British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section.
In a prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of adding meperidine 10 mg to intrathecal bupivacaine on the duration of early postoperative analgesia in 40 patients having elective Caesarean section under spinal anaesthesia. ⋯ Addition of meperidine 10 mg to intrathecal bupivacaine for Caesarean section is associated with prolonged postoperative analgesia but with greater intraoperative nausea and vomiting.
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Although the postanaesthesia care unit (PACU) can be noisy, the effect of noise on patients recovering from anaesthesia is unknown. We studied the sources and intensity of noise in the PACU and assessed its effect on patients' comfort. ⋯ Even though sound in the PACU exceeded the internationally recommended intensity (40 dBA), it did not cause discomfort. Conversation was the most common cause of excess noise.
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Biography Historical Article
The British Journal of Anaesthesia. An informal history of the first 25 years.
In 1961, some 7 months after starting anaesthesia in the Leeds General Infirmary, I took out a subscription to the British Journal of Anaesthesia. It cost Pound Sterling3.15s.0d (Pound Sterling3.75) a year. The publishers John Sherratt and Son of Altringham) sent me the back numbers from the start of that year. ⋯ Anaesthetists pioneered intensive care and latterly extended their roles in pain relief outside the operating theatre. All these developments have appeared in papers at some time in this journal. This is a personal view of the journal over its first 25 years: there will be errors and misinterpretations--these are mine.
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Comparative Study
Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique.
Cardiac output (CO) can be measured intermittently by bolus thermodilution methods in the pulmonary artery (COpa) or in the aorta (COart). A continuous thermodilution method (CCO) and a method for continuous estimation using the arterial pulse wave (PCCO) are also available. ⋯ Measurement with the aortic transpulmonary thermodilution technique gives continuous and intermittent values that agree with the pulmonary thermodilution method.
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Case Reports
Intraoperative pulmonary oedema in a child following systemic absorption of phenylephrine eyedrops.
Ophthalmic surgeons often apply phenylephrine topically to effect pupillary dilatation. We describe a paediatric patient in whom cardiac arrhythmias, severe hypertension and pulmonary oedema occurred following intraoperative ocular phenylephrine administration. We believe that systemic absorption of the drug was responsible and discuss ways in which this might be reduced when ocular phenylephrine is used in this context.