of the spinal needle seems to be of some importance to the effects on hearing level that may occur after spinal anaesthesia.
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We have conducted a prospective study into the ease of use and incidence of postdural puncture headache with the 'Portex' combined spinal/epidural set. The pack contains a 16-gauge Tuohy needle of standard 8 cm shaft length with a matching 26-gauge pencil point spinal needle. ⋯ There were two cases of significant postdural puncture headache requiring blood patch due to puncture by the 26-gauge spinal needle giving an incidence of 1.3%. This compares favourably with previously reported rates in obstetric patients.