ABSTRACT
Induction of anaesthesia in children in the age group 2-6 years is a special challenge. In order to minimise emotional and physical stress during induction of anaesthesia by gas inhalation, a toy telephone has been modified to deliver induction gases to the mouthpiece while taped nursery stories can be heard from a small speaker placed in the earpiece. The child holds the hand set and listens to a suitable story, while appropriate concentrations of inhalation agents are adjusted inconspicuously.
Subject(s)
Anesthesia, Inhalation/instrumentation , Psychology, Child , Child , Child, Preschool , Humans , Play and Playthings , Stress, Psychological/prevention & controlABSTRACT
Intravenous anaesthesia with a combination of ketamine (Ketalar) and midazolam (Dormicum) infusions was administered to a 49-year-old patient, with a documented history of opiate allergy, undergoing coronary artery bypass surgery. A ketamine infusion supplemented with indomethacin suppositories was used for postoperative pain control.
Subject(s)
Anesthesia, Intravenous , Coronary Artery Bypass , Ketamine , Midazolam , Drug Hypersensitivity , Humans , Intraoperative Care , Ketamine/administration & dosage , Male , Midazolam/administration & dosage , Middle Aged , Pain, PostoperativeSubject(s)
Anesthesia, Inhalation/instrumentation , Child , Child, Preschool , Equipment Design , Humans , Play and Playthings , TelephoneABSTRACT
A technique of neurolept anaesthesia using etomidate (Hypnomidate; Janssen) instead of nitrous oxide is described in which a continuous infusion of 1 mg/kg/h is used to supplement droperidol, fentanyl and alcuronium. This totally intravenous technique eliminates theatre pollution, may offer haemodynamic stability and may be of use in patients with raised intracranial pressure. Pain on injection and muscle movements which occur with etomidate administration do not detract from the value of this technique.
Subject(s)
Anesthesia, Intravenous/methods , Etomidate , Adolescent , Adult , Age Factors , Aged , Anesthesia Recovery Period , Body Weight , Female , Fentanyl , Humans , Male , Middle Aged , Time FactorsSubject(s)
Anesthesia, Obstetrical/methods , Anesthesia, Spinal/methods , Cesarean Section , Morphine , Female , Humans , PregnancyABSTRACT
Medical gases can be identified simply if they are supplied at different pipeline pressures. Routine maintenance errors, accidental pipeline cross-connections, or gas failures, can be automatically detected by incorporating a pneumatic unit with pressure-sensitive valves into the anaesthetic machine. A fail-safe method of ensuring the delivery of the correct gases to the patient is described.
Subject(s)
Equipment and Supplies, Hospital , Anesthesia, Inhalation/instrumentation , Equipment Safety , Gases , Maintenance and Engineering, Hospital , PressureABSTRACT
Thirty-six consecutive patients who had undergone major surgery were carefully studied for 6 hours postoperatively in an attempt to evaluate the relative analgesic and respiratory-depressant effect of morphine, ketamine, and placebo administered by continuous intravenous infusion. Side-effects, vital signs and respiratory measurements were recorded hourly by a consultant physician. With regard to the dosage and method of administration, ketamine was shown to be less effective than morphine for the first 3 hours postoperatively, but equally effective subsequently, whereas the patients who received ketamine showed a greater progressive tendency for their respiratory parameters to improve with time. Recommendations regarding the postoperative control of pain are made, and the need for further study is noted.
