Anaesthesia
-
The aim of this study was to assess whether passive smoking affected the frequency of airway complications in children undergoing general anaesthesia. One hundred and twenty-five children undergoing general anaesthesia for elective daycase surgery were monitored for adverse respiratory events and desaturation during induction, intra-operatively and in the recovery room. Oxygen saturation was monitored throughout and a venous sample was taken for estimation of carboxyhaemoglobin levels. ⋯ This was related to the cumulative number of cigarettes smoked by individuals to whom the child was exposed (p < 0.05). Neither carboxyhaemoglobin levels nor domiciliary address were predictive of desaturation. This study suggests that passive smoking contributes to postoperative arterial oxygen desaturation following general anaesthesia in children.
-
A postal survey of 801 members of the Obstetric Anaesthetists Association was carried out in the United Kingdom and Ireland to investigate the use of surgical facemasks whilst performing spinal and epidural blocks. Two hundred and twenty three out of 539 respondents (41.3%) routinely wore masks for both spinals and epidurals; 22 (4.1%) wore masks only for epidurals; 21 (3.9%) wore masks only for spinals and 273 (50.6%) did not wear masks for either spinals or epidurals. Fifty out of 240 (21%) of those who routinely wore masks did not believe that wearing a mask reduced the risk of infection. Only 83 out of 259 (32%) mask wearers changed their masks between cases.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Tropisetron and metoclopramide in the prevention of postoperative nausea and vomiting. A comparative, placebo controlled study in patients undergoing ophthalmic surgery.
One hundred and twenty patients undergoing elective ophthalmic surgery under general anaesthesia were investigated in a randomised, double-blind, parallel group study of postoperative nausea and vomiting. Patients received tropisetron 0.1 mg.kg-1, metoclopramide 0.25 mg.kg-1 or placebo given at the end of anaesthesia. ⋯ The patients in the placebo group required rescue antiemesis more often in the postanaesthesia care unit. Our results suggest that tropisetron may not be suitable as a routine, primary therapy for the prevention of postoperative nausea and vomiting.
-
There is no doubt that a group of patients at increased risk of peri-operative cardiac morbidity exists and must be managed with the emphasis on the prevention of myocardial ischaemia. It is also clear that a potentially far larger group are at risk of failing to meet the increased cardiovascular and metabolic demands of surgery and therefore suffering the consequences of a relative hypoperfusion injury. ⋯ The first and most important step is the recognition that this high risk group exists. Only then can this population be given similar consideration to those currently thought to be at risk of ischaemia.