Anaesthetists results

Prophylaxis of stress ulceration in intensive care units is the major interest to the anaesthetist. Here, it is given in a dose of 1 g every 6 hours via nasogastric tube. Several studies have shown sucralfate to be comparable in efficacy to H2 blockers. It has been claimed, but not proved, to result in a reduction in morbidity and mortality from nosocomial pneumonias in comparison to H2 antagonists. The latter, by raising gastric pH, eliminate the acid barrier to colonisation of the gut by pathogens, which sucralfate does not do. 

We thank the British Technology Group and the Association of Anaesthetists for sponsoring the University Research Program, Professor G. Smith and Dr. C. Hanning of Leicester University, Department of Anaesthesia, for their joint interest and clinical results, and our laboratory technicians P. Keating and R. Cameron for careful preparations and assays. 

Nitrous oxide is still used because of its rapid action and adding a little of this to other anaesthetics makes less likely another type of accident, that happens when the supply of anaesthetic runs out during the course of an operation and the anaesthetist is unaware of it. As a result, the patient starts to recover consciousness during the operation and consequently suffers extreme pain and trauma. Financial compensation in such cases can be particularly high. Nitrous oxide keeps the patient unaware of what is happening. 

High blood glucose concentration matters little over short periods, except in the critically ill. The programme for control should be agreed between anaesthetist and physician whenever diabetic patients must undergo general anaesthesia or modify their diets. There are many different techniques that can give satisfactory results. 

The sulfur analogue of pentobarbital, called thiopental (Figure 3.14), is widely used in operating theatres for the induction of general anaesthesia. Thiobarbiturates of this type have a much higher partition coefficient than the oxobarbiturates used as hypnotics (see Chapter 2). As a result, thiopental, when administered intravenously to a vein in the back of the hand, can in a matter of seconds induce unconsciousness that lasts for several minutes. This is sufficient time for the anaesthetist to introduce an airway to the patient and commence general anaesthesia. 

Several other cases of hepatitis resulting from occupational exposure to halo-thane have been reported. Thus, there is little doubt that hepatitis may follow the inhalation of this anaesthetic. Extensive surveys of post-operative jaundice have also been carried out. A summary of the findings will be given here. Despite numerous reports in the literature of liver damage in patients who had halothane anaesthesia, there is still considerable controversy between anaesthetists and pathologists as to whether the hepatitis and halothane are causally related. 

The principal aim of the present study was to exarrrine the effects of fatigue on anaesthetists responses to stress. The secondary aim of the study was to examine the effects of other mediating factors - attitudes towards stress, and personality - on anaesthetists perceived stress. The results of the study may assist in the possible design and re-stracturing of anaesthetists work rosters, as well as provide insights to assist anaesthetists in their management of stress and fatigue. 

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