Anaesthesia
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An injector gun of the type developed for vaccinations was used to perform intercostal nerve blocks. Analgesia was achieved in all patients to some degree, but the effectiveness of the technique was limited by the currently available local anaesthestics.
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Pollution in the dental outpatients surgery was assessed by measuring atmospheric nitrous oxide levels and comparing these with the venous blood concentrations in the operator-anaesthetist and his assistant. The effects of scavenging on both measurements have also been determined. Without scavenging the nitrous oxide level in the blood of the dentist was over four times that of the average anaesthetist working in an operating theatre. Some of the factors contributing to these high levels, and the effectiveness of scavenging are discussed.
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The organic and psychological problems of patients suffering from chronic abdominal pain are described and three case histories of patients who had undergone multiple surgery for their abdominal pain are presented. All three were treated by lumbar sympathetic lysis, resulting in relief of their pain. The possible reasons for this success are discussed.
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Letter Case Reports
The use of the fibre-optic bronchoscope for the passage of a double lumen tube.
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Randomized Controlled Trial Clinical Trial
Halothane uptake and nitrous oxide concentration. Arterial halothane levels during Caesarean section.
The effect on halothane uptake of changing the nitrous oxide concentration during the first few minutes of a general anaesthetic for Caesarean section was investigated. In 10 mothers anaesthesia was maintained with halothane 0.4%, nitrous oxide 33% and oxygen 66%. In 10 others the sole difference in anaesthetic technique was that the ratio of nitrous oxide to oxygen was reversed for the first 3 minutes only. ⋯ Cord blood concentrations between the two groups were comparable. The difference in halothane levels is a demonstration of the influence of the concentration effect of nitrous oxide on the uptake of halothane, the second gas effect. The relevance of anaesthetic uptake to obstetric anaesthesia and awareness is discussed.