British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Tracheal intubation after induction of anaesthesia with propofol, alfentanil and i.v. lignocaine.
We have assessed tracheal intubating conditions in 60 ASA I or II patients after induction of anaesthesia with propofol 2.5 mg kg-1 and alfentanil 10 or 20 micrograms kg-1 with or without i.v. lignocaine 1 mg kg-1. No neuromuscular blocking agents were administered. ⋯ Intubating conditions were acceptable in 20%, 73%, 73% and 93% of patients in groups 1-4, respectively. Intubating conditions were better and there was less coughing in the lignocaine group.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of recovery from anaesthesia induced in children with either propofol or thiopentone.
We studied 102 children undergoing day-case surgery, allocated randomly to receive either thiopentone 5 mg kg-1 or propofol 3 mg kg-1 i.v. at induction of anaesthesia. They then inhaled nitrous oxide and halothane in oxygen until a laryngeal mask airway could be inserted. Thereafter, halothane was substituted by isoflurane and analgesia provided by regional nerve block. ⋯ In children aged less than 5 yr, only the time to spontaneous eye opening was shorter after propofol induction (P < 0.05). In children aged 5-11 yr, times of spontaneous eye opening, giving name and discharge were shorter after propofol induction (P < 0.05). These results indicate that propofol hastened early recovery in children undergoing day-case surgery, but earlier discharge occurred only in older children.
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We describe a case of post lumbar puncture headache treated by extradural blood patch. Magnetic resonance imaging (MRI) demonstrated a large extradural haematoma extending over four spinal segments and extending out through the neural outlet foramina. There was significant compression of the thecal sac, supporting the theory that extradural blood patch causes tamponade at the site of dural puncture. The spread of clot was predominantly upwards from the injection site and subarachnoid extension of blood was also demonstrated.
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Biography Historical Article
John Henry Hill Lewellin: the first etherist in Glasgow.
John Henry Hill Lewellin, a surgeon-dentist, was the first to administer ether in Glasgow, on January 4, 1847. He was born in Calcutta, trained at St Bartholomew's Hospital, qualified M. R. ⋯ He remained there for about 18 months, advertising his dental practice in a high profile manner and, when the time came, he publicized his experience with ether in the local press in an exemplary way. He disappeared from Glasgow in June 1847, and reappeared in Australia 5 years later, practising as a dentist initially, and later as a general medical practitioner in Melbourne until his retirement in 1883. He died in 1886.
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Plasma concentrations of bupivacaine have been measured in 12 patients given bupivacaine through a paravertebral catheter placed under direct vision at thoracotomy. After an initial bolus of 0.5% bupivacaine 20 ml, mean (SEM) Cpmax was 1.45 (0.32) micrograms ml-1 and median (range) tCpmax was 25 (10-60) min. ⋯ No symptoms or signs of toxicity occurred. Separate measurement of R- and S-bupivacaine concentrations demonstrated significantly different concentration-time profiles.