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R J Chestnut

Publications and source records attributed to R J Chestnut.

4 recordsLinked to original sources

Anaesthesia for gynaecological laparoscopy--a comparison between the laryngeal mask airway and tracheal intubation.

In a single-blind, randomised, controlled study, we compared two anaesthetic techniques in 60 patients undergoing gynaecological laparoscopy. In the first group, ventilation was controlled, after paralysis and tracheal intubation. In the second group, a laryngeal mask airway was inserted and spontaneous or assisted ventilation allowed. There were no clinically significant differences in the intra-operative conditions of the two groups, although the procedure was quicker in the second group. The only significant difference in morbidity was a greater incidence of nausea and vomiting in the second group in the first 4 h after operation. We conclude that use of the laryngeal mask airway is an acceptable technique for elective gynaecological laparoscopy, in patients who are at low risk of regurgitation.

Adolescent↗

Suxamethonium--the relation between dose and response.

In a study which involved 120 adult patients, the ED95 of suxamethonium was shown to be 0.51 mg/kg, using an electromyographic technique. Marked individual variation in response was noted, for example a dose of 0.3 mg/kg produced a range of blockade from 4%-90%. Body surface area was shown to be more significantly related to blockade than lean body mass or total body weight.

Adolescent↗

Economy in the use of muscle relaxants. Vecuronium after pancuronium.

Vecuronium is an intermediate duration, non-depolarising muscle relaxant. When used during prolonged procedures, it may be given by intermittent injection, by continuous infusion or by a single very large dose at the start of anaesthesia. It may also be used to maintain relaxation after the initial use of a long-acting agent, such as pancuronium. This study demonstrates that the effect of a dose of vecuronium used in this fashion is increased when interaction with pancuronium takes place. The clinical and theoretical implications of this observation are discussed.

Adult↗