Anaesthesia
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Comparative Study
Subarachnoid anaesthesia for elective caesarean section. A comparison of two hyperbaric solutions.
Forty patients who underwent elective lower segment Caesarean section under subarachnoid anaesthesia received either 2.0 ml 0.5% cinchocaine in 6% dextrose or 2.5 ml 0.5% bupivacaine in 8% dextrose via a 26-gauge needle with the patient in the left lateral position. Onset time was rapid in both groups and the distribution of maximum ascent of sensory analgesia was T1-T6. ⋯ There were no significant differences between the two groups either in the incidence and severity of complications or in the condition of the neonates. The high incidence (50-65%) and often profound extent of hypotension seen throughout the trial, confirm the ineffectiveness of crystalloid preload of 1500 ml as a single prophylaxis against hypotension.
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Case Reports
Fibreoptic bronchoscopic nasotracheal intubation of a neonate with Pierre Robin syndrome.
A case of nasotracheal intubation using a fibreoptic bronchoscope and the Seldinger technique is described. A guide wire was passed through the suction channel of the fiberscope after the epiglottis and the vocal cords were seen; the fiberscope was removed and a nasotracheal tube passed over the wire into the trachea.
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The Ruben circle anaesthesia system was studied in the spontaneous breathing mode, and under certain conditions there was incompetence of the replaceable mushroom control valve. This causes a reverse flow of gas which results in rebreathing of expired gas when the system is used on spontaneously breathing patients. ⋯ These results were confirmed by observations on anaesthetised adult and paediatric patients during spontaneous breathing. We conclude that the system in its present form, is not suitable for use on spontaneously breathing paediatric patients.
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Comparative Study
A comparison of two pulse oximeters. Assessment of accuracy at low arterial saturation in paediatric surgical patients.
The accuracy of the Ohmeda Biox 3700 and the Nellcor N100E was assessed in 25 cyanosed children. The readings obtained from the two pulse oximeters were compared with arterial blood measurements using a Radiometer OSM-2 co-oximeter. Both pulse oximeters differed significantly from the co-oximeter measurements and in these patients the error of both machines exceeded the manufacturers' claims. However, the machines appeared to reflect changes in saturation accurately in the same patient.
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Two cases of acute inversion of the uterus that occurred through the uterine incision at the time of Caesarean section are described. These represent only the sixth and seventh cases reported in the literature at this time. The implications for the anaesthetist are discussed.