In the last 70 years, neuromuscular blocking drugs have become an established part of anaesthetic practice. They were first administered during abdominal surgery in 1942, when Griffith and Johnson in Montreal used Intocostrin, a biologically standardised mixture of the alkaloids…
It is estimated that up to 80% of patients experience postoperative nausea and vomiting (PONV) within the first 24 h after surgery. If risk factors are identified and acted upon, PONV can be easily managed, but for a small, high-risk cohort…
The International Association for the Study of Pain (IASP) defines pain as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’. It is clear from this definition that the…
Local anaesthetics are analgesic drugs that suppress action potentials by blocking voltage-activated sodium ion (Na + ) channels (VASCs) in excitable tissues. Examples include the amides (e.g. lidocaine, bupivacaine, levobupivacaine, ropivacaine) and esters (e.g. cocaine and procaine) ( Table 5.1…
A wide variety of therapeutic and non-therapeutic substances will obtund cerebral function and produce a continuum of cognitive states from almost fully awake to unexpected death ( Table 4.1 ). The clinically useful part of this spectrum is characterised by…
Inhalational and volatile anaesthetic agents are used widely for the induction and maintenance of general anaesthesia throughout the world. Since the famous demonstration of an ether anaesthetic by William Morton in 1846, the development of volatile anaesthetic agents paved the…
Statistics is the science of learning from data – from collection and organisation through to analysis, presentation and dissemination. Like all sciences, it has its own vocabulary and can sometimes appear somewhat impenetrable to the uninitiated. This chapter gives an…
Basic principles A drug is a molecule or particle that produces a therapeutic effect by modifying how a biological system responds to a physical or chemical stimulus. This effect can occur locally at the site of administration or after absorption…