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- Volume 8, Issue 1, 2002
Southern African Journal of Anaesthesia and Analgesia - Volume 8, Issue 1, 2002
Volume 8, Issue 1, 2002
Source: Southern African Journal of Anaesthesia and Analgesia 8 (2002)More Less
Extracted from text ... EDITORIAL Southern African Journal of Anaesthesia & Analgesia - February 2002 1 The first issue of the Southern African Journal of Anaesthesia and Analgesia for 2002 contains articles on a variety of subjects relevant to anaesthesia and analgesia. We are delighted to publish papers written by the registrars who won prizes at the All Africa/SASA 2001 congress. The Research prize was won by Dr Niall Evans, whose valuable research on the intubating laryngeal mask airway, is published in this issue. The Communication prize was won by Dr Joanne Blanckenberg's fascinating overview of the Channelopathies. If your response to this ..
Author Lewis J. LevienSource: Southern African Journal of Anaesthesia and Analgesia 8, pp 4 –6 (2002)More Less
Extracted from text ... GUEST EDITORIAL 4 Haemoglobin Based Oxygen Carrier : Use in South Africa Lewis J Levien MB BCh FCS(SA) PhD(Med) FACS Milpark Hospital, Johannesburg proteins, red blood cell stroma, endotoxin, bacteria, viruses and the agents that are thought to cause transmissible spongiform encephalopathies such as bovine spongiform encephalopathy (BSE) and variant Creutzfeld- Jakob disease (vCJD). This process produces a sterile, pyrogen-free balanced salt solution containing glutaraldehyde cross linked bovine haemoglobin polymers, which range in size from 130 to 500 kd and have an average molecular weight of 250 kd. 3 , 4 The product's oxygen dissociation curve is right-shifted with ..
The intubating laryngeal mask produces less heart rate response to intubation than conventional laryngoscopy : research articleSource: Southern African Journal of Anaesthesia and Analgesia 8, pp 8 –12 (2002)More Less
We compared heart rate and blood pressure changes to intubation produced by conventional laryngoscopic-guided intubation to those produced by blind intubation through the intubating laryngeal mask (ILM) in normotensive adults with normal airways. Forty paralysed, anaesthetised adults undergoing elective surgery were randomly assigned to one of two groups : 1. Blind intubation through the ILM using a straight silicone tracheal tube manufactured for specific use with the ILM; 2. Intubation with a size 3 macintosh laryngoscope using a polyvinyl chloride tube. Intubation success rate, number of intubation attempts, time to intubation were recorded. Heart rate and non-invasive blood pressure preinduction, preintubation and at one minute intervals after intubation until ten minutes post intubation were recorded. The intubation success rate was 90% (68% first attempt) for the ILM group and 100% (all first attempt) for the laryngoscopic group. Time to successful intubation was longer (50 vs 22s) and more intubation attempts were required in the ILM group (p<0.0001). Changes from pre-intubation values showed a significantly lower heart rate response in the ILM group at 4 to 10 minutes post intubation (p<0.05). The ILM may have a role in managing the intubation response in patients where an increase in heart rate is associated with an increased risk, such as in patients with ischaemic heart disease.
Author Joanne M. BlanckenbergSource: Southern African Journal of Anaesthesia and Analgesia 8, pp 13 –16 (2002)More Less
What at first glance appears to be a random selection of widely differing clinical presentations and syndromes, has recently been found to have as their common underlying factor an inherited abnormality of the mechanism in the cell wall, the ion channel, which is responsible for the transmembrane passage of various ions. Included in this diverse array of diseases are malignant hyperthermia, long QT syndrome, myotonia congenita, Eaton Lambert syndrome, certain forms of migraine and epilepsy, as well as cystic fibrosis. The common pathophysiology in all these diseases is an inherited abnormality of the amino acid sequence of the complex protein structure from which the ion channel is composed. These ion channels are ubiquitous in the body, their expression is not restricted only to excitable cells such as neurons or myocytes, and they may be found in the external membrane as well as internal organelles of cells such as pancreatic and renal cells. Because each of these diseases is caused by a discrete abnormality of an ion channel protein, this diverse variety of clinical manifestations is grouped together and described as the channelopathies. In order to better understand the pathophysiology involved in each of the channelopathies, it is necessary to review the normal physiology of the individual ion channels themselves.
Source: Southern African Journal of Anaesthesia and Analgesia 8, pp 17 –22 (2002)More Less
Tobacco and alcohol remain the most abused substances in South Africa and elsewhere in the western world. Tobacco is commonly smoked, but in South Africa it is also "sniffed" as snuff, and if inhaled causes as much damage as inhaled tobacco smoke. There is also a high incidence of related cancer. Likewise people exposed passively to tobacco smoke may acquire smoking-related conditions such as coronary artery disease and asthma.
Author Robert S. WolfSource: Southern African Journal of Anaesthesia and Analgesia 8 (2002)More Less
Extracted from text ... COMMENTARY 24 Pain management in the outpatient surgical setting Robert S. Wolf MD American Sports Medicine Institute Birmingham, AL USA emptive and post-operative setting. These medications inhibit prostaglandin synthesis, promote analgesia, and consequently decrease the post-operative demand for opioids. This is beneficial as excess opioid use can result in significant morbidity in terms of gastrointestinal side effects, mental status changes, and potential for addiction. However, traditional non-steroidal anti-inflammatory drugs (NSAIDs) have side effects including platelet inhibition and gastric ulceration which may prevent their use in the pre-operative setting. Moreover, ketorolac is contraindicated before major operations due to the increased ..
Source: Southern African Journal of Anaesthesia and Analgesia 8, pp 26 –29 (2002)More Less
Extracted from text ... GUIDELINES 26 Guidelines for sedation-analgesia in children - conscious sedation - part 1 : guidelines deep sedation and general anaesthesia. The transition from one level to another is not finite and a child may pass easily from a light level of sedation to general anaesthesia. This is particularly evident in infants and young children and more likely when the painful stimuli, or the cause for discomfort, have been removed. This continuum is not drug specific since these various levels can be achieved with virtually all sedative agents and particularly when they are used in combination or with opiate analgesics. ..