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  • 1
    Electronic Resource
    Electronic Resource
    Laryngotracheal stenosis: a serious complication of percutaneous tracheostomy (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 49 (1994), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Tracheostomy in patients requiring prolonged artificial ventilation in intensive care is increasingly being performed by a percutaneous dilatational technique, in preference to the standard surgical method. Since its introduction numerous series have reported favourably on its general safety in the short-term, but there have been few reports of longer term follow-up of patients. We present four cases of laryngotracheal stenosis, a previously unreported complication associated with the technique, and discuss the relevance of these to the future practice of percutaneous tracheostomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1994.tb03311.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    A comparison of propofol and midazolam by infusion to provide sedation in patients who receive spinal anaesthesia (1988)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 43 (1988), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Twenty patients scheduled for orthopaedic surgery under spinal anaesthesia received by intravenous infusion either 1% propofol or 0.1% midazolam at a rate adjusted to maintain adequate sedation as judged on a five-point scale. No other anaesthetic or analgesic drugs were given. The mean time to reach the required level of sedation was similar in both groups and the quality and ease of control of sedation were good in all patients. Mean infusion rates were 3.73 mg/kg/hour for propofol and 0.27 mg/hg/hour for midazolam. Airway maintenance was excellent and there were no side effects other than restlessness of the arms in one patient in each group. Recovery, judged by ability to open the eyes and recall date of birth, was significantly more rapid after propofol than after midazolam (2 and 10 minutes respectively after the end of infusion) and two patients in the latter group were unduly drowsy in the initial postoperative period. Pre- and postoperative amnesia were greater in the midazolam group but no patient had recall of peri-operative events. Psychometric tests showed significantly better recovery of higher mental function after propofol for up to 2 hours after surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1988.tb09084.x
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  • 3
    Electronic Resource
    Electronic Resource
    Drug dilution in anaesthetic practice (1985)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 40 (1985), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The accuracy of dilution by anaesthetists of commonly used drug preparations was assessed by ultra violet spectrophotometric assay of the diluted drugs. Percentage deviation from target concentrations was then calculated. Of a total of 358 drug dilutions carried out by 28 anaesthetists only 58% were within 10% of the target concentration while 6% lay outside 50% of the target concentration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1985.tb10760.x
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  • 4
    Electronic Resource
    Electronic Resource
    Continuous subcutaneous infusion of morphine for postoperative pain relief (1985)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 40 (1985), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A double-blind randomised study of 48 patients in whom continuous subcutaneous infusion and regular intramuscular injection of morphine were compared as analgesic regimens after upper abdominal surgery, is described. Over a 48-hour period, no difference in pain intensity between the two groups was found by comparing linear analogue scores, assessments on a four-point rank scale, peak expiratory flow rates or requirement for additional analgesia. Nausea and sedation were assessed using a four-point rank scale. These side effects were less frequent with subcutaneous infusion (p〈0.05). Two patients from each group were judged to have received an overdose. The infusion apparatus was simple and convenient to use. Continuous subcutaneous infusion of morphine is a practical and effective means of achieving postoperative analgesia but, as with other mandatory dosing regimens, relative overdosage may occur.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1985.tb10607.x
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  • 5
    Electronic Resource
    Electronic Resource
    The relationship of blood lactate concentrations, oxygen delivery and oxygen consumption in septic shock and the adult respiratory distress syndrome (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Tissue hypoxia is thought to be pivotal to the development of multiple organ failure, but cannot be measured directly in clinical practice. We assessed the relationship between initial arterial blood lactate concentrations and the presence of the phenomenon of delivery-dependent oxygen consumption, both of which may indicate tissue hypoxia. Twenty-three critically ill patients with septic shock and adult respiratory distress syndrome were studied prospectively and allocated to one of two groups according to blood lactate concentrations. In group 1, blood lactate concentration was less than the level widely accepted as significant (2 mmol.l−1); in group 2, the concentration exceeded 2 mmol.l−1. In both groups, resuscitation with colloid, blood and vasoactive drugs resulted in significant increases in oxygen delivery; in group 1 (n = 13), mean (SEM) oxygen delivery increased from 484 (36) to 730 (44) ml.min−1.m−2 (p 〈 0.005) and in group 2 (n = 10) from 550 (54) to 780 (54) ml.min−1.m−2 (p 〈 0.05). In neither group was there a significant change in oxygen consumption. However, there were individuals in both groups who exhibited pathological delivery dependence. This suggests that the absence of hyperlactataemia does not preclude delivery dependence of oxygen consumption with the attendant potential for tissue hypoxia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1992.tb04194.x
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  • 6
    Electronic Resource
    Electronic Resource
    Propofol infusion for control of status epilepticus (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Two patients with status epilepticus who were resistant to conventional treatment but responded to propofol infusions are reported. An electroencephalogram confirmed the seizures and their successful treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1990.tb14884.x
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  • 7
    Electronic Resource
    Electronic Resource
    Propofol for induction of anaesthesia in children (1988)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 43 (1988), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The induction characteristics, dosage requirements, cardiovascular and respiratory effects of propofol with added lignocaine were compared with those of thiopentone and halothane inhalational induction in two groups of children aged 1–5 years and 5–10 years. Propofol induction produced significantly greater decreases in blood pressure, particularly in the 1–5-year age group. Heart rate was maintained well with all three induction techniques. Pain on injection into a vein on the dorsum of the hand was significantly more common with propofol despite the addition of lignocaine. However, this was mild in the majority of children and did not interfere with the induction of anaesthesia. The incidence of respiratory depression and other adverse effects was low with all three induction methods. The mean induction doses of both intravenous agents were greater in the 1–5-year age group. The ratio of thiopentone to propofol dose was approximately 2.5:1 in both age groups. The high incidence of pain on injection with propofol may prove to be a significant drawback to its otherwise satisfactory use in children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1988.tb09010.x
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  • 8
    Electronic Resource
    Electronic Resource
    Persistent pneumothorax treated with continuous positive airway pressure (1987)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 42 (1987), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A patient who presented with persistent pneumothorax after blunt chest trauma is described. The lung re-expanded partially in response to chest drain suction but some areas remained collapsed. The institution of continuous positive airway pressure on an intermittent basis, was followed by complete re-expansion of the lung and resolution of the pneumothorax.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1987.tb05372.x
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  • 9
    Electronic Resource
    Electronic Resource
    Haemodynamic and oxygen transport effects of propofol infusion in critically ill adults (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 49 (1994), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effects of a sedative infusion of propofol on haemodynamics and oxygen transport were examined in critically ill adult patients. Ten patients receiving mechanical ventilation for treatment of septic shock and respiratory failure were given a decreasing rate propofol infusion designed to achieve and maintain a stable sedation level. Full cardiovascular and oxygen transport variables, arterial blood lactate concentrations and sedation scores were measured before infusion and at 1, 3 and 6 h after starting the infusion. There were significant reductions in mean (SEM) heart rate (97.3(2.9) to 85.7(3.9) beat.min-1 p 〈 0.05), mean arterial pressure (87.6(3.7) to 76.2(4.1)mmHg p 〈 0.05) and systemic vascular resistance index (1461(137) to 1327(141) dyne.s.cm-5.m-2 p 〈 0.05), with no significant change in cardiac filling pressures. There were no significant changes in cardiac output, oxygen delivery, oxygen consumption or arterial blood lactate concentrations. Controlled propofol sedation is well tolerated in appropriately monitored and resuscitated critically ill adult patients, and appears to have no major effects on whole-body oxygen transport.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1994.tb03517.x
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  • 10
    Electronic Resource
    Electronic Resource
    Propofol for intravenous sedation (1987)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 42 (1987), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This study investigated the properties of propofol when given by subanaesthetic infusion to provide sedation as an adjunct to spinal anaesthesia for lower limb surgery in 40 patients. Sedation, defined as sleep with preservation of eyelash reflex and purposeful reaction to verbal or mild physical stimulation, was satisfactorily achieved and maintained with minimal complications. The mean duration of infusion was 98 minutes and a mean infusion rate of 3.0 mg/kg/hour was required in patients over 65. This was significantly less (p 〈 0.005) than the 4.1 mg/kg/hour required in younger patients. Recovery was impressively rapid; patients regained full consciousness approximately 4 minutes after the end of infusion, and were free from minor postoperative sequelae. Conversion to general anaesthesia was achieved in three patients where surgery encroached outside the analgesic field of the regional block, simply by increasing the infusion rate to approximately 10 mg/kg/hour.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1987.tb02936.x
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