British journal of anaesthesia
-
Randomized Controlled Trial Clinical Trial
Supplemental oxygen for prevention of nausea and vomiting after breast surgery.
Administration of supplemental oxygen 80% has been shown to halve the incidence of postoperative nausea and vomiting (PONV). We tested the efficacy of supplemental oxygen 50% in decreasing the incidence of PONV after breast surgery. ⋯ The incidence of vomiting decreased during the short postoperative administration of supplemental oxygen 50%. However, perioperative oxygen 50% administration did not prevent PONV over the 24-h follow-up period in patients undergoing breast surgery performed under general anaesthesia.
-
Randomized Controlled Trial Clinical Trial
Effect of nitrous oxide on cerebrovascular reactivity to carbon dioxide in children during sevoflurane anaesthesia.
Sevoflurane and nitrous oxide have intrinsic cerebral vasodilatory activity. To determine the effects of nitrous oxide on cerebrovascular reactivity to carbon dioxide (CCO(2)R) during sevoflurane anaesthesia in children, middle cerebral artery blood flow velocity (V(mca)) was measured over a range of end-tidal carbon dioxide concentrations (E'(CO(2))), using transcranial Doppler (TCD) ultrasonography. ⋯ Cerebrovascular carbon dioxide reactivity is reduced at and above an E'(CO(2)) of 45 mm Hg during 1.0 and 1.5 MAC sevoflurane anaesthesia. The addition of nitrous oxide to 1.5 MAC sevoflurane diminishes CCO(2)R in the hypocapnic range. This should be taken into consideration when hyperventilation techniques for reduction of brain bulk are being contemplated in children with raised intracranial pressure.
-
Randomized Controlled Trial Clinical Trial
Blood/gas partition coefficients of halothane, isoflurane and sevoflurane in horse blood.
Blood/gas partition coefficients (lambda(b/g)) for volatile agents in horse blood are reported for halothane but not for isoflurane and sevoflurane. We measured the lambda(b/g) of halothane, isoflurane and sevoflurane in the blood of fasted horses. The correlation with age, weight and some haematological and biochemical variables was studied. The temperature correction factor for isoflurane solubility was calculated. ⋯ The lambda(b/g) values of halothane, isoflurane and sevoflurane in fasted horses are significantly lower than those reported in humans. The lambda(b/g) for halothane in this study agrees with values reported in the literature but a positive correlation with plasma triglycerides could not be confirmed. Knowledge of lambda(b/g) can refine models of anaesthetic uptake.
-
The lymphatic system is known to perform three major functions in the body: drainage of excess interstitial fluid and proteins back to the systemic circulation; regulation of immune responses by both cellular and humoral mechanisms; and absorption of lipids from the intestine. Lymphatic disorders are seen following malignancy, congenital malformations, thoracic and abdominal surgery, trauma, and infectious diseases. ⋯ Many lymphatic disorders are encountered in the operating theatre and critical care settings. Disorders of the lymphatic circulation relevant to anaesthesia and intensive care medicine are discussed in this review.
-
The temporal evolution of lung injury following post-traumatic shock is poorly understood. In the present study we have tested the hypothesis that manifestations of pulmonary vascular dysfunction may be demonstrable within the first hour after the onset of shock. ⋯ Pulmonary vascular injury manifesting as relative pulmonary hypertension and increased PVR may occur within the first hour after the onset of shock. These changes may not be accompanied by overt changes in oxygenation, compliance, or EVLWi. Br J Anaesth 2003; 91: 224-32