Anaesthesia and Intensive Care back issues from June 2006:
Muscle Relaxants-Atracurium and Other Recent Developments
Jun 01, 2006; ... The last few decides have been dominaled by the seareh for the perfect relaxant; in particular, an ultra-short-acting relaxant which does not depend upon plasma cholinesterases or liver metabolism for biodegradation. The perfect drug remains elusive but some interesting and useful drugs have ...
Safety in Anaesthesia
Jun 01, 2006; ... Pioneering Role of Anaesthetists in Quality and Safely Historically there was early involvement by Australian anaesthetists in the promotion of quality and safety. Outcomes were first evaluated in New South Wales (NSW) by the Special Committee Investigating Deaths Under Anaesthesia ...
Fluid Deficits and Hypotension During Colonoscopy
Jun 01, 2006; ... Lower intestinal endoscopy (of which the major part is colonoscopy) is an extremely common procedure in most developed countries. In Australia, about 435,000 were performed between July 2003 to June 2004', most with some form of conscious sedation. At present, little is known about the risks of ...
Data Linkage Enables Evaluation of Long-Term Survival After Intensive Care
Jun 01, 2006; ... SUMMARY Outcomes of intensive care are important to the patient and for assessment of benefit. Short-term outcomes after critical illness are well described, but less is known about long-term outcomes. This study describes the use of data linkage, combining intensive care unit (ICU) ...
Intravenous Fluid to Prevent Hypotension in Patients Undergoing Elective Colonoscopy
Jun 01, 2006; ... SUMMARY Colonoscopy may be associated with hypotension during sedation leading to postoperative morbidity. However, no treatment is proven to ameliorate intraoperative hypotension for this procedure. We therefore conducted a randomized trial to determine the effect of intravenous fluid ...
A Pilot Study to Test the Use of a Checklist in a Tertiary Intensive Care Unit as a Method of Ensuring Quality Processes of Care
Jun 01, 2006; ... SUMMARY This pilot study aimed to test the use of a checklist us a method of ensuring that certain processes of care are performed routinely and systematically in a tertiary intensive care unit. The pilot involved the development of a process indicator checklist, its implementation and ...
Positive End-expiratory Pressure Ventilation Increases Extravascular Lung Water Due to a Decrease in Lung Lymph Flow
Jun 01, 2006; ... SUMMARY Positive end-expiratory pressure (PEEP) is used to improve gas exchange, increase functional residual capacity, recruit air spaces, and decrease pulmonary shunt in patients suffering from respiratory failure. The effect of PEEP on extravascular lung water (EVLW), however, is ...
Skin Temperature During Sympathetic Block: A Clinical Comparison of Bupivacaine 0.5% and Ropivacaine 0.5% or 0.75%
Jun 01, 2006; ... SUMMARY Measurement of skin temperature can be used as an indicator of sympathetic blockade induced by neuraxial anaesthesia. Thie aim of the study was to test the skin temperature response to epidural administration of bupivacaine and different concentrations of ...
Recovery After Prolonged Anaesthesia for Acoustic Neuroma Surgery: Desflurane Versus Isoflurane
Jun 01, 2006; ... SUMMARY In this study, 33 patients were randomly assigned to receive desflurane (D) or isoflurane (I) for acoustic neuroma surgery. The time from end of the procedure to spontaneous breathing, extubation, eye-opening, hand-squeezing to command, and ability to state name, birthdate and ...
Protein Contamination of the Laryngeal Mask Airway and its Relationship to Re-use
Jun 01, 2006; ... SUMMARY The Laryngeal Musk Airway is a reusable device for maintaining the patency of a patient's airway during general anaesthesia. The device can he reused after it has heen cleaned and sterilized. Protein contamination of medical instruments is a concern and has been found to occur ...
10,000 Reasons To Step Out-Exercise Patterns and Pedometer Evaluation of Consultant Anaesthetists
Jun 01, 2006; ... SUMMARY Major international bodies recommend that adults should accumulate at least 30 minutes of moderate intensity physical activity every day. Ten thousand steps a day has been found to approximate 30 minutes of exercise. A questionnaire regarding exercise patterns was sent to all ...
Comparison of Remifentanil and Fentanyl in Anaesthesia for Elective Cardioversion
Jun 01, 2006; ... SUMMARY This prospective, randomized, double-blind study was designed to compare the recovery characteristics of remifentanil and fentanyl in combination with propofol for direct current cardioversion. Patients undergoing elective cardioversion received either intravenous fentanyl 1 ...
Patients' Understanding of Pre-operative Fasting
Jun 01, 2006; ... SUMMARY We aimed to assess elective day surgery patients' understanding of the reason for pre-operative fasting. One hundred adult patients presenting to the peri-operative unit for day procedures requiring general anaesthesia were sun-eyed before discharge. All day-stay, adult patients ...
Mixed Opioid-Mixed Message?
Jun 01, 2006; ... SUMMARY By exposing the mu-receptor (MOP-R) to more than one exogenous ligand, the administration during general anaesthesia of more than one opioid with principal action on the receptor may confound and lead to complications or unexpected outcomes. The giving of such a 'mixed message' ...
Propofol EDTA and Reduced Incidence of Infection
Jun 01, 2006; ... SUMMARY Propofol formulated in a lipid vehicle supports the growth of microorganisms. There have been worldwide reports of extrinsic microbial contamination of propofol leading to outbreaks of serious postoperative nosocomial infections. Therefore it is essential that medical ...
Anaesthetic Management of a Patient with Relapsing Polychondritis Undergoing Laparoscopic Surgery
Jun 01, 2006; ... SUMMARY We describe the anaesthetic management of a patient with relapsing polychondritis who underwent laparoscopic cholecystectomy. We jailed to secure a patent airway with a ProSeal(TM) laryngeal mask airway, probably because of the deformity of the larynx. The glottis was small and ...
Use of Recombinant Activated Factor VII After Axillofemoral Bypass Grafting
Jun 01, 2006; ... SUMMARY Recombinant activated factor VII (rFVIIa) is a powerful prohaemostatic agent that theoretically predisposes to thrombosis after peripheral vascular surgery. He report the use of rFVII to reduce bleeding in a patient alter axillofemoral bypass grafting for ruptured aorto-iliac ...
Upper Airway Obstruction Caused by Ingestion of Concentrated Acetic Acid
Jun 01, 2006; ... SUMMARY We report a case of rapidly progressive severe upper airway obstruction in a small child caused by accidental ingestion of 80% acetic acid. Emergency cricothyrotomy was necessary after both endotracheal intubation and bag-valve-mask ventilation were not possible. Although ...
Development of Bilateral Herpes Zoster following Thoracoscopic Splanchnicectomy
Jun 01, 2006; ... SUMMARY A 39-year-old female presented for elective bilateral thoracoscopic splanchnicectomy for chronic severe visceral pain. Surgery and anaesthesia were uneventful and she gained good symptomatic relief. Postoperative recovery was complicated by the development on day Jour of ...
Cricothyroidotomy: A Short-term Measure for Elective Ventilation in a Patient with Challenging Neck Anatomy
Jun 01, 2006; ... SUMMARY Cricothyroidotomy is a well established technique of airway management in emergency situations where translaryngeal intubation cannot be achieved. This case report describes a case where cricothyroidotomy was used for elective ventilation for short period of 48 hours in a ...
Systemic Capillary Leak Syndrome Associated with Compartment Syndrome and Rhabdomyolysis
Jun 01, 2006; ... SUMMARY Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by recurrent spontaneous episodes of hypovolaemic shock due to marked plasma shifts from the intravascular to the extravascular space. This presents as the characteristic triad of hypotension, ...
A Serious and Repeatable Electrical Hazard-Compressed Electrical Cord and an Operating Table
Jun 01, 2006; ... SUMMARY We describe a previously unreported hazard resulting from compression of an electrical cable by an operating theatre table. This resulted in a live wire contact to the operating table. Intermittent connection of the table to earth during a procedure resulted in triggering of a ...
Enhancement of pulse oximeter plethysmographic waveform in a patient with Takayasu's arteritis
Jun 01, 2006; ... Monitoring of pulse oximetry and blood pressure has always been a problem in patients with Takayasu's arteritis (pulseless disease). Numerous methods have been used to detect the pulse or improve the plethysniographic signal. These include the application of vasodilating cream, digital nerve ...
Simplified format of cardiac risk stratification: Assisting the physician in decision-making
Jun 01, 2006; ... Preoperative assessment of patients with heart disease could influence the management of the patient and consequently reduce perioperative cardiac morbidity and mortality1. Numerous studies have analysed patient status and have directed the physician to the most appropriate conduct by ...
Anaesthesia for neurosurgery in sitting position/Reply
Jun 01, 2006; ... We read with interest the article, Anaesthesia for neurosugery in sitting position: A practical approach1. We would like to express our opinion on the following points. We disagree with the author's statement that venous air embolism (VAE) deteeted by capnography is always significant ....
Mivacurium in multicore disease
Jun 01, 2006; ... Multicore disease is a rare, inherited myopathy also referred as minieore, multiple minieore or minieore-nuillieore myopathy. It is commonly accepted that succinylcholine should he avoided in patients with myopathies1. However, to our knowledge the complete lime course of neuroimiscular blockade ...
The utility of fluoroscopic guidance in thoracic epidural placement/Reply
Jun 01, 2006; ... In response to Hooten and colleagues' recently published paper1, I would like to question the reasoning behind their concluding remarks that "the use of fluoroscopy ensured that each patient had a functional thoracic cpidural catheter". Points to note are: * It is equally likely that ...
The American Society of Anesthesiologists: A Century of Challenges and Progress
Jun 01, 2006; ... The American Society of Anesthesiologists: A Century of Challenges and Progress. D. R. Bacon. K. E. McGoldriek, M. J. Lema; Wood Library-Museum of Anesthesiology, 520 N Northwest Highway, Park Ridge, Illinois 6006, U.S.A.; $55: pp. 216; ISBN 1-HH4545-15-2. This history of the American ...
Emergencies in Anaesthesia
Jun 01, 2006; ... Emergencies in Anaesthesia. Eds K. G. Allman, A. K. McIndoe, I. H. Wilson; Oxford University Press, Great Clarendon Street, Oxford OX2 6DP, U.K: £19.95: 180×100 mm: pp. 496; ISBN-10: 0-19-852099-9; ISBN-13: 978-0-19-852099-3. This pocket-sized handbook has a stated aim of helping ...
International Anesthesiology Clinics: Selected Anesthetic Issues in High Risk Patients, Vol 43, Number 4
Jun 01, 2006; ... International Anesthesiology Clinics: Selected Anesthetic Issues in High Risk Patients, Vol 43, Number 4. A. Lindsey, M. D. Nelson; Lippincott Williams & Wilkins, 16522 Hunters Green Parkway, Hagerstown, MD, 21740-2116, U.S.A.; US$317; pp. 199; ISBN: 0020-5907. This volume is a good ...
Clinical Anesthesiology
Jun 01, 2006; ... Clinical Anesthesiology. G. F. Morgan, M. S. Mikhail, M. J. Murray; Lange Medical Books/McGraw Hill, McGraw-Hill Australia Pty Ltd, Locked Bag 2233, North Ryde, BCm N.S.W. 1670; $99.95; ISBN: 0-07-142358-3. This is a large volume with wide coverage of topics in anaesthesia. It includes ...
A View from the Head End, Medical cartoons to ease the pain
Jun 01, 2006; ... A View from the Head End, Medical cartoons to ease the pain, Steve Yentis; tfm Publishing Ltd, Castle Hill Barns, Harley, Shrewsbury, Shropshire, SY5 6LX, UK; $29.95 USD; 200×170 mm; pp. 128; ISBN: 1-903378-42-7. Members of the community, medical or otherwise, view a visit to the ...
Future Meetings
Jun 01, 2006; ... 2006 June 2-3. Madrid. Spain: 9th European Society for Intravenous Anaesthesia (EuroSIVA) Meeting. Venue: Hotel Hesperia, Madrid, Spain. Website: www.eurosiva.org June 3-6, Madrid, Spain: Euroanaesthesia 2006 - Annual Meeting of the European Society of Anaesthesiology ....
"The Anaesthetist" 1933-An Iconic Australian Medical Photograph
Jun 01, 2006; ... Key Words: anaesthesia, anaesthetist, history, photograph, Cazneaux SUMMARY Harold Cazneaux was the greatest Australian photographer of the early 20th century. In 1933, he took this image entitled 'The Anaesthetist'. It is an important documentation of a clinical anaesthetist of ...
Some Observations on Early Military Anaesthesia
Jun 01, 2006; ... Key Words: anaesthesia, history, military, equipment SUMMARY Although anaesthesia was discovered in 1846, pain relief had been used for many years previously. Opium, mandragora, and Indian hemp amongst others have been used since the earliest times as alluded to by many of the ...
Brian Dwyer and the St. Vincent's Pain Clinic 1962 to 1989
Jun 01, 2006; ... Key Words: pain clinic, history, St. Vincent's Hospital, Brian Dwyer SUMMARY Brian Dwyer was the Director of the Department of Anaesthetics at St. Vincent's Hospital in Sydney from 1955 to 1985. He developed a major interest in the management of intractable pain and was most ...
The Early Development of Intravenous Apparatus
Jun 01, 2006; ... Key Words: anaesthesia, history, equipment, intravenous, cannula SUMMARY Modem anaesthetists rely on the intravenous route for administration of drugs and fluids. This paper traces the development of intravenous equipment from the first, tentative experiments with the intravenous ...
The Introduction of Halothane into Clinical Practice: The Oxford Experience
Jun 01, 2006; ... Key Words: anaesthesia, halothane, history, Oxford, Nuffield Department SUMMARY This paper reviews the clinical situation in anaesthesia before the introduction of halothane into clinical practice in 1956, emphasising the limitations of agents available at the time. The ...
The Inventors
Jun 01, 2006; ... Key Words: anaesthesia, equipment, inventors, Australian SUMMARY Amongst Australian anaesthetists there have been many whose ingenuity and mechanical knowledge produced ingenious devices. Lidwill and Geoffrey Kaye come immediately to mind, and their contributions are ...
The Contribution of Newspapers and Their Advertisements to the History of Colonial Anaesthesia
Jun 01, 2006; ... Key Words: anaesthesia, history SUMMARY The first news to reach New Zealand about the beneficial effects of inhalation of ether during surgical operations arrived in Wellington on Sunday July 4 1847. This was 283 days after the first successful demonstration in Boston. The mail ...
Australia's First Anaesthetic Department-75 Years at the RPA
Jun 01, 2006; ... Australia's First Anaesthetic Department-75 Years at the RPA. Barry Baker; Jobson Foundation Incorporated, PO Box M6, Camperdown, N.S.W. 2050, Australia; $25; 150X210 mm; pp. 172; ISBN: 0-646-44555-3. This is a meticulously researched book and an interesting and most enjoyable read ....
Catalyst
Jun 01, 2006; ... Catalyst. Brown K.; Brolga Publishing, PO Box 12544, A'Beckett Street, Melbourne, Vic. 8006; $29.95; 230 x 150 mm; pp. 354; ISBN: 1-9207-8538-8. Kester Brown is an exceptional person, and this is an exceptional autobiography. He has covered a remarkable field, from the earliest ...