British journal of anaesthesia
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Case Reports
Unintentional arterial puncture during cephalic vein cannulation: case report and anatomical study.
The cephalic antebrachial vein is often used for venous access. However, superficial radial arteries of the forearm are known and unintentional arterial puncture can result from attempts to cannulate the lateral veins of the arm. ⋯ If venous cannulation is attempted at the radial side of the wrist, palpation for pulsation should reduce the danger of arterial puncture.
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Anaesthetic steroids are established positive allosteric modulators of GABAA receptors, but little is known concerning steroid modulation of strychnine-sensitive glycine receptors, the principal mediators of fast, inhibitory neurotransmission in the brain stem and spinal cord. This study compared the modulatory actions of five anaesthetic pregnane steroids and two non-anaesthetic isomers at human recombinant alpha1 glycine and alpha1beta2gamma2L GABAA receptors. ⋯ The data demonstrate that structure-activity relationships for steroid modulation at glycine and GABAA receptors differ. Comparing the EC50 values reported here with free plasma concentrations during steroid-induced anaesthesia indicates that a selective modulation of GABAA receptor activity is likely to occur in vivo.
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The modified nasal trumpet (MNT) is a prepackaged nasopharyngeal airway modified with distal holes and fitted with a 15 mm adaptor allowing connection to an anaesthesia circuit. It may be useful for airway management during anaesthesia. ⋯ The MNT was disappointing as a primary airway device under general anaesthesia but was useful for giving oxygen after extubation and for facilitation of fibreoptic intubation. It can cause nosebleeds.