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Biomedical subjects

C E Famewo

Publications and source records attributed to C E Famewo.

31 records · Page 2Linked to original sources
PubMed1979

Plasma potassium, sodium and blood sugar following etomidate and suxamethonium.

Changes in plasma potassium, sodium and blood sugar were studied in Nigerian patients following induction of anaesthesia with etomidate and suxamethonium. Healthy patients presenting for elective surgery as well as psychiatric patients presenting for electroconvulsive therapy were studied. Plasma potasium was essentially unaffected by etomidate administration, but rose significantly when suxamethonium was given. This rise was higher than that observed with thiopentone and suxamethonium in a previous study on a similar group of Nigerians. Blood sugar was not significantly increased by the administration of etomidate but rose significantly after suxamethonium was given. This hyperglycaemic response was greater than when thiopentone was used as the induction agent. Administration of ECT was associated with a further increase in blood sugar. It is concluded that thiopentone is preferable to etomidate in situations where increases in plasma potassium and blood sugar are undesirable following administration of suxamethonium.

Adult↗
PubMed1978

Further experience with etomidate.

We report our further anaesthetic experience with Etomidate in 100 patients. The cardiovascular and respiratory systems were not significantly affected but intraocular pressure was reduced. The occurrence of pain during injection of Etomidate was unaffected by analgesic premedication but was reduced by using a solution buffered to a higher pH and by choosing a big vein for injection. The myoclonic movements often seen with Etomidate anaesthesia were transient and have so far not created any major problem; they were reduced by a slower speed of injection but unaffected by diazepam premedication or pretreatment with low dose of a non-depolarizing muscle relaxant (pancuronium). Etomidate is a satisfactory alternative to thiopentone in situations where depression of the cardiovascular and respiratory systems are undersirable or where barbiturates are otherwise contraindicated and is a usefull addition to the induction agents in our anaesthetic practice.

Adolescent↗
PubMed1977

Effect of etomidate on intra-ocular pressure.

Etomidate, a new short-acting non-barbiturate hypnotic, was administered to 40 patients between the ages of 12 years and 65 years. Intra-ocular pressure was measured before and after etomidate injection using a Schiotz tonometer. A significant reduction of intra-ocular pressure was found to follow etomidate injection in spite of the often associated myoclonic movements. The mechanism of reduction of intra-ocular pressure has not been determined in this study. It is suggested that etomidate will be a useful intravenous induction agent where elevation of intra-ocular pressure is undesirable.

Adolescent↗
PubMed1977

Clinical trial of etomidate. Preliminary observations on a new non-barbiturate induction agent.

This is a preliminary report of our clinical experience with etomidate, a new intravenous non-barbiturate anaesthetic agent. Thirty-two patients undergoing minor surgical procedures were anaesthetized, induction being with etomidate 0.3 mg/kg body weight. Induction was fast and smooth. Twenty-eight per cent of the patients complained of pain at site of injection but the pain disappeared on flushing with water for injection. Following etomidate injection, 37.5 per cent of patients developed myoclonic movements which were usually mild and self-limiting. We were impressed by the relative stability of the cardiovascular and respiratory systems. Etomidate looks promising and further work is in progress on other aspects of this drug.

Anesthesia, Intravenous↗
PubMed1977

A re-evaluation of anticholergic premedication.

One hundred and twenty healthy Nigerian female patients undergoing minor gynaecological operations were divided randomly into two groups. One group of 58 patients received intramuscular atropine as the only premedication on the ward while the other group of 62 patients received their atropine intravenously at the time of induction of anaesthesia. Anaesthesia was induced with thipentone and maintained with nitrous oxide, oxygen, and halothane using a facemask. There was equally satisfactory control of secretions in both groups. However, due to the occasional difficulties in achieving optimal timing of intramuscular atropine as well as the uncomfortably dry mouth complained of by 87.7 per cent of the patients who had intramuscular atropine, the intravenous administration at induction is to be preferred. Moreover, one saves the patient an extra injection.

Adult↗
PubMed1976

Awareness and dreams during general anaesthesia for Caesarian section a study of incidence.

One hundred Nigerian patients presenting for emergency caesarian section were interviewed within the first 24 hours post-operatively. The purpose was to determine the incidence of awareness and dreams. The standard anaesthetic technique consisted of atropine 0.6 mg and thiopentone 250 mg given intravenously at the time of induction, suxamethonium bromide 40 mg intravenously to facilitate tracheal intubation and nitrous oxide/oxygen/pancuronium for maintenance. The incidence of awareness was 4% while the incidence of dreaming was 17%. Most (94%) of the patients said they dreamed only occasionally at home and of these, 15% claimed they dreamed more frequently when pregnant than when not pregnant.

Adult↗
PubMed1975

Use of aspirin in haemorrhagic shock.

Haemorrhagic shock was induced in two similar groups of dogs for two hours. One group received aspirin before shock and the other group served as a control. When blood was retransfused the PVR which was markedly elevated during shock returned to pre-shock value in the aspirin group but was elevated 100 per cent in the control group, despite correction of a cidosis. Aspirin reduces collagen-induced platelet aggregation and thereby inhibits the formation of platelet micro-emboli without affecting the coagulationfactors. This effect of aspirin is thought to be responsible for the lowering of the elevated PVR to pre-shock values in the aspirin group following retransfusion. Because of the metabolic acidosis associated with the shock state, concurrent administration of sodium bicarbonate is recommended when transfusing shocked patients with blood. A clinical trial of aspirin in early treatment of shocked patients as well as for prophylaxis in high risk situations is justified.

Animals↗
PubMed1975

Use of chloroquine in shock.

One group of dogs received single doses of intramuscular chloroquine and another group served as a control. The dogs were subjected to haemorrhagic shock and then retransfused with their own blood after two hours of shock. The chloroquine-treated dogs had normal PA pressures after correction of acidosis and significantly smaller increases in the pulmonary vascular resistance. The results are similar but less marked than those obtained with aspirin. Chloroquine inhibited in vitro platelet aggregation by 50% and was not associated with any increased bleeding. This may be an advantage when used in patients with multiple trauma or increased bleeding tendency.

Animals↗
PubMedDate not supplied

A study of different doses of atracurium to prevent suxamethonium-induced fasciculations.

Pretreatment with 3 different doses of atracurium (0.035 mg/kg, 0.05 mg/kg, 0.07 mg/kg) was investigated in order to determine the optimal dose that would prevent suxamethonium-induced fasciculations with minimal side effects to the patient and without significant antagonism of suxamethonium block. A total of 80 patients was studied. There were 20 patients in each of three atracurium groups while a fourth group of 20 patients served as control. Atracurium reduced the incidence of fasciculations from 100% observed in the control to between 0 and 40% in the atracurium groups. The optimal dose of atracurium appears to be 0.05 mg/kg, using a pretreatment interval of 3 minutes. Routine pretreatment of all patients is not mandatory, but it is recommended whenever the side-effects of suxamethonium are particularly undesirable, as in ocular laceration, raised intracranial pressure, full stomach and in very muscular patients.

Adult↗
PubMedDate not supplied

Study of incidence of post-operative pain among Nigerian patients.

The incidence of post-operative pain was determined among 200 adult Nigerian patients who presented for a variety of surgical procedures. The overall incidence of moderate to severe post-operative pain was 68% while the remaining 32% complained of only mild pain. When the results were categorized according to the site and type of surgery, the highest incidence of pain were found following surgery of anorectal region (90%), thoracotomy (88%), major joints (88%) and upper abdomen (80%). The use of opiates pre-operatively for premedication and anaesthetic techniques using intra-operative opiates or ketamine delay the onset and reduce the severity of post-operative pain. No sex difference was observed but elderly patients (especially above 50 years of age) tended to have lower pain ratings.

Adolescent↗