Anaesthesia
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A caudal epidural catheter was inserted in 20 premature, high risk infants for abdominal or thoracic surgery under combined caudal epidural and general anaesthesia. Epidurography was used to confirm the position of the catheter which was found to be misplaced in three patients. The catheter penetrated the dura in one case, in another the tip was located in an epidural vessel and in the third the catheter was seen to be curled up within the epidural space. It was concluded that epidurographic control is essential with this method of anaesthesia in very small infants, in whom it was found to provide considerable advantages despite serious risks.
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Biography Historical Article
The Trilite inhaler. An historical review and performance assessment.
The Trilite inhaler was developed for use in World War II. Its efficient performance is confirmed and a brief biography of its inventor is also given.
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A new needle, 120 mm long and 26 gauge in diameter, has been introduced for subarachnoid anaesthesia. The resistance to flow through the needle was measured using a pressure monitor infusion pump and compared with the resistance to flow through a 90-mm 26-gauge needle; there was a threefold increase in resistance in the 120-mm needle compared to the 90-mm needle, which could not be explained by the difference in length alone and must reflect a decrease in the internal diameter of the long needle. This results in difficulty in identifying the subarachnoid space by backflow of cerebrospinal fluid.
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The laryngeal mask airway was used in 200 children during a variety of surgical procedures. Some problem with the use of the device was encountered in 47 cases (23%), but in only five cases (2.5%) were the problems serious enough to warrant abandonment of its use. ⋯ The mask was used in 16 children with known airway problems. It is concluded that the size 2 laryngeal mask airway can be successfully used within the weight range 6-30 kg.