ABSTRACT
Potentially hazardous noise levels are generated in the course of major orthopaedic surgery. The risk to staff is probably real but very small. We used a sound level meter to record maximum and mean levels and found peak values which exceeded 100 dB(A). If sustained, there is a possibility of significant inner ear damage and perhaps permanent troublesome tinnitus, especially among elderly and already hearing-impaired patients. This could be eliminated by the use of ear defenders or disposable earplugs.
Subject(s)
Environmental Exposure , Environmental Exposure/adverse effects , Hearing Loss, Noise-Induced/etiology , Noise/adverse effects , Operating Rooms , Orthopedic Procedures , Adolescent , Adult , Aged , Aged, 80 and over , Anesthesia, General , Environmental Exposure/analysis , Environmental Monitoring/methods , Female , Humans , Male , Middle Aged , Risk AssessmentSubject(s)
Anesthetics, Combined/administration & dosage , Anesthetics, Local/administration & dosage , Lidocaine/administration & dosage , Pain/prevention & control , Phlebotomy/adverse effects , Prilocaine/administration & dosage , Tetracaine/administration & dosage , Adolescent , Adult , Aged , Aged, 80 and over , Drug Administration Schedule , Female , Humans , Lidocaine, Prilocaine Drug Combination , Male , Middle AgedABSTRACT
Bone injury while undergoing electro-convulsive therapy is thought to be rare. We report a case of hip fracture during treatment which was associated with osteoporosis. Patients at increased risk could be identified.
Subject(s)
Electroconvulsive Therapy/adverse effects , Femoral Neck Fractures/etiology , Aged , Antidepressive Agents/therapeutic use , Arthroplasty , Depressive Disorder/drug therapy , Depressive Disorder/therapy , Female , Femoral Neck Fractures/surgery , Humans , Osteoporosis/complicationsSubject(s)
Laryngeal Masks/adverse effects , Pharyngitis/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
The incidence of sore throat after the use of the laryngeal mask was assessed with a randomized trial in 839 patients. Sore throat occurred more often in women, older patients or after multiple insertion attempts. It was found that the frequency in women, but not in men, was lowered from 11.9% to 3.9% (P = 0.012) by reducing intracuff pressure to the minimum required for an effective seal.
Subject(s)
Intubation, Intratracheal/adverse effects , Laryngeal Masks , Pharyngitis/etiology , Pharyngitis/prevention & control , Adolescent , Adult , Aged , Aged, 80 and over , Double-Blind Method , Female , Humans , Male , Middle Aged , Risk FactorsSubject(s)
Laryngeal Masks/adverse effects , Pharyngitis/etiology , Adult , Humans , Pressure , Sex FactorsABSTRACT
Irrigation of the bladder after transurethral resection of the prostate is often distressing because of pain arising from detrusor muscle spasm. The effect of post-operative oral diazepam was compared with sacral epidural (caudal) block at the time of surgery, both treatments together and a control group, assessed by three-point rank scoring. Either treatment significantly reduced the incidence of pain reported by patients, P < 0.001. No patient experienced pain after both treatments.
Subject(s)
Analgesics, Non-Narcotic/therapeutic use , Diazepam/therapeutic use , Pain, Postoperative/drug therapy , Prostatectomy , Urinary Bladder Diseases/drug therapy , Aged , Aged, 80 and over , Analgesia, Epidural , Anesthetics, Local , Bupivacaine , Double-Blind Method , Humans , Male , Middle AgedABSTRACT
General anaesthesia for a patient with tuberous sclerosis was complicated by epilepsy. The choice of drugs was related to control of his fits and intercurrent therapy. Thiopentone, vecuronium, and nitrous oxide with isoflurane were satisfactory.
Subject(s)
Anesthesia, Dental , Anesthesia, General , Dental Prophylaxis , Tooth Extraction , Tuberous Sclerosis , Adult , Anesthetics, Inhalation/administration & dosage , Anesthetics, Intravenous/administration & dosage , Dental Care for Chronically Ill , Epilepsy/physiopathology , Humans , Isoflurane/administration & dosage , Male , Neuromuscular Blockade , Neuromuscular Nondepolarizing Agents/administration & dosage , Nitrous Oxide/administration & dosage , Thiopental/administration & dosage , Tuberous Sclerosis/physiopathology , Vecuronium Bromide/administration & dosageABSTRACT
Many adults are distressed by painful investigations or treatment, including venepuncture. The early effects of Eutectic Mixture of Local Anaesthetics (EMLA) 5%, on relief of pinprick pain in the antecubital area was investigated and compared with EMLA plus glyceryl trinitrate and with a placebo cream in 100 patients. Topical analgesia after application of EMLA developed within 5 min in 69% and within 10 min in 83% of those tested, significantly different from placebo, (P = 0.01).
Subject(s)
Analgesia , Anesthetics, Local/pharmacology , Lidocaine/pharmacology , Nitroglycerin/pharmacology , Prilocaine/pharmacology , Vasodilator Agents/pharmacology , Adolescent , Adult , Aged , Aged, 80 and over , Double-Blind Method , Drug Combinations , Female , Humans , Lidocaine, Prilocaine Drug Combination , Male , Middle Aged , Time FactorsSubject(s)
Analgesia/methods , Anesthetics, Local , Lidocaine , Phlebotomy , Prilocaine , Drug Combinations , Humans , Lidocaine, Prilocaine Drug Combination , OintmentsABSTRACT
The effect of topical anaesthesia on the discomfort caused by insertion of nasogastric tubes in conscious patients was assessed. An intra-nasal spray of 4% lignocaine significantly reduced the distress experienced without any increase in difficulty (P < 0.01).
