South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Adult respiratory distress syndrome is being recognized more frequently as a complication of a number of conditions. The causes, pathophysiology, pathology, clinical manifestations and management are reviewed in this article. The use of positive end-expiratory pressure (PEEP) and super-PEEP is discussed. The value of measurements of mixed venous oxygen partial pressure (PVO2) in the treatment of respiratory failure, especially in the presence of high inspired oxygen tensions, is explained and emphasized.
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Review
Anaesthesia for caesarean section. An updated review of its special problems and their management.
We have attempted to update a previous review of the hazards and problems confronting the mother, fetus and anaesthetist at caesarean section. A recent survey of obstetric anaesthesia within the Republic and South West Africa indicates that a significant proportion of anaesthetic services for midwifery are provided by non-specialist practitioners in hospitals outside major population centres. We believe that both mothers and their infants will gain from the careful perusal by their doctors of this review.
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The physiology and pharmacological management of postoperative pain are briefly discussed. Although narcotic analgesics are still the mainstay in the management of postoperative pain the judicious use of non-narcotic analgesics, anticholinergics, tranquillizers and soporifics as well as the administration of local anaesthetic agents could contribute greatly to the alleviation of postoperative pain and discomfort. Certain regimens for intravenous medication are outlined and strong emphasis is placed on the fact that postoperative pain relief is the duty of the doctor and not that of unskilled nursing staff.