Anaesthesia
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Historical Article
Classification of peripheral nerve fibres. An historical perspective.
The historical development of the nomenclature used to describe peripheral nerve fibres is described. Some of the properties of nerve fibres and their maturation are discusses. ⋯ A-alpha, beta, gamma, delta, B and C) should be used for efferent nerve fibres, while the nomenclature introduced by Lloyd44 (i.e. groups I,II, III and IV) should be applied to afferent fibres. The terms B, 'gamma efferent', Ia and Ib have specific implications with regard to their source or distribution irrespective of the conduction velocities of the fibres contributing to these groups.
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The Bain anaesthetic breathing system-a modified Mapleson 'D' circuit10-had been evaluated during anaesthesia using controlled ventilation. Results obtained from over 140 patients show that a highly predictable PaCO2 may be obtained by adjusting the fresh gas inflow according to body weight in patients weighing over 40 kg (mean PaCO2 at a fresh gas inflow of 70 ml/kg/minute=40.8 mmHg; mean PaCO2 at a fresh gas inflow of 100 ml/kg/minute=34.3 mmHg). ⋯ In addition, the circuit is lightweight, disposable but re-usable, facilitates pollution control and is easily used as an independent resuscitator. It is suggested that it may qualify as a universal breathing system.
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Propanidid was used for the induction of anaesthesia at Caesarean section in 50 healthy mothers. All parturients were considered to have normal placental function. Anaesthesia was maintained with nitrous oxide, oxygen, muscle relaxant and controlled ventilation. ⋯ Propanidid, therefore, appeared to be associated with a greater degree of foetal acidaemia than did thiopentone. In addition, painful factual recall during surgery was encountered in 6 percent of cases. It is concluded that propanidid, although theoretically offering advantages over thiopentone to the obstetric anaesthetist, in practice, did not fulfil this promise.
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A cannula and conveniently arranged ancillary apparatus designed to assist endotracheal intubation of patients with upper respiratory tract obstruction prior to tracheostomy are described.