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Biomedical subjects

R I Keen

Publications and source records attributed to R I Keen.

9 recordsLinked to original sources

Mood and cognitive functions in anaesthetists working in actively scavenged operating theatres.

Twenty-two anaesthetists participated in a study to assess the influence of occupational exposure to anaesthetic agents on mood (arousal and stress) and cognitive functions. In a cross-over design, each anaesthetist worked one day in a reference facility (for example, intensive care) and another day in a scavenged operating theatre where time-weighted exposure averaged nitrous oxide 58 p.p.m. and halothane 1.4 p.p.m. The results showed that arousal scores reached a peak in the middle of the theatre day, but this appeared to reflect the nature of operating theatre work rather than exposure. Reports of stress were also unaffected by exposure, although higher scores were associated with longer and more demanding work. Similarly, there was no evidence that exposure impaired performance of tasks assessing syntactic and semantic reasoning, verbal and spatial memory, sensory-motor reaction time and attention. Performance in these tasks was, however, sensitive to the cognitive demands of the tasks and to naturally varying non-exposure factors. It is concluded that, compared with the reference condition, the concentrations of anaesthetic agents found in actively scavenged operating theatres have no detrimental effect on either the mood or the cognitive functions of anaesthetists.

Adult↗

Morbidity and early retirement among anaesthetists and other specialists.

An historically prospective study of the rates of early retirement due to permanent ill health, early retirement between 60 and 64 years of age for other reasons, and deaths while in post, among consultant anaesthetists in England was carried out. The control group comprised consultants in four other hospital specialty groups. Approximately two-thirds of all consultants employed in the five specialties at National Health Service hospitals in England during 1966-83 were included in the study. Ill-health retirements among male anaesthetists were more than twice those expected on the basis of rates in the control group (p less than 0.001). The number of other early retirements between 60 and 64 was a third higher than expected (p less than 0.005). The number of deaths in post was also raised. For the smaller group of female anaesthetists there was not a statistically significant excess of ill-health retirements, but the number of early retirements between 60 and 64 was significantly greater than expected (p less than 0.005), as was the number of deaths in post (p less than 0.001). Possible causes of these excesses are discussed.

Adult↗

Myasthenia gravis and atracurium. A case report.

The degree, duration of and recovery from neuromuscular blockade induced by atracurium in a patient with myasthenia gravis were monitored and recorded using the evoked compound muscle action potentials (EMG). The anaesthetic and perioperative management were simplified by the use of this technique. The significance of the behaviour of atracurium is discussed.

Action Potentials↗

Anaesthesia for microsurgery of the larynx.

The anaesthetic requirements for microsurgery of the larynx are described and techniques in frequent use reviewed. A method involving the Coplans nasotracheal cuffed tube and using controlled ventilation is described and its advantages detailed. The illustrations and blood gas measurements support the authors' view that this technique is the most satisfactory at present available.

Anesthesia, General↗