A complication of intra-arterial shunting during carotid endarterectomy.
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Biomedical subjects
Publications and source records attributed to F A Millar.
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A patient is described who, despite severe pre-operative respiratory disability, had her persistent pneumothorax successfully managed by thoracoscopic pleurectomy. The technique causes considerably less pain and interference with respiratory function postoperatively than does conventional thoracotomy. Potential anaesthetic problems arise because of the necessity of insufflating carbon dioxide at pressures of up to 1 kPa to maintain a pneumothorax during surgery.
A randomised controlled study was undertaken to assess the analgesic efficacy of continuous lumbar plexus block for the first 48 hours after total knee replacement surgery. Boluses of 0.5% bupivacaine with adrenaline 1 in 200,000 (0.3 ml/kg) were administered through a cannula inserted into the neurovascular sheath of the femoral nerve. Thirteen patients who received this block required significantly less morphine than a control group of 16 patients. Pain scores were similar and there were no complications related to this technique.
Phosphoinositides of chick and rat retina were labelled with [3H]inositol. Exposure of retinal preparations to light for 30 s caused loss of labelled phosphatidylinositol 4,5-bisphosphate and to a smaller extent of the other phosphoinositides. Similar light-induced changes were seen when rod outer segment preparations were used and, when these were illuminated in calcium-free media, phosphatidylinositol 4,5-bisphosphate was the only lipid affected. No inositol 1,4,5-trisphosphate was seen after either 30 s or 5 s of illumination of retina or 30 s illumination of rod outer segments. It is concluded that this compound plays no direct part in vertebrate photoreceptor light transduction, though phosphoinositide metabolism might relate to adaptation mechanisms.
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BACKGROUND AND OBJECTIVES: There is debate regarding the use of central neural block in the presence of hemostasis-altering drugs. This study aims to examine current practice. METHODS: A survey was made of the members of the Scottish Society of Anaesthetists and the U.K. branch of the European Society of Regional Anaesthesia to determine the pattern of use of central neural block in patients who are receiving drugs known to alter hemostasis. RESULTS: Spinal anesthetics were considered safer than single epidural injections (P < .05) and single epidural injections safer than infusions via epidural catheters (P < .05). CONCLUSIONS: There is general agreement regarding contraindication of central neural block in the presence of full anticoagulation with either heparin or warfarin, but there is less consensus about the use of central neural block in the presence of low-dose subcutaneous heparin. There is some confusion about the role of aspirin and its duration of action.