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Biomedical subjects

R E John

Publications and source records attributed to R E John.

5 recordsLinked to original sources

Propofol infusion vs thiopentone/isoflurane anaesthesia for prominent ear correction in children.

Postoperative nausea and vomiting (PONV) frequently follows prominent ear correction under general anaesthesia in children. In a prospective, single-blind study, we compared the incidence of PONV after propofol infusion anaesthesia with that following thiopentone induction and isoflurane maintenance in 30 children aged from four to 14 years randomly allocated to one of two groups. All the children were mechanically ventilated. Anaesthesia was supplemented in both groups with nitrous oxide and infiltration of the ears using a mixture of bupivacaine, adrenaline, and hyaluronidase. One child receiving propofol (group P) complained of nausea, compared with eight receiving thiopentone/ isoflurane, (group T) (P = 0.005), while three children in group P and ten in group T vomited before hospital discharge, (P = 0.01). Eight children in group P were considered to be fit for discharge on the day of surgery as against four in group T, (not significant). Only four out of twelve children receiving opioid analgesia vomited.

Adolescent↗

Airway protection by the laryngeal mask. A barrier to dye placed in the pharynx.

Methylene blue was placed in the pharynx of 64 patients undergoing anaesthesia with the laryngeal mask. No leak of dye into the larynx was detected on fibreoptic inspection of the inside of the mask in any subject. The use of the laryngeal mask as a means of protecting the airway during procedures such as minor nasal operations is therefore supported.

Airway Obstruction↗

A boy with an anterior mediastinal mass.

A 12-year-old boy presented for biopsy of a large mediastinal mass. General anaesthesia precipitated immediate severe airway obstruction. This was overcome by the insertion of two microlaryngeal tubes, one into each main bronchus. The anaesthetic management of patients with an anterior mediastinal mass is discussed and the importance of pre-operative assessment stressed.

Airway Obstruction↗