Ropivacaine/unspecified spinal anaesthetic

Objective:Acquisition of a new range of skills occurs during first year anaesthesia training. At present, no defined logbook targets exist for the Irish anaesthesia trainee.The aim of this study was to quantify the number of practical procedures performed and supervision required during first year anaesthesia training.Methods:A retrospective analysis of prospectively maintained logbooks of three first year anaesthesia trainees was performed.Results:In the first three months, mean numbers of cases were 224, enodotrachael tube (ETT) 64, laryngael mask airway (LMA) 55, spinal anaesthetic 12, arterial lines 9.5, central lines 0.5, peripheral nerve blockade (PNB) 2, epidurals 0. There was 91.5% direct supervision and 8.5% indirect supervision.In the final three months, mean numbers of cases were 205.5, ETT 28, LMA 35, spinals 50, arterial line insertions 4.5, central line insertions 1.5, PNB 3.5, epidurals 80. There was 68.5% direct supervision and 31.5% indirect supervision.Conclusions:Defined logbook targets are needed to quantify trainee progress.

Download Full-text

The spinal anaesthetic effect of dextromethorphan, dextrorphan, and 3-methoxymorphinan

European Journal of Pharmacology ◽

10.1016/j.ejphar.2007.05.019 ◽

2007 ◽

Vol 569 (3) ◽

pp. 188-193 ◽

Cited By ~ 20

Author(s):

Yu-Wen Chen ◽

Yen-Chia Chen ◽

Ching-Nan Lin ◽

Chin-Chen Chu ◽

Mao-Tsun Lin ◽

...

Keyword(s):

Spinal Anaesthetic ◽

Anaesthetic Effect

Download Full-text

Spinal Anaesthesia—Early Australian Experience

Anaesthesia and Intensive Care ◽

10.1177/0310057x0503301s06 ◽

2005 ◽

Vol 33 (1_suppl) ◽

pp. 39-44 ◽

Cited By ~ 1

Author(s):

L. J. Mcbride

Keyword(s):

Lumbar Puncture ◽

Spinal Anaesthesia ◽

Cardiac Failure ◽

European Settlement ◽

Spinal Anaesthetic ◽

Communication Difficulties ◽

Land Mass ◽

Second Year ◽

Australian Experience ◽

The Town

Australia in 1902 was a fledgling colony in its second year of Federation with a population of around 3.7 million. European settlement had been largely confined to the coastal margins of this enormous land mass, although some bold adventurers in search of gold and farmland had struggled their way into the interior. Horsham, situated 300 km northwest of Melbourne in the state of Victoria, was founded in June 1849. By 1902 the town, with a population of around 2500, had grown to boast a hospital, two doctors, a pharmacist and a dentist. It was at the Horsham Hospital on January 7, 1902 that Dr Robert Ritchie performed Australia's first recorded spinal anaesthetic. Ritchie performed a lumbar puncture at the L3–4 level, injected 2 ml of 2% cocaine solution and waited for a total of 20 minutes before realising that the sensation the patient was feeling when he pinched him was pressure, not pain. The 78-year-old man with a gangrenous right leg, prostatic obstruction and congestive cardiac failure was laid supine, and had his right leg amputated through the thigh while being administered brandy and water. Strychnine injections were administered four hourly postoperatively. The adoption of the technique of spinal anaesthesia spread quickly in Australia despite communication difficulties at that time.

Download Full-text

Anæsthesia in Gynæcology

Proceedings of the Royal Society of Medicine ◽

10.1177/003591573302700201 ◽

1933 ◽

Vol 27 (2) ◽

pp. 105-112

Author(s):

H. P. Fairlie

Keyword(s):

Blood Pressure ◽

Pelvic Surgery ◽

Depth Of Anaesthesia ◽

Trendelenburg Position ◽

Safe Method ◽

Spinal Anaesthetic ◽

Group 2 ◽

Minor Operations ◽

Type Of Anaesthesia ◽

Group 1

The operations of gynæcology are divided into two classes: (1) Minor: including perineal repairs, colporrhaphies, vaginal hysterectomies, dilatations and curettings, etc., and (2) Major: abdominal sections. For both groups routine premedication is a combination of morphia and nembutal, the former in ⅙-grain, and the latter in 3-grain doses. For Group 1 three methods of anæsthesia are described: ( a) Ethylene and oxygen, producing in nearly all cases an adequate depth of anæsthesia without the addition of ether. A safe type of anæsthesia and one from which recovery takes place quickly. ( b) Planocaine in 20% solution, made up with sodium bisulphate, as a spinal anæsthetic, described by Mr. Dickson Wright. The dose usually injected is 0·5 c.c. ( c) Sodium evipan given intravenously, though rather uncertain in action seems to serve well for such minor operations as curettage and insertion of radium. In Group 2 (major operations), the author's choice is between ( a) ether administered with a little additional oxygen to counteract the asphyxial tendency which the Trendelenburg position occasions, and ( b) spinal anæsthesia with percaine. For intra-abdominal pelvic surgery the latter is a very safe method for two reasons: (1) The dose required is comparatively small, and (2) the Trendelenburg position helps materially to prevent the fall of blood-pressure which a spinal anæsthetic tends to produce.

Download Full-text