Recently added articles from Anaesthesia and Intensive Care:

The Monash Computer-controlled Electromyograph

Oct 01, 2006; Cass, N M; Brown, T C K ... This apparatus was built, based on a model developed at the Department of Electrical Engineering, Monash University. The Head of Department, Professor Douglas Lampard (Hon. F.F.A.R.A.C.S.) was very interested in biophysics and developed a physiological laboratory. A fortuitous association with ...

Fatigue and the Anaesthetist

Oct 01, 2006; Merry, A F; Warman, G R ... Many older anaesthetists recall being rostered for continuous duty for 72 hours at a time, or even longer. Some sleep was possible but the facilities for this were often less than satisfactory. Contemporary industrial agreements have substantially reduced the hours junior doctors are permitted ...

The Effect of Excess Protamine on Thrombelastography In Vitro

Oct 01, 2006; Gibbs, N M; Yim, D; Weightman, W; Sheminant, M; Rowe, R ... SUMMARY The aim of the current study was to assess the direct effect of protamine on conventional thrombelastography in vitro. Protamine was added to blood samples collected from 25 adult cardiac surgical patients prior to the induction of anaesthesia and after separation from ...

Clonidine as an Analgesic Adjuvant to Continuous Paravertebral Bupivacaine for Post-thoracotomy Pain

Oct 01, 2006; Bhatnagar, S; Mishra, S; Madhurima, S; Gurjar, M; Mondal, A S ... SUMMARY We prospectivefy evaluated the effect of clonidine as an adjuvant to bupivacaine for continuous paravertebral intercostal nerve block, measuring pain and sedation scores and pulmonary function tests. Thirty patients scheduled to undergo thoracotomy were randomized to receive ...

Unplanned Admission to the Intensive Care Unit in Postoperative Patients-An Indicator of Quality of Anaesthetic Care?

Oct 01, 2006; Piercy, M; Lau, S; Loh, F; Reid, D; Et al ... SUMMARY As a clinical indicator, unplanned admission to the Intensive Care Unit from the operating room has been thought to reflect the quality of anaesthesia care intraoperatively. To explore this concept, we examined all such admissions at three hospitals over a three-month period ....

Relative Adrenal Insufficiency in Etomidate-Naïve Patients with Septic Shock

Oct 01, 2006; Jones, D; Hayes, M; Webb, S; French, C; Bellomo, R ... SUMMARY A recent study reported that 77% of patients with septic shock had relative adrenal insufficiency. However, all patients were mechanically ventilated and received high-dose inotropes. In addition, at least 24% had prior exposure to etomidate, a drug known to suppress adrenal ...

Bispectral Index Guided Timing of Intubation without Neuromuscular Blockade during Sevoflurane Induction of Anaesthesia in Adults

Oct 01, 2006; van Twest, R M ... SUMMARY The aim of this study was to assess the effectiveness ofbispectral index monitoring (BIS) as a guide to the timing of intubation during sevoflurane induction of anaesthesia without the use of neuromuscular blocking agents in adults, and specifically, whether a target BIS value of ...

A Comparison of 5% Dextrose in 0.9% Normal Saline Versus Non-Dextrose-Containing Crystalloids as the Initial Intravenous Replacement Fluid in Elective Surgery

Oct 01, 2006; Chin, K J; Macachor, J; Ong, K C; Ong, B C ... SUMMARY Intravenous fluid replacement in adult elective surgery is often initiated with dextrose-containing fluids. We sought to determine if this practice resulted in significant hypergfycaemia and if there was a risk of hypoglycaemia if non-dextrose-containing crystalloids were used ...

The Margin of Safety of a Left Double-Lumen Tracheobronchial Tube Depends on the Length of the Bronchial Cuff and Tip

Oct 01, 2006; Partridge, L; Russell, W J ... SUMMARY The left tracheobronchial double-lumen tube is the commonest device to separate the left and right lungs for differential ventilation. With the appropriate tube, the left bronchial cuff is positioned in the bronchus so that the cuff is beyond the carina but the tip of the tube ...

A Prospective Observational Study of the Effect of Night Duty on the Cognitive Function of Anaesthetic Registrars

Oct 01, 2006; Griffiths, J D; McCutcheon, C; Silbert, B S; Maruff, P ... SUMMARY The issue of fatigue in hospital medical staff represents a potential health and safety risk to both staff and patients, and is receiving worldwide interest. We aimed to characterize the cognitive performance of anaesthetic registrars before and after a series of night shifts. We ...

Association of Obesity with Increased Mortality in the Critically Ill Patient

Oct 01, 2006; Aldawood, A; Arabi, Y; Dabbagh, O ... SUMMARY The impact of obesity on critical care outcomes has been an issue for debate in the literature. Variable data and conflicting results have been reported. The purpose of our study is to examine the impact of obesity on the outcome of patients admitted to a tertiary closed ...

A Comparison of Patient Self-administered and Investigatoradministered Measurement of Quality of Recovery Using the QoR-40

Oct 01, 2006; Gower, S T; Quigg, C A; Hunt, J O; Wallace, S K; Myles, P S ... SUMMARY A 40-item questionnaire (the QoR-40) had been previously developed to measure five dimensions of quality of recovery after anaesthesia and surgery. Each of the 40 items is rated on a scale of 1 to 5, with a maximum score of 200. In this study we compared patient self-administered ...

Incidence of Infections in Patients with Status Epilepticus Requiring Intensive Care and Effect on Resource Utilization

Oct 01, 2006; Ala-Kokko, T I; Säynäjäkangas, P; Laurila, P; Ohtonen, P; Laurila, J J ... SUMMARY Data from a six-year period were retrospectively retrieved from medical records and an intensive care unit data management system to study the impact of infections on patients with status epilepticus. Out of 161 admitted patients, 33 had a community-acquired infection and 35 ...

Assessing the Accuracy of Self-Reported Height and Weight in an Elective Surgical Population in a Melbourne Metropolitan Hospital

Oct 01, 2006; Bowden, C; Loughnan, T ... SUMMARY A Health Questionnaire serves as a screening form as part of our Hospital Preadmission process and is completed by all patients scheduled for elective surgery. We reviewed the completed Health Questionaires of 444 patients. Completion of the Health Questionnaire requires patients ...

Short-Term Low-Dose Propofol Anaesthesia Associated with Severe Metabolic Acidosis

Oct 01, 2006; Chukwuemeka, A; Ko, R; Ralph-Edwards, A ... SUMMARY Propofol-induced metabolic acidosis is well recognised in the paediatric literature, but the existence of such a syndrome in adults remains contentious. In most reported cases, metabolic acidosis complicated prolonged administration of propofol in critically ill patients. We ...

Asystole during Percutaneous Ethanol Injection of Symptomatic Vertebral Haemangioma

Oct 01, 2006; Sharma, D; Jain, V; Rath, G P ... SUMMARY Computed tomography guided percutaneous ethanol injection is frequently employed for treatment of symptomatic vertebral haemangiomas. The procedure is performed under monitored anaesthesia care in the prone position. It has several advantages over open surgery and other ...

Severe Dehydration and Acute Renal Failure Associated with External Ventricular Drainage of Cerebrospinal Fluid in Children

Oct 01, 2006; Simpson, S; Yung, M; Slater, A ... SUMMARY We report three paediatric cases of severe dehydration and hyponalraemia with circulatory compromise associated with the use of external ventricular drainage of cerebrospinal fluid. Two of the children had cardiac arrests. All were successfully resuscitated. While there were ...

Thrombogenic Side-Effects of Recombinant Factor VIIa after use in Coronary Artery Bypass Surgery

Oct 01, 2006; White, M C; Pryn, S J; Monk, C R ... SUMMARY Recombinant activated factor VII (rFVIIa) has been used 'off licence' to successfully treat bleeding and reduce transfusion requirements in complex cardiac surgery. However, concerns over thrombogenic side-effects have limited but not excluded its use in patients undergoing ...

Salmon Calcitonin in the Treatment of Post Herpetic Neuralgia

Oct 01, 2006; Visser, E J; Kwei, P L ... SUMMARY A 78-year-old man with severe chronic obstructive pulmonary disease presented to our pain medicine clinic for treatment of post herpetic neuralgia. Pharmacotherapy with tricyclic antidepressants, anticonvulsants, tramadol and traditional analgesics had failed, primarily due to ...

Postoperative Thrombotic Microangiopathy Following Radical Cystectomy for Bladder Cancer

Oct 01, 2006; Tauzin-Fin, P; Sesay, M; Ryman, A; Ballanger, P; Combe, C ... SUMMARY This report describes the perioperative management of disseminated intravascular coagulation occurring abruptly during a planned cystectomy for non-metastatic bladder papillary carcinoma. Peroperatively, profuse bleeding and an acute decrease in blood pressure were effectively ...