Anaesthesia
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Comparative Study Clinical Trial Controlled Clinical Trial
The palpation of pulses.
In 554 anaesthetised patients, the times taken to separately palpate and identify each of the carotid, radial, brachial and femoral pulses were recorded. The patients were divided into three groups based on the form of airway management chosen (tracheal tube, facemask or laryngeal mask airway). ⋯ The carotid pulse was not so easily identified, requiring 10 s to enable an identification rate of greater than 95%. The presence of a laryngeal mask airway or a tracheal tube did not hinder the identification of carotid pulse.
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Clinical Trial Controlled Clinical Trial
Effects of topical benzocaine and lignocaine on upper airway reflex sensitivity.
We studied the degree and duration of effect on upper airway reflex sensitivity of oral benzocaine lozenges, nebulised lignocaine and lignocaine sprayed onto the vocal cords under direct vision, using low concentrations of ammonia as a stimulus to upper airway receptors. Ten minutes after the administration of oral benzocaine 20 mg the threshold response of the upper airway to ammonia (NH3TR) had risen significantly from baseline mean (SEM) of 680 (95) to 975 (109) ppm of ammonia with a return to baseline values after 25 min (n = 8, p < 0.05, repeated measures of ANOVA; p < 0.001, t-test). ⋯ The application of 4% nebulised lignocaine 4 ml significantly increased NH3TR from a baseline mean (SEM) of 770 (56) to a maximum of 1190 (63) ppm of ammonia with a significant elevation in the threshold persisting for 30 min (n = 8, p < 0.001, repeated measures of ANOVA; p < 0.05, t-test). The maximum elevations in NH3TR with the two methods of lignocaine delivery were significantly different (p < 0.01, 2-way ANOVA).
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Case Reports
Transient radicular irritation after single subarachnoid injection of isobaric 2% lignocaine for spinal anaesthesia.
Several cases have been reported recently in which symptoms suggestive of transient radicular irritation occurred following the use of hyperbaric 5% lignocaine for spinal anaesthesia. We report on three patients in whom we observed similar symptoms attributable to this kind of radicular irritation following uneventful spinal anaesthesia using isobaric 2% lignocaine. All three patients underwent minor gynaecological procedures and developed burning pains in the buttocks within 24 h of surgery. The long-term outcome was not clear for all the patients, but in at least one the pain disappeared.
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In the early 1940s, Dr M. H. ⋯ The apparatus was essentially a combination of Water's to-and-fro soda-lime canister and Hewitt's ether inhaler. The description of the apparatus is followed by a brief historical note on Dr Armstrong-Davison.
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A 39-year-old man developed a unilateral recurrent laryngeal nerve palsy following laryngeal mask airway insertion for a day case procedure.