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Biomedical subjects

C E Blogg

Publications and source records attributed to C E Blogg.

At least 19 recordsLinked to original sources
PubMed1996

Removal of the laryngeal mask airway in children: anaesthetized compared with awake.

We studied 60 children, aged 12 months to 8 yr, undergoing plastic surgery under general anaesthesia supplemented by regional anaesthesia. Patients were allocated randomly to have the laryngeal mask airway removed either on awakening or while anaesthetized. Subsequent observation of respiratory factors and oxygen saturation showed a significant difference between the groups for coughing (P < 0.001), with a greater incidence (17 of 33) in the awake group compared with those from whom the laryngeal mask airway was removed while anaesthetized (two of 27). There were no differences in the incidences of laryngospasm, desaturation (< 95%) and excess salivation between the groups. Removed of the laryngeal mask airway during deep anaesthesia reduced coughing in the immediate postoperative period.

Anesthesia, General↗
PubMed1993

A modified sensor for pulse oximetry in children.

Pulse oximetry is a powerful tool for patient monitoring but there are practical problems with its application in small children. Standard probes may be too large to be used easily and dedicated paediatric probes may be awkward to apply. The authors describe a modification of the Nellcor 'Oxiband' probe which simplifies its use in children. The modified probe was compared in 27 children with the conventional 'clothes-peg' type of device and found to under-read by 1.5% with 95% confidence intervals of +/- 3.1%. This is comparable to the error of the 'Oxiband' probe in normal use of +/- 3% over the range of saturations 70-95%. It is concluded that the modified probe may safely be used in clinical practice.

Anesthesia, General↗
PubMed1993

Suxamethonium-induced muscle pains are not related to cholinesterase activity.

We have investigated the possibility of using the pre-operative measurement of cholinesterase activity to predict the postoperative development of myalgia following the administration of suxamethonium. Seventy-seven patients presenting for elective extraction of wisdom teeth were entered in the study. All patients received a standard anaesthetic regimen, including suxamethonium to facilitate tracheal intubation, and standardised postoperative analgesia. Myalgia was assessed postoperatively and no correlation between muscle pains and cholinesterase activity was found.

Adult↗
PubMed1992

Cricoid pressure may prevent insertion of the laryngeal mask airway.

We have studied 42 female patients undergoing elective day-case surgery allocated randomly to two groups. After induction of anaesthesia an attempt was made to insert a laryngeal mask airway after application of cricoid pressure in one group or with no cricoid pressure in the other. The anaesthetist was unaware of the application, or not, of cricoid pressure. Successful insertion was achieved at the first or second attempt in 19 of the 22 patients in the non-cricoid pressure group, but in only three of the 20 patients in the cricoid pressure group (chi 2 18.62, P < 0.001). The laryngeal mask airway was then inserted successfully in all 17 patients after removal of cricoid pressure. The implications of having to remove cricoid pressure if a laryngeal mask airway is to be inserted are discussed.

Adolescent↗
PubMed1991

Comparison of the effects of oral nizatidine and ranitidine on gastric volume and pH in patients undergoing gynaecological laparoscopy.

Ninety patients who presented for elective gynaecological laparoscopy as day cases were allocated at random to three groups and studied on a double blind basis to compare the effects of nizatidine, ranitidine or placebo on gastric secretion. All the patients received the active drugs or placebo orally at least 45 minutes before the induction of anaesthesia. After tracheal intubation gastric fluid was aspirated via an orogastric tube and the volume and pH of the aspirate were measured. Venous blood samples were obtained at the times of gastric sampling to determine the plasma levels of the drugs. The proportion of patients with both pH greater than 2.5 and volume less than 25 ml were 100%, 90%, and 92.9% in the nizatidine, ranitidine and placebo groups respectively. There was no difference in volume between groups. Two patients in the nizatidine group without a measurable aspirate had blood levels less than the therapeutic range. The median pH values in both treated groups were significantly greater than in the placebo group, but there were no differences between the two treated groups. There were 19 (67.8%) patients in the placebo group with pH less than 2.5. This was significantly higher than the 2 (7.4%) and 6 (20%) in the nizatidine and ranitidine groups respectively. When the time interval between drug administration and induction of anaesthesia was divided arbitrarily into 45-90 minutes and greater than 90 minutes, all the patients in the nizatidine and ranitidine groups with pH less than 2.5 were given the drugs in the 45-90 minute interval; this suggests a latent period is required before the gastric pH increases. Nizatidine may be an effective protective agent against acid aspiration syndrome.

Adult↗
PubMed1990

Intravenous fluid load and recovery. A double-blind comparison in gynaecological patients who had day-case laparoscopy.

The effect of intra-operative fluid and dextrose administration upon recovery was tested in a randomised, double-blind trial. Three groups of 25 patients, each undergoing laparoscopic examination as day cases, were studied. The two groups who received fluid (20 ml/kg compound sodium lactate solution) showed significant improvement (p less than 0.05) in the variables that reflected hydration. The fluid group who also received dextrose (1 g/kg) exhibited further significant improvement. Intra-operative fluid and dextrose administration appears to confer some benefit upon recovery in patients who have minor surgery.

Adolescent↗
PubMed1987

Feedback control of neuromuscular blockade. A simple system for infusion of atracurium.

A simple system for closed-loop control of neuromuscular blockade is described. It comprises a Datex Relaxograph, a small relay and a syringe pump. The equipment is commercially available and requires no complex custom-built electronics. Atracurium was infused in a semicontinuous manner to 11 patients who underwent general anaesthesia for a variety of surgical procedures. Neuromuscular blockade oscillated within a narrow range around the preset level. The mean rate of infusion of atracurium was 0.5 mg/kg/hour (SD 0.13). The mean recovery time was 25.5 minutes (SD 7.95).

Adult↗
PubMed1986

Maternal awareness.

Explore the source record for details and available documents.

Anesthesia, Inhalation↗
PubMed1986

Transdermal hyoscine and postoperative nausea and vomiting.

Forty-two patients, undergoing major gynaecological surgery, were randomly allocated to have a patch applied to the skin behind one ear, containing either hyoscine or placebo. They were followed up at 24-hour intervals for 3 days postoperatively and divided into matched pairs for statistical analysis. There was a significant (p less than 0.01) reduction in nausea and vomiting in the first 24 hours postoperatively, but no difference thereafter. There was an increased incidence of visual disturbance in the hyoscine group at 48 hours, but no other differences in the side effects studied at any other time. However, despite receiving hyoscine there was still a high incidence (68%) of severe nausea and vomiting.

Administration, Topical↗
PubMed1986

Triazolam premedication. A comparison with lorazepam and placebo in gynaecological patients.

A randomised, double blind study, of 58 female patients undergoing laparoscopic investigation was carried out to compare triazolam 0.25 mg, lorazepam 2 mg, or placebo as oral premedication. Each patient was assessed by only one of the authors both pre- and postoperatively with regard to anxiolysis, sedation and rapidity of recovery. Triazolam and lorazepam were each associated with a significant reduction in anxiety compared to the initial assessment, whereas placebo had no anxiolytic effect. Sixty minutes after premedication, patients who had received triazolam were significantly more sleepy than patients given placebo or lorazepam. Two hours after the operation, the patients who had had triazolam or lorazepam were significantly more sleepy than those who received placebo. However, at 6 hours postoperatively there was no difference between triazolam and placebo, whilst those who had been given lorazepam were still significantly more sleepy than those given placebo. Triazolam appears to offer advantages over either lorazepam or placebo in patients who require rapid recovery, sedation and reduction in pre-operative anxiety.

Adolescent↗
PubMed1985

Adverse effects of suxamethonium. Failure of prevention by atracurium or fazadinium.

One hundred patients were allocated randomly to pretreatment with atracurium 2.5 mg, atracurium 5 mg, fazadinium 3.75 mg or saline 3 minutes before the injection of suxamethonium. The effect upon neuromuscular conduction was studied by recording the mechanical response of the adductor pollicis muscle to indirect stimulation of the ulnar nerve using repeated 2 Hz train of four stimuli. Blood samples were taken at intervals for the measurement of serum potassium. There was no significant difference in the incidence of postoperative muscle pains between the groups in the first 72 hours following anaesthesia. The use of the larger pretreatment dose of atracurium resulted in clinically significant neuromuscular blockade in three of the subjects. Minimal changes in serum potassium occurred in all patients but there was no statistical difference between the groups.

Adolescent↗
PubMed1977

Etomidate in electroconvulsive therapy. A within-patient comparison with alphaxalone/alphadalone.

In a group of 31 patients undergoing electroconvulsive therapy, there was no significant difference between the times of return of eyelash reflex, swallowing and respiration following a single induction dose of 0.2 mg/kg of etomidate as compared with an induction dose of 0.036 ml/kg of alphaxalone/alphadalone. The incidence of involuntary movements and increased muscle tone was significantly greater after etomidate than following alphaxalone/alphadalone; but the involuntary movements were never marked. The overall incidence of pain on injection was 15% after etomidate. There was a low incidence of venous sequelae following either drug.

Adolescent↗