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Biomedical subjects

D G Bogod

Publications and source records attributed to D G Bogod.

27 records · Page 2Linked to original sources
PubMed1990

The addition of fentanyl to epidural bupivacaine in first stage labour.

Epidural analgesia was studied in 100 healthy Chinese women with uncomplicated pregnancies in first stage labour. Patients were randomly allocated to receive 8 ml of one of the following five solutions: bupivacaine 0.125% with fentanyl 50 micrograms or fentanyl 100 micrograms, bupivacaine 0.25% plain, bupivacaine 0.25% with fentanyl 50 micrograms or fentanyl 100 micrograms. There was no difference in quality of analgesia among groups as measured by the reduction of visual analogue pain scores 20 minutes after the epidural dose. The duration of analgesia was similar among groups with the overall median duration being 105 minutes. There was no difference in method of delivery or neonatal Apgar scores. The least concentrated mixture providing good quality analgesia for the first stage of labour was the combination of bupivacaine 0.125% with fentanyl 50 micrograms.

Adult↗
PubMed1989

The effect of H2 antagonists on duration of action of suxamethonium in the parturient.

Fifteen patients who underwent elective Caesarean section were given sodium citrate, either alone or combined with oral cimetidine or ranitidine, as antacid premedication. No significant differences in time to 25 or 50% recovery of the first twitch of a train-of-four after administration of suxamethonium were found between any of the groups. It is concluded that H2-antagonists do not significantly affect the duration of action of suxamethonium in parturients, in contrast to the findings of a study in nonpregnant patients.

Anesthesia, General↗
PubMed1988

Maximum FIO2 during caesarean section.

Forty patients undergoing elective and emergency Caesarean section (excluding severe fetal distress) were divided into four groups to receive 50% oxygen, 50% nitrous oxide, and 0.5% halothane (group 1, controls) or 100% oxygen supplemented by 1.5 x MAC of halothane, enflurane or isoflurane (groups 2,3,4, respectively) reducing to 1.0 x MAC 5 min after induction. The umbilical venous PO2 in the oxygen-only groups was higher than in the oxygen-nitrous oxide groups, this difference reaching statistical significance when the patients in the oxygen-only groups were combined. Blood loss and uterine contractility were unaffected by the increased concentrations of volatile agents, and awareness did not occur. Improved cardiovascular stability was demonstrated in the elective high-oxygen groups. The technique is safe and warrants further study, since there are no important ethical objections.

Anesthesia, Inhalation↗
PubMed1988

Midwive's assessment of the upper sensory level after epidural blockade.

The ability of midwives to assess accurately the level of epidural blockade after a short period of instruction was examined. Seventy-two midwives estimated the upper level bilaterally in 100 patients, by detection of the loss of sensation to a cold stimulus. The midwife and anaesthetist were in complete agreement over the level of block in 71.5% of cases; the midwife overestimated the height of the block in 9.5% of cases, and underestimated in 19%. The midwife underestimated by three spinal segments in 1.5% of cases, and never by more. The technique was acceptable to patients and midwives alike. This procedure should enable safe management of obstetric analgesia, whoever administers top-ups; accurate detection of a block that recedes below therapeutic levels should facilitate earlier top-ups and thus reduce pain for the patient in labour.

Anesthesia, Epidural↗
PubMed1987

Extradural infusion of 0.125% bupivacaine at 10 ml h-1 to women during labour.

One hundred primigravidae were allocated randomly to receive either an extradural infusion of 0.125% bupivacaine (Marcain) 10 ml (12.5 mg) per hour during labour, or no infusion. Both groups had intermittent "top-ups" of 0.5% bupivacaine when indicated. The mean interval between top-ups was significantly longer in the infusion group (218 min v. 152 min). Seventy-six percent of the mothers in the infusion group required no or only one top-up. Although the infusion patients received a higher mean dose of bupivacaine (178 mg v. 130 mg), there was no difference between the groups with respect to mode of delivery, need for urinary catheterization, adverse cardiovascular effects on mother or fetus, or the time taken after delivery to recover sensation and motor power. The only real disadvantage was that the infusion group had an increased incidence of lower limb weakness (64% v. 44%). The neonates had similar Apgar scores, times to sustained respiration and requirements for resuscitation. The technique, therefore, should be safe if coupled with testing of sensory level, as no block extended higher than T6.

Adult↗
PubMed1987

Recovery of bowel motility after surgery. Detection of time of first flatus from carbon dioxide concentration and patient estimate after nalbuphine and placebo.

Co-ordinated bowel motility has been studied after surgery. The time to first flatus (TFF) was noted by 20 patients aged 60 yr or older and measured simultaneously using a carbon dioxide analyser. After cystoscopy under general anaesthesia, 10 patients received nalbuphine 20 mg i.v., and 10 patients had placebo (normal saline). In 16 patients (80%) the two observed times coincided and there were no false reports. Two patients were asleep, and did not report TFF. In two others the sampling tube became obstructed. Therefore, both methods are of value; the carbon dioxide analyser, however, is a sensitive and accurate monitor of the initial passage of flatus which does not require patient co-operation. In the i.v. nalbuphine group, the median TFF was more than three times as long (212 min) as that in the placebo group (64 min) (P less than 0.01).

Aged↗