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Biomedical subjects

R J Eltringham

Publications and source records attributed to R J Eltringham.

At least 19 recordsLinked to original sources

A comparison of glyceryl trinitrate and labetalol as hypotensive agents in microsurgery of the middle ear.

Ninety-five patients undergoing microsurgery of the middle ear were anaesthetised using thiopentone, nitrous oxide, oxygen and halothane via a low flow circle system, with carbon-dioxide absorption. Systolic blood pressure was reduced to approximately 65 mmHg either by the use of increments of labetalol, or by an infusion of glyceryl trinitrate (GTN). The degree of haemostasis achieved was assessed by the surgeon who was unaware which hypotensive agent was being used. Both hypotensive agents produced good conditions in all patients. Thus GTN is a suitable agent to induce hypotension for this type of microsurgery.

Adolescent

Rational fluid therapy during surgery.

Administration of intravenous fluids during surgery is commonplace, yet there is enormous variation in the type and quantity of fluid given. That so few problems have been encountered is testimony to the body's ability to deal with extreme variations in hydration. A considerable amount of research would be required to achieve a rational approach to fluid balance in every patient; some guidelines can, however, be provided.

Body Fluid Compartments

Hypotensive anaesthesia for microsurgery of the middle ear. A comparison between isoflurane and halothane.

Fifty patients undergoing microsurgery of the ear were anaesthetised using thiopentone, nitrous oxide, oxygen and either halothane or isoflurane, via a low flow circle system with carbon dioxide absorption. Systolic blood pressure was reduced to approximately 70 mmHg by the additional use of increments of labetalol; the patients breathed spontaneously. The degree of haemostasis was assessed by the surgeon who was unaware which volatile agent was being used to supplement anaesthesia. Isoflurane, although it is a potent vasodilator produced operating conditions which were indistinguishable from halothane. Isoflurane is thus a safe and reliable alternative to halothane as a volatile agent used to supplement anaesthesia when using induced hypotension for middle ear surgery.

Adolescent

Anaesthetic management of the morbidly obese.

The problems associated with obesity are brought into sharp focus at the time of a surgical operation. The anaesthetist has a major role to play in preventing serious complications and must be aware of the many potential hazards. Extra vigilance is required to guide these patients safely through the perioperative period.

Adult