British journal of anaesthesia
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A ventilator, of new design, is described which has been evaluated on a lung model and in animals. It is simple, versatile, inexpensive and easy to sterilize. A single breathing tube is used in which the respiratory gas is introduced near the patient's airway while a jet in a more distal part of the tube drives the respiratory gas into the patient's lungs. ⋯ It can be used for any age group with any desired respiratory gas, and is suitable for use in the operating theatre and the intensive care unit. As there are no valves in the breathing system, which is open to the atmosphere at all times, complicated systems for synchronizing the machine with spontaneous breathing are not required. PEEP, NEEP, CPAP and IMV are applied easily.
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The electrocardiograph (ECG) was recorded continuously in 20 children undergoing adenoidectomy during halothane anaesthesia. Five surface ECG leads and an oesophageal lead were used. In 11 children, there were QRS complexes which had a shape distinctly different from that of the ordinary sinus-evoked beats. ⋯ Although the anomalous QRS complexes were premature, P waves and P-P intervals were unchanged. In some children, there appeared to be ventricular capture beats and fusion beats. Because of this, and in view of evidence gathered from studies in animals, by other authors, we considered it likely that the anomalous beats were ventricular in origin.
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The rationale, anatomy and technique of transsacral phenol injection are described and the author's results in the treatment of nine patients with intractable perineal pain presented. The technique is recommended as a safe, simple and useful alternative to intrathecal neurolysis in this condition.
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This survey compared the safety of 261 healthy mothers of whom 170 received extradural and 91 general anaesthesia for Caesarean section. Anaesthetics were conducted in routine hospital practice by six anaesthetic registrars. ⋯ Hypotension occurred in 11 patients, inadequacy of analgesia in 25 patients and a period of unawareness in 16 patients following sedation after delivery. Extradural block for Caesarean section is thus seen as safer than general anaesthesia when performed by the same group of anaesthetic trainees on healthy mothers.