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Biomedical subjects

G A Osborne

Publications and source records attributed to G A Osborne.

23 records · Page 2Linked to original sources
PubMed1991

Intra-operative patient-controlled sedation.

Patient-controlled sedation using propofol is described in 23 ASA 1 patients undergoing surgical extraction of third molars. Cardiovascular and respiratory stability was maintained and sedation was no deeper than full eyelid closure with prompt response to verbal command. Amnesia for the extractions was common (70%), but there was no significant amnesia for recovery room events. Intra-operative patient cooperation was good, postoperative patient satisfaction high and all patients stated they liked the self-administration and would use the same technique again. Propofol dose was correlated with both procedure length (r = 0.587; p = 0.003) and surgical difficulty (rs = 0.550; p = 0.010).

Adult↗
PubMed1991

Intra-operative patient-controlled sedation. Comparison of patient-controlled propofol with anaesthetist-administered midazolam and fentanyl.

The quality of sedation and postoperative recovery have been assessed for intra-operative sedation provided by either patient-controlled sedation with propofol or a standard method using divided doses of midazolam and fentanyl, in 40 ASA 1 day surgery patients undergoing extraction of third molar teeth under local analgesia. Patient-controlled sedation with propofol produced sedation no deeper than full eyelid closure with prompt response to verbal command, but deeper levels were seen in three patients in the midazolam and fentanyl group. Patient satisfaction was higher in the patient-controlled sedation propofol group for both subjective intra-operative feelings (p less than 0.01) and willingness to have the procedure again in the same manner (p less than 0.05). Amnesia was more limited to intra-operative events (rather than extending into the postoperative period) in the patient-controlled sedation propofol group (p less than 0.05). Drug dose was correlated with duration of procedure and surgical difficulty in the patient-controlled sedation propofol group but not in the midazolam and fentanyl group. Postoperative testing included a new computerised test, the FAST index, which indicated a dose-dependent reduction in cognitive function in the midazolam and fentanyl group, which persisted until the time of discharge. Changes in cognitive function in the patient-controlled sedation propofol group in the same postoperative interval were significantly less and not related to propofol dose.

Adult↗
PubMed1991

Fluid uptake in laser endometrial ablation.

Fluid uptake was measured from accurate preoperative and postoperative patient weights for 25 consecutive patients undergoing Nd:YAG laser endometrial ablation under general anaesthesia. One patient had a uterine perforation with 5.1 litres of fluid deposited in the peritoneal cavity. In the remaining 24 cases, maximum fluid uptake was 5.1 litres, three patients absorbed more than four litres and eight absorbed more than two litres. In those same 24 patients, the mean fluid uptake was 1.5 litres (SD 1.6) and six patients without tubal ligation had a higher mean uptake (2.2 litres, SD 1.7) than the eighteen with surgically occluded Fallopian tubes (1.3 litres, SD 1.4) but the difference was not statistically significant. Fluid uptake has the potential to cause significant morbidity in this procedure. Both procedure duration and volume of uterine irrigation fluid were poor predictors of fluid gain. Observation of the ongoing volume deficit between infused and collected fluid provided intraoperative monitoring of fluid gain that prevented complications from fluid overload in healthy patients. However, this method of monitoring fluid uptake may be insufficient to prevent either complications from glycine absorption, if glycine is used for irrigation, or fluid overload in patients with cardiac disease.

Adult↗
PubMed1990

Plasma and cerebrospinal fluid concentration of temazepam following oral drug administration.

Thirteen male patients were administered 20 mg of temazepam orally 1 to 2 h prior to undergoing spinal anaesthesia for a urological procedure. Samples of blood and CSF were drawn just before insertion of the spinal and the concentration of drug estimated in these two media. The results obtained indicated that a highly significant correlation existed between the unbound concentration of temazepam in plasma and the concentration of drug present in CSF. Temazepam appeared to be an effective light pre-medicant in all of the subjects studied.

Administration, Oral↗