British journal of anaesthesia
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Paediatric anaesthesia is made easier and safer by use of the correct equipment. The widening range and increasing complexity of available apparatus makes it essential for the anaesthetist to judge which items are most useful in any individual case. As a general rule, the simplest pieces of equipment are the most reliable and among the most useful.
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The in vitro sensitivities to local anaesthetic blockade of A, B and C nerve fibres in rabbit vagus nerves were examined using a series of structurally similar amino-ester agents which varied in lipid solubility and anaesthetic potency. A fibres were found to be the most sensitive and C fibres the least sensitive to conduction blockade with all the agents, provided that equilibrium blockade was allowed to develop. A correlation existed between the intrinsic anaesthetic potency of the various agents and their lipid solubilities. ⋯ As lipid solubility decreased through the series studied, so the onset of conduction blockade of A fibres was prolonged. It is suggested that this related to decreasing ability to penetrate the lipid diffusion barriers around A fibres. The traditional view that C fibres were more sensitive to block may have arisen because of confusion between absolute sensitivity and rate of development of conduction blockade.
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Randomized Controlled Trial Clinical Trial
Continuous monitoring of blood glucose concentration during open-heart surgery.
Continuous monitoring of blood glucose concentration was compared with frequent intermittent sampling in 12 non-diabetic adult patients undergoing open-heart surgery with cardiopulmonary by-pass using priming fluids free of glucose. Continuous monitoring revealed several changes which were not detected on intermittent sampling. ⋯ Rewarming from hypothermic by-pass was associated with a 3 (+/- 0.5)-mmol litre-1 increase in blood glucose concentration (P less than 0.01). Commencement of infusions of sympathomimetic agents resulted in a similar increase.