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Biomedical subjects

C D Hanning

Publications and source records attributed to C D Hanning.

At least 19 recordsLinked to original sources
PubMed1990

Review of the rectal use of opioids.

The rectal route for the administration of opioid analgesics is often forgotten by physicians seeking alternatives to the oral route. This article reviews the physiology of rectal drug absorption and such data as exists on the different opioids that have been administered by this route. Conventional fatty-based suppositories have a place in the management of chronic pain but the variability in dissolution and drug absorption limit their usefulness. Recently, sustained release vehicles have become available that offer the prospect of the attainment of steady analgesic drug concentrations with once or twice daily dosing. Early studies with the morphine hydrogel suppository suggest that it may be capable of fulfilling this prospect. Their inherent safety, as dose-dumping is impossible, will make them suitable for use in the home.

Administration, Rectal↗
PubMed1990

Comparison of four pulse oximeters: effects of venous occlusion and cold-induced peripheral vasoconstriction.

The ability of four pulse oximeters (the Ohmeda 3700, Nellcor N100 and N200 and the Datex Oscar) to detect hypoxaemia was determined in the presence of venous obstruction and cold-induced peripheral vasoconstriction. Significant increases in detection time for hypoxaemia were found in both cases. There were no significant differences in detection time between the instruments, although the Ohmeda 3700 displayed smaller values of SaO2 under certain conditions. Peripheral vasoconstriction was induced using three differing methods which gave differing results, thus emphasizing the importance of methodology in assessments of pulse oximetry.

Body Temperature↗
PubMed1990

Effect of motion artefact on pulse oximeters: evaluation of four instruments and finger probes.

The ability of the Ohmeda 3700, Nellcor N200, Datex Satlite Plus and Simed S100 pulse oximeters to detect induced hypoxaemia in the presence of motion artefact was assessed, under conditions of controlled vibration using an industrial vibration facility. Vibration at 4 Hz and 8 Hz induced increases in detection time for hypoxaemia and spurious decreases in the displayed SaO2 in some of the oximeters tested. Finger-dependent differences in oximeter performance and pulse rate registration were noted especially in those oximeters without ECG linkage (Ohmeda 3700 and Simed S100). Subsequently, eight different pulse oximeter finger probes were assessed for those characteristics that may predispose to motion artefact. There were marked differences in the mass of the probes, the forces exerted on the test finger and in the force required to displace the probes from the subject's finger. Differences in both the microprocessor programmes and the physical characteristics of the finger probes may explain the observed differences in function. Similar studies should form part of the standard evaluation of new pulse oximeters.

Adult↗
PubMed1990

Further development of a morphine hydrogel suppository.

1. A sustained release monolithic morphine hydrogel suppository (MHS) was developed and administered to five volunteers. 2. The MHS delivered a mean of 55 mg morphine over 12 h. The mean plasma morphine concentration was 15 ng ml-1 from 2 to 12 h after administration. 3. Plasma morphine concentrations were comparable with those reported for the same dose given orally over the same time period. 4. The morphine hydrogel suppository appears to be an effective means of delivering morphine and may be of value in the management of chronic pain.

Administration, Rectal↗
PubMed1990

A comparison of the effects of zolpidem and placebo on respiration and oxygen saturation during sleep in the healthy elderly.

1. In a double-blind placebo controlled trial, zolpidem 10 mg, a new imidazopyridine hypnotic drug, was administered to 10 elderly female patients and placebo to 11, all recovering from hip and knee replacement surgery. Respiratory monitoring with an inductance plethysmograph and pulse oximeter showed that treatment over a 4 night period did not increase significantly the severity, frequency or duration of hypoxaemic episodes leading to SaO2 less than 90% or less than 85% when compared with placebo. Confidence intervals (corrected for baseline differences) for the median differences between the two groups on night 7, the fourth night of treatment, were from -1.85 to 0.480 and from -1.07 to 0 respectively for the frequency, and from -0.76 to 0.15 and -0.5 to 0 for the duration of the hypoxaemic episodes. The incidence of sleep related respiratory disturbances was not significantly increased compared with placebo on any night. 2. Respiratory monitoring using a simple inductance plethysmograph and pulse oximeter is acceptable to patients and staff. 3. The evaluation of all hypnotic and sedative drugs should include their effects on respiration during sleep.

Aged↗
PubMed1990

How to insert a peripheral venous cannula.

Peripheral venous cannulation is the commonest vascular surgical procedure. It is usually performed by a junior doctor who has learnt the skill from a colleague only marginally more skilled. Correct technique will improve the chances of success and patient comfort and safety.

Antisepsis↗
PubMed1986

Hyperbaric bupivacaine and hyperbaric cinchocaine: a comparison of their use for spinal anaesthesia.

A new spinal analgesic formulation, 'heavy bupivacaine', was compared clinically with a commonly used agent. Sixty patients, who required spinal analgesia for transurethral prostatectomy, received either 1.5 ml of hyperbaric 0.5% cinchocaine (Nupercaine, Percaine, Dibucaine) in 6% dextrose or 2.5 ml of hyperbaric 0.5% bupivacaine (Marcain) in 8% dextrose. The onset, rate of rise, plateau height of the sensory block, reduction in blood pressure and peak expiratory flow rate, and the operative and post-operative blood loss did not differ significantly. Motor blockade was significantly less with bupivacaine. It is concluded that hyperbaric bupivacaine is an acceptable alternative to hyperbaric cinchocaine for spinal analgesia for transurethral prostatectomy.

Anesthesia, Spinal↗
PubMed1979

Flail chest.

Explore the source record for details and available documents.

Humans↗
PubMed1978

Movement of the critically ill within hospital.

Critically ill patients can be safely moved within hospital using a mobile intensive care unit (MICU). The MICU allows the critically ill to benefit from specialised investigation and treatment they might otherwise be denied. The MICU in use at the Western Infirmary, Glasgow is described and its merits outline in the light of clinical experience gained over a twelve month period.

Adult↗
PubMed1977

Respiratory effects and amnesia after premedication with morphine or lorazepam.

Lorazepam, a new benzodiazepine, was compared with morphine for premedication. Ten patients received morphine 10 mg/70 kg i.m. and 10 received lorazepam 4 mg/70 kg i.m. Respiratory effects were assessed from the change in slope (S) and intercept (B) of the carbon dioxide response line, using a development of Read's rebreathing method. Morphine depressed S by 47% (P less than 0.01), but after lorazepam S increased by 27% (P less than 0.05), neither drug altering B significantly. In two volunteers lorazepam was assessed by both the rebreathing and the steady-state methods; after lorazepam S was smaller by the steady-state than by the rebreathing technique. The findings for lorazepam are consistent with the known effects of sleep on carbon dioxide sensitivity. Amnesia lasting 4-8 h occurred in all patients who received lorazepam so that pain and nausea during this period were not recalled, but no patient who received morphine experienced amnesia. We conclude that lorazepam merits further study, particularly where sedation without respiratory depression is needed, as in obstetrics, and where amnesia for uncomfortable procedures is required.

Adolescent↗