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Biomedical subjects

D W Barron

Publications and source records attributed to D W Barron.

5 recordsLinked to original sources

The influence of naloxone infusion on the action of intrathecal diamorphine: low-dose naloxone and neuroendocrine responses.

The influence of an intravenous infusion of naloxone 1 microgram kg-1 h-1, in combination with intrathecal diamorphine, on analgesia and hormonal stress responses after laminectomy was assessed in a blinded, randomized, placebo-controlled study. Twenty-seven patients undergoing laminectomy with postoperative analgesia provided by intrathecal diamorphine were investigated. Analgesia was reduced by naloxone (P less than 0.05), and the duration of analgesia was shortened by 180 min. The postoperative concentrations of both blood glucose and serum cortisol were reduced in the naloxone group compared to the control group (P less than 0.05). These results may indicate an excitatory role for the hypothalamic mu receptor in hypothalamo-pituitary-adrenocortical axis regulation.

Adult

Biochemical disturbances associated with total hip replacement.

A prospective study on 227 patients undergoing arthroplasty of the hip was carried out with reference to the effects on the cardiovascular and respiratory systems. Investigations revealed that the placing of acrylic bone cement and the prosthesis in the femoral shaft produced clinical and biochemical disturbances which were consistent with pulmonary microembolism. A fall in arterial oxygen tension during the procedure and hypoxaemia extending into the postoperative period with elevation of serum lipase and a fall in triglycerides supported the idea that embolisation with marrow fat occurred. The method of venting (by catheter or proximal hole) did not influence the biochemical disturbances. The implications of these findings are discussed.

Arrhythmias, Cardiac

Clinical considerations in anaesthesia for hip arthroplasty.

Experiences with the anaesthetic management of 248 patients undergoing total hip replacement are presented. Blood loss does not appear to be influenced by hypertension, the method of venting or the type of anaesthetic, with the exception of neurolept-analgesia. The importance of oxygen therapy in the treatment of the pulmonary embolic syndrome is stressed and the prevention of deep venous thrombosis is discussed. Mortality and morbidity figures are given.

Aged

Intramedullary pressure patterns.

The insertion of cement and femoral prosthesis in total hip replacement produces biochemical abnormalities. These are thought to be caused by a marked rise in intramedullary pressure. Surgeons aim to reduce these pressures by using different methods of insertion and venting. The present investigation was undertaken to establish if any one method was superior to the others. The greatest modification of acrylic pressure was obtained by means of a drill hole. Thie highest rise in pressure was produced by the insertion of the femoral prosthesis and this was little modified by any of the alternatives of the use of a 3/16 inch drill hole, a 16-gauge catheter, and cement gun.

Bone Cements