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Biomedical subjects

A W Harrop-Griffiths

Publications and source records attributed to A W Harrop-Griffiths.

12 recordsLinked to original sources
PubMed1996

Postoperative pain. Expectation and experience after coronary artery bypass grafting.

A study of 43 patients undergoing coronary artery bypass grafting was conducted in order to compare pre-operative expectation of pain severity and duration to actual postoperative experience. As judged by linear visual analogue scores, patients expected more pain than they experienced (p = 0.0359). For the majority of patients, pain duration was less than expected. Eighty-four per cent of patients reported that their pain was better or the same as expected. Ninety-five per cent of patients were satisfied or very satisfied with postoperative analgesia. The authors conclude that, although the standard of postoperative analgesia after coronary artery bypass grafting remains objectively poor (the median postoperative pain score was 4 on a 10 cm linear visual analogue pain score), patients are usually satisfied with their pain relief. The authors suggest that this may be related to patients' pre-operative overestimation of postoperative pain severity. The authors caution against giving patients unrealistic expectations of the quality of postoperative analgesia.

Adult↗
PubMed1992

Mivacurium chloride: a study to evaluate its use during propofol-nitrous oxide anaesthesia.

We assessed the neuromuscular and cardiovascular effects of mivacurium chloride, a neuromuscular blocking agent, in 33 patients during propofol-nitrous oxide anaesthesia. Neuromuscular function was assessed with supramaximal stimuli of the ulnar nerve, using surface electrodes at the wrist, with repeat trains of four. Mivacurium given as a bolus of 0.15 mg.kg-1 (ED95 x 2) was found to be haemodynamically stable. Intubating conditions assessed at 2 and 2.5 min were either good or excellent. All patients developed a block of 100% in a mean (SD) time of 105 (34) s. There were mean (SD) intervals of 12 (2.4) min before the reappearance of the first twitch of the train of four (T1) following the bolus dose, and 15.8 (3.1) min for the T1 to reach 25% of its control value (TC). Seventeen patients received an infusion of mivacurium to maintain neuromuscular blockade (T1:TC 10-20%) with a mean (SD) infusion rate of 6.9 (2.2) micrograms.kg-1.min-1. Recovery from neuromuscular blockade was assessed with spontaneous offset or augmented with edrophonium following either the initial bolus or an infusion. Following a bolus it took a mean (SD) of 26.2 (3.7) min for the fourth twitch of the train of four (T4):T1 ratio to reach 0.7. In patients receiving an infusion with spontaneous offset it took a mean (SD) time of 12.0 (2.2) min to reach the T4:T1 ratio of 0.7 from a T1:TC value of 8.8. Edrophonium significantly decreased the recovery time in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Regional anaesthesia and cough effectiveness. A study in patients undergoing caesarean section.

We report the results of a study of the effects of spinal and epidural anaesthesia for Caesarean section on commonly used indicators of a patient's ability to cough effectively. Both spinal and epidural anaesthesia, after the achievement of a block adequate for surgery, were associated with statistically significant decreases (p less than 0.05) in all the respiratory variables recorded: forced vital capacity, forced expiratory volume in one second, peak expiratory flow rate and maximum expiratory pressure. We conclude that although the observed changes are unlikely to impair the normal patient's ability to cough effectively in these circumstances, there may be clinically significant impairment in the presence of an inadvertently high block or in a patient with pre-existing pulmonary disease.

Anesthesia, Epidural↗
PubMed1991

Pain after surgery.

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Clinical Trials as Topic↗
PubMed1990

Midazolam and flumazenil in the anaesthetic management of trigeminal nerve thermocoagulation.

A technique is described for the anaesthetic management of trigeminal nerve thermocoagulation by administration of repeated doses of midazolam and flumazenil. "Wake-up" times after administration of flumazenil in 20 patients were shorter than those reported during spontaneous recovery from methohexitone or propofol anaesthesia. The midazolam dose required for a second phase of sedation after antagonism of the first with flumazenil was significantly less than that for the first phase of sedation. There was no evidence of postoperative resedation. Reversal of sedation was associated with an increase in arterial pressure.

Alfentanil↗
PubMed1990

Caesarean section in a patient with haemoglobin SC disease and a phaeochromocytoma.

The anaesthetic management of a patient with haemoglobin SC disease for lower segment Caesarean section and excision of a phaeochromocytoma is described. The patient was given a general anaesthetic for the surgical procedure after exchange transfusion had achieved an haemoglobin A concentration of greater than 50%. A live infant was delivered and a suprarenal phaeochromocytoma was excised during a 6.5 hour procedure. The patient's postoperative recovery was uneventful.

Adrenal Gland Neoplasms↗
PubMed1987

High frequency ventilation and afferent vagal activity.

Recordings were made from pulmonary afferent fibres in the vagus nerves of anaesthetised dogs during conventional and high frequency ventilation. In single and multiple fibre preparations, the mean spike counts per minute at 14 breaths/minute were in the ranges 36.9-155.3 and 755-1921, respectively. These counts decreased by up to 61 and 44% respectively at 100 breaths/minute, and by 27-89% and 22-51% at 200 breaths/minute. At this frequency there was a further decrease of between 19 and 65% when the positive end expiratory pressure was removed. The findings of this study are intuitively acceptable, since pulmonary stretch receptor activity is proportional to tidal volume, and are in keeping with the clinical impression that high frequency ventilation per se does not eliminate respiratory drive.

Animals↗
PubMed1986

Intubating conditions following pre-induction priming with alcuronium.

Three priming doses of alcuronium have been investigated and, using a logistic transformation technique, the priming dose required to produce adequate intubating conditions in 99% of patients at 60 seconds following the second dose of alcuronium has been deduced. This dose, 106.5 micrograms/kg is extremely high and may be unsafe if used, since 30% of our patients complained of side effects when given a priming dose of only 50 micrograms/kg.

Adult↗