Anaesthesia
-
Comparative Study
The effects of the exaggerated lithotomy position for radical perineal prostatectomy on respiratory mechanics.
The exaggerated lithotomy position is used during radical perineal prostatectomy to increase perineal exposure. The aim of this study was to evaluate the effects of the exaggerated lithotomy position on respiratory mechanics and arterial blood gases. ⋯ Arterial oxygen tension was significantly decreased by 26.9%; however, no significant differences were seen in end-tidal or arterial carbon dioxide tension. These results indicate that the exaggerated lithotomy position under general anaesthesia can cause significant effects on respiratory system mechanics and arterial oxygenation and highlights the need for careful monitoring of patients placed in this position for surgery.
-
We tested the hypothesis that protein cross-contamination occurs during batch cleaning and autoclaving of a reusable extraglottic airway device, the ProSeal laryngeal mask airway. At the end of each day for 10 days, nine laryngeal mask airways that had been used for non-intra-oral surgery were cleaned and autoclaved alongside a new unused laryngeal mask airway. In addition, a new unused laryngeal mask airway underwent the same cleaning and autoclaving procedures in isolation. ⋯ Protein staining was detected on all unused laryngeal mask airways that were processed by batch, but none on those processed in isolation. Protein staining was more severe with the used compared with the unused laryngeal mask airways (p < 0.001). We conclude that protein cross-contamination of the laryngeal mask airway occurs during batch cleaning and autoclaving and recommend that reusable airway devices are cleaned in isolation.
-
The aim of this study is to compare the brightness of laryngoscope light between instruments, and the variability within the same instrument. A secondary aim is to compare the light from a reusable laryngoscope with a single use design. Testing equipment was constructed which provided a qualitative measure of light output from laryngoscopes. ⋯ Laryngoscopes in anaesthetic rooms around the hospital were then tested repeatedly, and the results were compared to the anaesthetists' opinions. There was considerable intersubject and intrasubject variation in the reusable design, often failing to satisfy the minimum brightness. The single use blades were found to be brighter and more reliable than reusable blades.
-
In 20 women undergoing Caesarean section, we determined brachial arterial blood pressure, heart rate and cardiac output (using an oesophageal Doppler probe) just after uterine incision and during the application of extra-abdominal uterine fundal pressure to facilitate delivery. Mean (SD) systolic aortic flow time (354.3 (35.4) ms), cardiac output (3.85 (0.68) l.min(-1)), heart rate (80.6 (14.2) beats.min(-1)) and blood pressure (84.7 (12.1) mmHg) decreased when fundal pressure was applied compared with after uterine incision (397.6 (31.6) ms, 4.69 (0.78) l.min(-1), 95.1 (14.0) beats.min(-1)and 100.3 (12.0) mmHg, respectively; p < 0.05). ⋯ The mothers and babies were not observed to be clinically compromised. The results suggest that applying fundal pressure to facilitate Caesarean delivery produces significant haemodynamic effects but the impact of these effects may be clinically insignificant.