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Biomedical subjects

E A Shipton

Publications and source records attributed to E A Shipton.

At least 37 records · Page 2Linked to original sources
PubMed1993

A hypermetabolic reaction during anaesthesia and surgery. A case report.

A young man underwent anaesthesia and surgery after multiple fractures. After 2 hours of anaesthesia, the patient developed hypercapnia, acidosis, hyperpyrexia and mild muscle rigidity. He was treated for malignant hyperthermia. Muscle tension studies with caffeine-halothane and muscle histology proved normal. The differential diagnosis of this abnormal metabolic response is briefly discussed.

Adult↗
PubMed1993

Introducing a patient-controlled analgesia-based acute pain relief service into southern Africa--the first 10 months.

The 10 months after the introduction of the first acute pain relief service (APRS) in southern Africa is described. Seven hundred patients were treated with morphine by means of patient-controlled analgesia (PCA), administered to patients after major surgery or extensive burns via the intravenous (IV) or subcutaneous (SC) route. The efficacy, safety and resource implications were assessed. The results showed that pain control was good, with the majority of patients (66%) experiencing mild pain during the first 24 hours. The pump was used by each patient for an average of 4.32 days. The mean total dose of morphine used was 105.2 mg via the IV route and 114.6 mg via the SC route. Over the 10 months, the 25 PCA pumps worked 80,000 pump-hours; only 3 pumps malfunctioned. A total of 86,861 mg morphine was used during this period with rare morbidity and no mortality. Only 1 patient experienced sedation and respiratory depression. The benefits of an APRS with PCA to patients and medical staff alike are discussed.

Adolescent↗
PubMed1992

Patient-controlled analgesia. Its South African debut in a provincial hospital.

Patient-controlled analgesia (PCA) is a well-established technique for the relief of acute and chronic pain. It is widely used in Western hospitals. Patient and staff education is required to provide successful analgesia. This paper reports the successful introduction of PCA on a large scale in a provincial hospital. The considerable potential difficulties in communication and education appear to have been overcome. The widespread introduction of PCA in all our hospitals would appear to be feasible.

Adolescent↗
PubMed1992

Extending patient-controlled analgesia to patient-controlled neuroleptanalgesia.

A trial was conducted (among 22 patients) to assess a new use of patient-controlled devices. Using a patient-controlled analgesia (PCA) pump under the anaesthetist's guidance, the patients self-administered a neurolept mixture consisting of droperidol and alfentanil. The patients were then able to undergo minor surgery (dilatation and curettage). The majority remained detached, sedated and pain-free, while able to control the PCA pump during the procedure. Patient-controlled neuroleptanalgesia or PCNA, as we propose to call this technique, appeared practical, effective and safe. The method was generally well accepted and highly rated by the patients.

Adolescent↗
PubMed1992

Unexplained hypertension during induction of a patient with phaeochromocytoma.

An unexplained hypertensive response during the induction of anaesthesia for phaeochromocytoma resection is described. This response was not accompanied by elevations in plasma catecholamine levels. It occurred despite heavy premedication and followed induction with etomidate, alfentanil, lignocaine, vecuronium and magnesium sulphate (MgSO4). A bolus of esmolol (0.5 mg/kg) lowered the blood pressure rapidly. Subsequent haemodynamic manipulations were carried out by varying the rate of an esmolol infusion. A constant background infusion of MgSO4 was maintained throughout the procedure. These produced satisfactory haemodynamic control despite marked rises in plasma catecholamine levels.

Adrenal Gland Neoplasms↗
PubMed1992

Postoperative pain--an update.

Adequate treatment of pain after surgery is central to the care of postoperative patients. Preventing pain or reducing its impact makes subsequent pain management easier. The establishment of 'acute pain relief services' will improve relief offered. Recent pharmacological, psychological and technical advances in this field are briefly discussed.

Humans↗
PubMed1992

The case for patient-controlled analgesia. Inter-patient variation in postoperative analgesic requirements.

Postoperative morphine requirements were assessed for the first 48 hours after surgery in 93 consecutive patients undergoing elective or emergency laparotomies. Analgesia was provided by patient-controlled analgesic (PCA) pumps. Daily morphine utilisation was recorded. At the conclusion of PCA therapy, patients were asked to assess their quality of analgesia. Eighty-one patients, who reported good or excellent pain relief, were included in the study. Data are presented demonstrating the wide variation in morphine requirements necessary to produce this level of analgesia.

Adult↗