Update Basic Sciences

Disorders in acid-base balance are commonly found in critically ill patients. Clinicians responsible for these patients need a clear understanding of acid-base pathophysiology in order to provide effective treatment for these disorders. Acid-base Disorders in Critical Care (Update 28, 2012) – December 21, 2012

This article is a review of the current recommendations relating to this group of patients and outlines the approach to management of acute pain in the opioid tolerant patient by anaesthetists in the hospital setting.Acute pain management for opioid tolerant patients – October 28, 2011

Atropine a naturally occurring alkaloid of Atropa belladonna, is a competitive antagonist of muscarinic cholinergic receptors. It’s pharmacological properties are described here.
Atropine – June 1, 1996

The ANS can be thought of as the regulatory system that partly or wholly controls most of the body’s organ systems and homeostatic mechanisms. Its basic anatomy and physiology are described here.Autonomic Nervous System – Anatomy and Physiology – December 1, 2008

A balance exists between sympathetic and parasympathetic outflow. Many common pathologies and surgical procedures can affect this balance, leading to disturbances in the function of organ systems. Drugs can contribute to autonomic disturbance, but drugs can also be used to redress the balance. Autonomic Nervous System Pharmacology – December 1, 2008

This article describes the electrical and magnetic activity within the body, which can be detected and measured using electrodes or transducers. Invasive blood pressure monitoring is used as an example of monitoring of a biological signal.Biological Signals and their Measurement – December 1, 2008

Adequate blood pressure is essential to maintain the blood supply and function of vital organs. Measurement of blood pressure is therefore a key part of the monitoring of patients during anaesthesia and critical care.Blood Pressure Measurement – June 1, 2000

In this article the underlying physiology of water, sodium and potassium homeostasis are described with frequent reference to relevant clinical situations.Body Fluid Compartments, Sodium and Potassium – December 1, 2008

This article focuses on the breathing systems used with plenum anaesthetic machines (those with a supply of pressurized gas); drawover apparatus will be described in a future article.Breathing Systems – December 1, 2008

Calcium is an essential ion within the human body. The maintenance of a constant free ionised calcium concentration is biologically important for the function of excitable tissues. Abnormalities in serum calcium values may have profound effects on neurological, gastrointestinal and renal function.Calcium Homeostasis – December 1, 2004

This article describes the routes of transport of carbon dioxide around the body and their physiological effectsCarbon Dioxide Transport – December 1, 2008

The subject of cardiovascular pharmacology is diverse, and this article concentrates on areas relevant to the anaesthetist. The pathophysiology of common diseases of the heart and circulation is discussed before considering the drugs used for treatment.
Cardiovascular Pharmacology for Anaesthetists – June 1, 2000

This article aims to provide an overview of the physiology of the cardiovascular system and its response to anaesthesia. The next article in this section deals with myocardial physiology in greater detail.Cardiovascular Physiology – December 1, 2008

The normal adult skull can be considered as a bony box of fixed volume, containing brain, blood and cerebrospinal fluid (CSF). An understanding of how these components interact is essential in managing normal patients under anaesthesia and those with intracranial pathology. These factors will be considered in two sections – cerebral blood flow and intracranial pressure.Cerebral Blood Flow and Intracranial Pressure – December 1, 2008

Continuous flow anaesthetic machines date back to the first availability of compressed gases, and despite numerous modifications the modern apparatus retains many of the features of the original Boyle’s machine, a British Oxygen Company trade name in honour of the British anaesthetist H E G Boyle (1875- 1941). This article describes the basic principles of continuous flow apparatusContinuous Flow Anaesthetic Apparatus – The Boyle’s Machine – June 1, 1996

Decontamination of medical equipment involves the destruction or removal of any organisms present in order to prevent them infecting other patients or hospital staff. Decontamination reduces the risks of cross infection, helps to maintain the useful life of equipment and is important in the overall control of hospital acquired infection.Decontamination Procedures for Medical Equipment – December 1, 2008

This article describes the ways in which draw-over apparatus can be used to provide safe, high quality anaesthesia.Drawover anaesthesia Parts 2 and 3 (Update 3) – December 1, 1993

This paper discusses the equipment and role of drawover anaesthesia for the uninitiated ‘plenum anaesthetist’ while also delving into some of the finer aspects for experienced users.Drawover Anaesthesia Review (Update 15) – December 1, 2002

Cardiac arrhythmias during anaesthesia and surgery occur in up to 86% of patients. Many are of clinical significance and therefore their detection is of considerable importance. This article will discuss the basic principles of using the ECG monitor in the operating theatre. It will describe the main rhythm abnormalities and give practical guidance on how to recognise and treat them.ECG Monitoring in Theatre – June 1, 2000

This article outlines the areas of knowledge concerning electricity and magnetism that are essential for the practice of safe anaesthesia. The areas covered include basic concepts, amplification of biological potentials, sources of electrical interference, electrical hazards and their causes and prevention, diathermy and defibrillators.Electricity and Magnetism – December 1, 2008

This article discusses the basic physiology of the principal endocrine glands, the pituitary, thyroid and adrenal glands. Endocrine Physiology – December 1, 2008

An endotracheal tube introducer made of thick copper wire can be used to stiffen the tube during intubation. This may be of help during difficult intubations. An introducer can be easily made as described in this article.
Endotracheal Tube Introducer – Make Your Own – June 1, 1995

Oxygen supports combustion. Any flammable substance may become dangerous when exposed to an atmosphere of 100% oxygen and this effect is worsened either in the presence of high pressure or in the presence of heat. The following short report describes a life threatening incident that occurred during the handling of oxygen. It is written with the intention of demonstrating the danger we face when dealing with oxygen in the operating theatre.Explosion of an Oxygen Regulator – December 1, 2004

This article describes the principles behind and the clinical use of the fibreoptic intubating laryngoscope.Fibreoptic Intubating Laryngoscope – December 1, 2004

This article explains how fires and explosions develop and the precautions which, when acted upon, help to avoid this serious and sometimes disastrous event. Fires and Explosions in the Operating Room – December 1, 2008

This article covers the definition of flow, the different types of flow are there and the physical principles govern them. The Hagan-Pouseille equation and its relevance to clinical anaesthetic practice are explained.Flow – December 1, 2008

The use of anaesthetic gases, such as nitrous oxide and volatile agents, within the closed environment of the operating theatre may lead to the chronic exposure of staff with potential adverse consequences on health. Certain agents, notably ether are potentially flammable and should not be allowed to accumulate. This article describes the component features of anaesthetic gas scavenging systems.Gas Scavenging in Anaesthesia – December 1, 2008

Although a range of different inhaled anaesthetic agents are available in different settings around the world, the principles involved remain unchanged and a good understanding of the properties of commonly used gases and vapours is essential for the safe conduct of anaesthesia.Gases and Vapours – December 1, 2008

An anaesthetic machine suitable for use in poor-resource settings should be reliable, easy to understand and operate, economical to run, require minimal servicing which can be carried out locally and be versatile, so that the same machine can be used in all patients both as an anaesthetic machine in the operating room and as a ventilator in a recovery room or ICU. The Glostavent anaesthetic machine has been designed to fulfill these requirements.Glostavent Anaesthetic Machine – June 1, 2003

Halothane and diethyl ether, the two anaesthetics most commonly used in developing countries, have the unusual property that they form an azeotrope when mixed in the ratio of about 2 parts halothane to 1 part ether. This aazeotrope behaves physically as though it were a single compound.Halothane-Ether Azeotrope – June 1, 2004