Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
A new epidural catheter. Closer eyes for safety?
A new design of epidural catheter with three lateral eyes placed in close proximity to its closed end is described. Prototype models of this catheter were tested in 200 obstetric and surgical patients. In a single-blind randomised study it was found to be easy to insert and highly satisfactory in use, when compared to the current catheter type, with three widely spaced lateral eyes. It is hoped that the close spacing of the eyes will eliminate the complication of multicompartment block, as seen with earlier multihole catheters, and improve the safety of epidural block.
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Three portable suction devices were evaluated and compared with a wall-mounted vacuum driven suction unit. The Repro-med Res-Q-Vac, the Dräger Sujector 2000 and the Laerdal suction unit were assessed by measuring the time taken to aspirate 140 ml of mock gastric contents. ⋯ These compare favourable with the Ohmeda suction unit (7.27 (6.2-8.9)). Each type of device has advantages and disadvantages when factors such as size, power supply and portability are considered, and each will be the most suitable for a particular situation.
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The case notes and anaesthetic charts of 44 patients with dystrophic epidermolysis bullosa were reviewed retrospectively. A total of 390 general anaesthetics were performed for 469 surgical procedures over a 10-year period. Procedures included repair of syndactyly, dilatation of oesophageal strictures, extraction of teeth, excision of skin tumours and other procedures related to dystrophic epidermolysis bullosa. ⋯ Previous reports have suggested problems with the use of suxamethonium, nondepolarising muscle relaxants and thiopentone. These agents were all used in many of our patients without any adverse effects. There was one intra-operative death in a 35-year-old woman having an oesophageal dilatation which was complicated by oesophageal rupture.
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Two hundred and five patients, aged 16-45 years, undergoing day care surgery were given a spinal anaesthetic using either a 26- or a 27-gauge Quincke point spinal needle. The occurrence of headache and accompanying symptoms postoperatively was analysed from 186 returned questionnaires. ⋯ The headache and accompanying symptoms were similar to that seen with a postdural puncture headache except that it was not aggravated by posture. A system of grading the severity of both type of headache is presented and standardised criteria for the classification of postdural puncture headache are proposed.