Occlusion of endotracheal tubes by the distended cuff.
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Biomedical subjects
Publications and source records attributed to D L Orr.
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After any patient who is to receive a local anesthetic has given informed consent about the possibility of broken instruments, the practitioner should carefully prepare the patient and instrumentation for a successful anesthetic. If a needle does break and cannot be immediately removed, the practitioner should not try to retrieve it. The patient should be referred to a knowledgeable specialist familiar with the detailed anatomy of the head and neck and the surgical removal of foreign bodies from the same.
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Three topical anesthetics and a placebo were compared in 102 separate trials. The degree of anesthesia produced with each agent was determined by placing a needle in the palate near the palatal foramen. Pain produced was rated by the participants on a scale from 1 to 5.
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A mould which was isolated from a solution of paracetamol was identified as a Penicillium species and was found to possess the ability to utilise a series of substituted acetanilides, including paracetamol (4-hydroxyacetanilide), phenacetin (4-ethoxyacetanilide) and metacetamol (3-hydroxyacetanilide) as sole carbon sources for growth. Studies with washed-cell suspensions indicated that growth of the Penicillium isolate in the presence of paracetamol induced the respective enzyme systems for the degradation of this compound. Manometric studies measuring oxygen uptake rates, indicated that the mould was capable of degrading paracetamol to acetate and 4-aminophenol. Acetate was further metabolised whilst 4-aminophenol accumulated in the growth medium and was subsequently i-entified by UV spectroscopy and thin-layer chromatography. Similar experiments with phenacetin indicated metabolism by the mould to acetate and 4-ethoxyaniline which was isolated and identified by subsequent analysis of the growth medium. However, unlike 4-aminophenol and 4-ethoxyaniline, the degradation product (3-aminophenol) from metacetamol metabolism was further degraded by the mould.
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