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Biomedical subjects

D M McAuley

Publications and source records attributed to D M McAuley.

9 recordsLinked to original sources
PubMed1993

Effect of hand soaking on sensory testing.

This study investigates the effect of hand soaking on sensory testing scores in 58 patients with leprosy. Sensation was tested with Semmes-Weinstein monofilaments and scored. Patients were tested before and after soaking their hands in water for 30 minutes. A statistically significant improvement in sensory testing scores for individual nerve territories was noted. The importance of these findings should be considered when using sensory testing as an evaluative tool for nerve damage in leprosy.

Adolescent↗
PubMed1991

Problems in day care surgery.

In-patient admission represents a failure of a day care service. The hospital records of 105 patients transferred from the day ward to the in-patient wards were studied retrospectively. Of 2,039 patients treated in the day care ward, 105 (5%) required in-patient admission over a 12 month period. Of these 105 admissions, 17% did not fulfil the criteria for day care patients, 46% had surgical problems, and 35% anaesthetic-associated problems. The in-patient admission rate could be reduced by improved out-patient selection of cases, use of a separate day care theatre, increased use of local anaesthetic techniques, reduction in the use of parenteral opioids, the use of simple oral analgesics or non-steroidal anti-inflammatory agents as pre-emptive analgesia and a wider use of propofol as an induction agent which provides superior recovery from anaesthesia.

Ambulatory Surgical Procedures↗
PubMed1985

Cimetidine in labour: absence of adverse effect on the high-risk fetus.

In a prospective randomized trial, 36 women received cimetidine and 32 magnesium trisilicate mixture BP as antacid therapy every 2 h in labour. The women belonged to a high-risk category and the infants born were less than 36 weeks gestation, or less than 2000 g birthweight or otherwise in jeopardy because of severe maternal pre-eclampsia or diabetes. Measurements of a wide range of haematological and biochemical variables revealed no differences between the two groups of babies. The frequency of complications found in the infants was similar, although infants born to the women who received magnesium trisilicate required oxygen therapy for a longer period. Cimetidine did not appear to affect the development of gastric acidity, or to increase bacterial colonization of the gastrointestinal tract in the infant.

Adult↗
PubMed1984

Oral ranitidine in labour.

Ranitidine 150 mg orally was given every 6 hours to 909 women in labour, while a control group of 378 women received conventional alkali therapy. No differences in incidences of operative intervention, placental retention or post-partum haemorrhage were observed between groups. Gastric sampling during emergency anaesthesia revealed a pH less than 2.5 in four of 51 women who received ranitidine and in two of 31 women who received magnesium trisilicate. Gastric volumes were slightly lower (mean 83 ml) in the study group than in the control group (mean 122 ml). Absorption of ranitidine was greatly slowed following narcotic administration and gastric volume was significantly higher in those patients given narcotics in labour. Apgar scores were similar in both groups of infants, and babies whose mothers were given ranitidine showed no delay in achieving high gastric acidity and no increase in bacterial colonization of the gastro-intestinal tract. Low levels only of ranitidine were found in the blood of babies at 2-3 hours and approximately 12 hours after birth.

Anesthesia, Obstetrical↗
PubMed1984

Combined treatment with ranitidine and saline antacids prior to obstetric anaesthesia.

Ranitidine 150 mg was given to 126 patients requiring elective Caesarean section under general anaesthesia: 43 women had ranitidine alone, 43 had this supplemented by a pre-induction dose of sodium citrate and 40 patients had ranitidine plus sodium bicarbonate. All three sub-groups provided satisfactory gastric pH and volume. Ranitidine 150 mg was given orally every 6 hours to women in labour. Of 221 patients requiring general anaesthesia during labour, 103 women received 30 ml 0.3 M sodium citrate and 118 women, 20 ml of 8.4% sodium bicarbonate 10 minutes before induction of anaesthesia. In the citrate sub-group there was one patient with a gastric pH less than 2.5 (mean pH 6.2, SEM 0.13 range 2.1-8.4). In the bicarbonate sub-group the lowest gastric acidity was 3.8 (mean pH 8.3, SEM 0.11 range 3.8-9.83).

Anesthesia, General↗
PubMed1983

Ranitidine as an antacid before elective Caesarean section.

In a preliminary study, 20 women in labour received ranitidine 50 mg intravenously. No significant changes were seen in the height, frequency or amplitude of uterine contractions or in fetal heart rate or pattern. No neonatal problems attributable to ranitidine were found. Ranitidine crossed the placenta, the mean fetal-maternal ratio being 0.9. Levels in the infants 12 hours following delivery were all very low. Ranitidine 150 mg orally was given to 80 healthy women undergoing elective Caesarean section at varying times from 75 to 510 minutes pre-operatively. From 2 to 6 hours following ingestion, the pH of gastric contents was greater than 2.5 in all but one patient. The mean volume aspirated (8 ml) was significantly lower than in a control group receiving magnesium trisilicate (mean volume 30 ml). Neonatal assessment included Apgar scoring, neurobehavioural examination, feeding progress, measurement of acidity and culture of gastric aspirates. No significant differences between groups were found. Blood levels indicated that the oral drug is readily absorbed by the parturient and that a smaller proportion is transferred to the fetus, mean fetal-maternal ratio at delivery being 0.38.

Adult↗
PubMed1982

Effect of preanaesthetic medication on anaesthesia with ICI 35, 868.

The effect of three commonly used premedicants and a control on anaesthesia with ICI 35, 868 is described. Two randomized studies were performed--one a group study of induction characteristics at 2 mg kg-1 and the other a detailed study in patients undergoing minor gynaecological surgery with an induction dose of 1.5 mg kg-1 and maintenance with incremental doses plus 66% nitrous oxide in oxygen. Premedication had little effect on the already good induction characteristics. Only heavy opiate premedication produced reliable induction at 1.5 mg kg-1, but with an increase in side-effects. Diazepam appears to be the premedicant of choice, although the overall frequency of pain on injection has not been affected by premedication.

Adolescent↗
PubMed1982

Lorazepam premedication for labour.

Fifty primigravidae were given either lorazepam (2 mg) or identical dummy tablets in early labour, in a randomized double-blind fashion. Analgesia (standardized at pethidine 100 mg) was given as required, and pain relief was assessed by visual analogue scale. Analgesia was significantly better in those mothers who had received lorazepam. There was a higher incidence of respiratory depression at birth in the infants in this group, although this was not statistically significant. Patients given lorazepam were all satisfied with their analgesic regimen compared with half of those given an inactive tablet. There was a higher incidence of amnesia for labour in the active group. There is a need for a similar study of the effects of other drugs which are given to supplement pethidine in labour.

Adolescent↗