Thesis--Tandläkarhögskolan, Stockholm. / Contains errata slip. Without thesis statement. Includes bibliographical references (p. 72-74).

Introduction A protocol has been devised in which a 20ml mixture of hyperbaric bupivacaine and fentanyl is prepared in a multi-dose syringe, from which aliquots are withdrawn into individual sterile syringes for use in spinal anaesthesia. The risk of microbial contamination of these multi-dose syringes is unknown and this study was designed to assess such risk. Methodology In this pilot study, each syringe was prepared using non-aseptic technique to contain a mixture comprising Fentanyl 10 μg.ml-1, Bupivacaine 4mg.ml-1and Dextrose 64mg.ml-1, with a total volume of 20ml. Syringes were then allocated to pairs. Aliquots were withdrawn hourly from one syringe of each pair for a twelve-hour study period, whilst the other syringe was sampled only at the beginning and end of the same period. All aliquots were withdrawn using standard aseptic technique in an operating theatre environment. For each syringe pair, both samples from the control syringe and four of the samples from the multi-dose syringe were submitted for microbiological culture. Results Of the 120 samples taken, one sample was excluded. Of the remaining 119 samples submitted for microbiological investigation, only one yielded growth. This sample had been taken from a multi-dose syringe at the beginning of the study period. Subsequent samples withdrawn from the same syringe were found to be sterile. The organism which had been cultured from this sample was Staphylococcus aureus (S. aureus). Conclusion It is possible that the culture medium which yielded the microbial growth was contaminated, which would explain why subsequent samples from the same syringe were sterile. Alternatively, bupivacaine is known to be strongly antimicrobial against some pathogens and it is conceivable that there may have been initial contamination of the syringe by S. aureus, which was inhibited by the bupivacaine to produce subsequent sterile samples. Whilst this may suggest that the use of multi-dose syringes for spinal anaesthesia could be safe, in light of the inconclusive result, further investigation is warranted.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Science in Dentistry Johannesburg, 2014 / Dental caries is one of the most common chronic childhood diseases and its prevalence is increasing globally. Dental general anaesthetic is resource intensive and not without risk. These services exist frequently to manage children with advanced stages of dental disease. The patients accessing this facility, as well as the treatment they receive, require analysis in order to address the demand for this form of treatment. Objectives: • To determine the age, ethnicity, home language, socioeconomic status, distance travelled and how many patients accessing this facility are physically or mentally compromised. • To determine the source of referral and the referral request. • To determine the waiting time before treatment. • To record the treatment received. • To record the average duration of each procedure. ! xi! • To determine how many of the patients were not scheduled but received treatment. • To determine the incidence of repeat dental general anaesthetic. • To assess how gender and ethnicity might influence the treatment outcomes. • To compare the treatment received by the mentally and physically compromised patients to that received by the rest of the study population. Methods: This was a retrospective, observational, cross-sectional study of paediatric patients undergoing dental general anaesthetic at Wits Dental Hospital in 2011. A total of 516 patients were treated at this facility in 2011 and 459 met the inclusion criteria of being ≤ 16 years. A sample size of 300 was calculated. One hundred and ninetyfour( 64.9%) of the sample patient files were retrieved. Data was also collected from the theatre register and day sheet(appointment register). Information was extracted from the various sources and recorded on a data capture sheet. This was then captured in Excel and exported into SPSS, Version 21, for analysis. Results: The mean age of healthy children in this study was 4,90 years. Of the healthy patients 54.3% were male. Black patients were underrepresented in this group. English(27.2%) ! xii! and Zulu(26.5%) were the most commonly reported home languages. As expected most patients were classified as younger than 6 years or committed children according to the hospital classification based on assets and income. More than half the population travelled distances greater than 10km for treatment. Mentally and physically compromised patients comprised 13.7% of the study population. 20.4% of patients had been referred to this facility and private dentists accounted for the majority of the referrals. The waiting time was 5.03 months before treatment. An average of 9.19 extractions were performed on healthy patients and the mean duration of each procedure was 29.07 minutes. 17.4% of patients were found to be unscheduled. Only 1% of the patients had a history of previous dental general anaesthetic. Recommendation: Addressing the social determinants of disease in the study population will reduce the demand for this type of service. The severity of dental disease can be improved with early diagnosis. Prevention and promotion programs need to be designed with the specific demographic characteristics of these patients in mind. The study highlighted areas for further research

The complication of postoperative nausea and vomiting is still one of the most common today. The potential for secondary complications associated with retching and vomiting such as aspiration pneumonitis strain of suture line with possible hemorrhage, and potential fluid and electrolyte imbalance makes prevention of retching and vomiting a primary concern in the management of the postoperative patient. The use of antiemetic drugs to prevent or control postoperative nausea and vomiting is a long-standing practice. Droperidol, an antiemetic, routinely used since being introduced in 1963, has been found to be successful in treating postoperative nausea and vomiting. This study examines the effect of droperidol .018 mg/kg given intramuscularly one half hour prior to the end of anesthesia on postoperative emesis in the adult gynecological patient presenting for total abdominal hysterectomy. Twelve patients were in this double-blind study, six acted as controls and six were in the experimental group. All subjects were premedicated with morphine sulfate 0.1 mg/kg and glycopyrrolate 0.2 mg, intramuscularly administered. All were induced with pentathol 4 mg/kg preceded by curare 3 mg and followed by succinylcholine 1.5 mg/kg for intubation. The subjects were maintained on isoflurane, sixty percent nitrous in oxygen, and pancuronium for relaxation. The subjects were of similar age and weight. Duration of anesthesia was similar with a mean of 2.93 hours overall. The incidence of retching or vomiting was considered as the same result. The droperidol group had one subject retch only and another retch and vomit. This gave a 33 percent incidence of retching and vomiting. The control group had three subjects retch and vomit, giving a 50 percent incidence. The small sample size provided no statistical significance. The results showed a trend of decreased vomiting in the adult subject presenting for total abdominal hysterectomy. The routine use of droperidol in this particular population cannot be recommended from these results.

Master of Dental Surgery / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Thesis (M.S.)--Central Connecticut State University, 2003. / Thesis advisor: Cheryl Watson. " ... in partial fulfillment of the requirements for the degree of Master of Anesthesia in Bilogical Sciences." Includes bibliographical references (leaves 93-101). Also available via the World Wide Web.

Master of Dental Surgery / This work was digitised and made available on open access by the University of Sydney, Faculty of Dentistry and Sydney eScholarship . It may only be used for the purposes of research and study. Where possible, the Faculty will try to notify the author of this work. If you have any inquiries or issues regarding this work being made available please contact the Sydney eScholarship Repository Coordinator - ses@library.usyd.edu.au

Thesis (M.S.) -- Central Connecticut State University, 2007. / Thesis advisor: Ruth Rollin. "... in partial fulfillment of the requirements for the degree of Master of Science in Biological Sciences." Includes bibliographical references (leaves 68-73). Also available via the World Wide Web.

Thesis (doctoral)--Universität Rostock, 1933. / At head of title: Aus dem Pharmakologischen Institut der Universität Rostock.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 62-64).