Abstract:
:Some patients with high cervical spinal cord injury are largely or completely dependent on mechanical ventilator support. Diaphragmatic phrenic nerve pacing is a new technique that offers some patients greater independence from mechanical ventilation. In selected patients, electrodes are placed on the abdominal side of the diaphragm via laparoscopy. An external pacing box provides the pacing stimulus. We report our experience with four patients with spinal cord injury in a pilot project, presenting for laparoscopic insertion of diaphragmatic phrenic nerve pacing leads inserted. The surgery took about two hours and diaphragmatic mapping precluded muscle relaxants. We used desflurane with remifentanil for maintenance. Apart from transferring the patients to and from their usual ventilators, other anaesthesia issues were difficult venous and arterial access for lines and long-term tracheostomies with no cuff or cuffs filled with water While hypotension was a frequent problem, one patient also developed intraoperative hypertension secondary to autonomic dysreflexia. Preoperative testing predicted pacing outcome with three of the four patients having successful pacing with tidal volumes of up to 10 ml/kg at the end of surgery. This initial Australian experience may lead to greater use of the technique.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Story D,Mariampillai E,Nikfarjam M,Howard M,Nunn A,Onders Rdoi
10.1177/0310057X1003800418subject
Has Abstractpub_date
2010-07-01 00:00:00pages
740-3issue
4eissn
0310-057Xissn
1448-0271pii
20091005journal_volume
38pub_type
杂志文章abstract::Three volatile anaesthetic agent monitors (Datex Normac Anesthetic Agent Monitor, Engstrom Emma Multigas Monitor and Penlon Halothane Meter) were evaluated for the effects of nitrous oxide or water vapour, and for their linearity, stability, and rate of response to a change in concentration of various anaesthetic agen...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8601400419
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abstract::Neuromuscular blocking agents are often avoided in anticipated difficult airway scenarios. However to facilitate jet ventilation, muscle relaxants are useful. We report a case of a potentially threatened airway in a 21-year-old with a large infraglottic pedunculated polyp. In this case rocuronium was used on induction...
journal_title:Anaesthesia and intensive care
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doi:10.1177/0310057X1003800226
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abstract::Objective assessment of the results of surgical sympathectomy and sympathetic block (both temporary and permanent) are not widely practised. This article comments briefly on the available methods, and describes the use of the abolition of the skin potential response (formerly known as the psychogalvanic reflex) to ass...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7900700408
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abstract::The occurrence of ventricular fibrillation after aortic de-clamping during cardiac surgery is common, and if prolonged may contribute to myocardial ischaemia. The use of lignocaine cardioplegia to minimize reperfusion ventricular fibrillation was studied in 141 patients undergoing first time coronary artery surgery in...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X9402200420
更新日期:1994-08-01 00:00:00
abstract::The sub-Tenon's technique uses blunt dissection and a blunt probe to inject local anaesthetic into the posterior sub-Tenon's space. This avoids the potentially catastrophic complications which result from passing a sharp needle blindly into the orbit and retrobulbar space. The anatomy of Tenon's capsule and the block ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9602400217
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abstract::EMLA cream (Astra Pharmaceuticals) which contains lignocaine and prilocaine, is widely used in a thick layer to reduce the pain associated with venepuncture. Application of smaller amounts of cream lowers cost and may reduce side-effects. The efficacy of a thick layer (using 2.0 ml) and a thin layer (using 0.5 ml) of ...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X9101900305
更新日期:1991-08-01 00:00:00
abstract::A computer controlled ventilation system was employed to maintain a constant end-expired CO2 percentage (FECO2) during a series of studies on young dogs aimed at measuring brain temperature differences during surface cooling hypothermia. The conclusion is that an FECO2 of six per cent or more is desirable if brain tem...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7600400107
更新日期:1976-02-01 00:00:00
abstract::The aim of the study was to calculate the in vitro inspiratory resistance (R(ETT)) of adult endotracheal tubes (ETT), via the end-inspiratory occlusion method, and to apply this method in vivo in order to estimate R(ETT) value in real time. By plotting R(ETT) over inspiratory flow (V) and calculating Rohrer's coeffici...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1103900311
更新日期:2011-05-01 00:00:00
abstract::We report a case of a 15-year-old male who developed severe left-sided hemiplegia and hemi-sensory loss 20 minutes after arrival in post anaesthetic care unit following an uneventful general anaesthesia for removal of a cannulated screw of left hip. Initial CT and MRI/MRA with diffusion-weighted imaging were unremarka...
journal_title:Anaesthesia and intensive care
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doi:10.1177/0310057X0703500318
更新日期:2007-06-01 00:00:00
abstract::Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk-benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperativ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X20960734
更新日期:2020-11-01 00:00:00
abstract::The Western Australian Anaesthetic Mortality Committee has collected data since 1980. During this time, reporting of anaesthesia mortality has been mandatory in Western Australia, confidentiality and legal protection have been ensured, consistent definitions and classifications have been used, and reasonable estimates...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0503300511
更新日期:2005-10-01 00:00:00
abstract::We present a technique of retrosternal block for symptomatic treatment for dyspnoea of various aetiologies. In our experience with 20 patients, a retrosternal block using lignocaine improved symptoms within minutes. The block was easy to perform and was helpful when the patients' symptoms were not relieved by conventi...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0503300420
更新日期:2005-08-01 00:00:00
abstract::A review of the medical records from two public hospitals in Sydney was undertaken to determine the incidence of this uncommon complication. Twenty-seven cases of uterine rupture were reported out of 31,115 deliveries with an incidence of 0.086% (versus 0.05% in the current literature). The incidence associated with p...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9602400612
更新日期:1996-12-01 00:00:00
abstract::Analgesia below the knee can be achieved by blocking the tibial nerve and the common peroneal nerve in the popliteal fossa, and the saphenous nerve adjacent to the knee. The anatomy and technique of nerve block in the popliteal fossa is described, the nerve being located prior to blockade using a peripheral nerve stim...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8401200103
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abstract::Chlormethiazole ethanedisulphonate (Hemineurin) was administered to provide light sedation in patients undergoing surgery with neural blockade. A two stage intravenous infusion system was used and consisted of a loading dose 1520 mg over 30 minutes followed by a maintenance rate of 10 mg/min for the desired period. Pa...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8000800405
更新日期:1980-11-01 00:00:00
abstract::The provision of optimal analgesia after caesarean section remains a challenge as satisfactory pain relief must be combined with patient satisfaction, including the ability to care for the newborn. In a prospective study of 132 patients, we have compared epidural analgesia with intravenous patient-controlled analgesia...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,更正并重新发布的文章,杂志文章,随机对照试验
doi:10.1177/0310057X9302100537
更新日期:1993-10-01 00:00:00
abstract::Difficulties in positioning Robertshaw tubes have been reviewed in a retrospective and a prospective series. Pre-operative cheat X-rays did not help in predicting difficulties. The performance of the Robertshaw tube was carefully recorded for each malposition in the prospective series, and the relationship of the malp...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7500300404
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abstract::In order to introduce the technique of epidural narcotics for pain relief in Papua New Guinea, fifty patients were given low doses of epidural morphine and thereupon the quality of analgesia and morbidity evaluated. The lowest effective epidural morphine dose was determined by considering the patient's characteristics...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8901700315
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abstract::The efficacy of the McCoy laryngoscope, external laryngeal pressure, and their combination to improve the laryngoscopic view was evaluated in 219 patients and compared with the Macintosh laryngoscope. An experienced laryngoscopist performed laryngoscopy twice using the Macintosh laryngoscope and the McCoy laryngoscope...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
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abstract::Frailty assessment in patients admitted to intensive care is often limited using traditional clinical frailty assessment tools. Opportunistic use of contemporary computed tomography (CT) can provide an objective estimate of low skeletal muscle mass (sarcopenia) as a proxy for frailty. The aim of this study was to esta...
journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
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journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8201000105
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abstract::The pre- and postoperative effects of oral diazepam (0.5 mg/kg), trimeprazine (4 mg/kg), pentobarbitone (3 mg/kg) and a placebo were compared in a randomized double-blind clinical trial in 149 children, aged one to ten years, undergoing adenotonsillectomy. The anaesthetic was standardised and each patient received int...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Anaesthesia and intensive care
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abstract::An elevated serum lactate level is associated with morbidity and mortality in patients with severe sepsis and septic shock. In patients with hepatic dysfunction, however an elevated serum lactate level may be due to either impaired lactate clearance or excessive production. Thus, we evaluated whether the initial serum...
journal_title:Anaesthesia and intensive care
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abstract::Talc is the most frequently used chemical agent to induce pleurodesis and complications after this procedure, usually benign and self-limiting, are resolved easily. Pneumonitis with acute respiratory distress after talc pleurodesis is a rare complication, it requires intensive treatment and may be fatal. We describe a...
journal_title:Anaesthesia and intensive care
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abstract::In this study we investigated in vitro and in vivo effects of propofol in malignant hyperthermia susceptible (MHS) patients in order to assess the safety of propofol infusion as a non-triggering anaesthetic technique for diagnostic and therapeutic procedures. In vitro, human MHS muscle samples were exposed to propofol...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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更新日期:1995-12-01 00:00:00
abstract::Normal saline or air is used to identify loss of resistance during identification of the epidural space for combined spinal-epidural analgesia. Following epidural needle placement using air for loss of resistance, up to 80% of parturients move, grimace, vocalise or experience paraesthesia or dysaesthesia during subseq...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1003800608
更新日期:2010-11-01 00:00:00
abstract::Pancuronium and a continuous infusion of althesin was used to produce muscular relaxation in a patient with myotonic dystrophy. Excellent muscle relaxation with absence of percussion or surgically induced myotonia was obtained but the EMG was not modified; an intracellular site of action of althesin is postulated. Car...
journal_title:Anaesthesia and intensive care
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更新日期:1977-02-01 00:00:00