Anaesthesia
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Randomized Controlled Trial Clinical Trial
Reduction of gastric acid secretion. The efficacy of pre-anaesthetic oral cimetidine in children.
Cimetidine 10 mg/kg orally was given at varying times from 60 to 240 minutes pre-operatively to 100 healthy children between the ages of 6 months and 14 years. Cimetidine proved to be most effective when given between 120 and 180 minutes before the induction of anaesthesia. ⋯ In these patients the mean (SD) half-life of cimetidine was 138 (18) minutes. The reduction of gastric juice volume and acidity produced by 10 mg/kg oral cimetidine given 120-180 minutes prior to induction of anaesthesia has important clinical implications.
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Comparative Study
Continuous monitoring of blood PO2 in extracorporeal systems. An in vitro evaluation of a re-usable oxygen electrode.
The technique of intermittent sampling of blood during extracorporeal circulation and in vitro analysis to establish that the blood-gas status of the patient is within acceptable limits has drawbacks which may be overcome by continuous monitoring. An evaluation of an oxygen monitoring system and a comparison with a blood gas analyser have been performed. ⋯ There was no significant difference between the calculated value and the monitor readings but the blood gas analyser results were significantly lower (p less than 0.01) than the calculated values of the tonometered blood. The reasons for this difference and the potential clinical advantages of continuous monitoring are discussed.
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IgE levels were measured in 105 patients after immediate (101) and delayed (4) anaphylactoid reactions to anaesthetic drugs. It was not possible on the basis of allergic history and IgE levels in patients to determine the drugs to which the patients were likely to react. A history of allergy, atopy with or without elevated IgE levels, does not aid the selection of anaesthetic drugs for initial or repeat anaesthesia.
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In investigating the possible causes of an observed complication of intravenous regional anaesthesia, cubital fossa venous pressures were measured distal to an inflated tourniquet as standard 40 ml volumes of normal saline were injected. The maximal pressures obtainable were limited by tourniquet pressure since the veins compressed under the tourniquet acted as 'Starling' spillover resistors. ⋯ The rates of rise and maximum values of venous pressures tended to be increased by increased injection rates, and by failure to exsanguinate the arm, but the choice of injection site was paramount. Compared with more distal injections, cubital fossa venous injections are more likely to lead to leakage under the tourniquet and should never be used for intravenous regional anaesthesia.