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Biomedical subjects

G H Bush

Publications and source records attributed to G H Bush.

At least 19 recordsLinked to original sources
PubMed1995

Can persistent cerebral damage be caused by hyperglycaemia?

An eight-year-old girl demonstrated severe and persistent neurological damage following an uneventful anaesthetic for a planned appendicectomy. The perioperative period was remarkable only in that the patient experienced very severe hyperglycaemia and an epileptiform convulsion. A possible mechanism for neurological damage as a result of severe hyperglycaemia is described.

Anesthesia, General↗
PubMed1988

Peri-operative dreaming in paediatric patients who receive suxamethonium.

A prospective study is described of peri-operative dreaming in 144 paediatric patients aged 5-14 years who received suxamethonium for day case surgery. No case of awareness was elicited. One group received pretreatment with 80 micrograms/kg [corrected] tubocurarine. The incidence of dreaming in the 72 patients who were not pretreated was 16.7% compared with 2.8% in the patients pretreated with tubocurarine. This difference is statistically significant. The use of an intermittent suxamethonium technique gives a high incidence of dreaming which may be caused by muscle spindle discharge that produces cerebral arousal. Pretreatment with a non-depolarizing agent decreases this risk of dreaming.

Adolescent↗
PubMed1988

Peri-operative dreaming and awareness in children.

Dreaming under anaesthesia was investigated in a prospective study of 120 day case paediatric patients, aged 5-17 years, who underwent a variety of surgical procedures. Patients were anaesthetised using the 'Liverpool technique' of paediatric anaesthesia (nitrous oxide-oxygen-relaxant). No patient reported awareness, but 23 of 120 patients (19%) reported dreams. Analysis of the data revealed that the choice of muscle relaxant, (nondepolarising or depolarising) had a statistically significant effect on the incidence of dreaming (p less than 0.05). It is suggested that the technique of intermittent intravenous suxamethonium may result in increased muscle spindle discharge and cause cerebral arousal and an increased incidence of dreaming.

Adolescent↗
PubMed1988

Pain-free injection in infants. Use of a lignocaine-prilocaine cream to prevent pain at intravenous induction of general anaesthesia in 1-5-year-old children.

A randomised, placebo-controlled, double-blind study was undertaken in 111 children between the ages of 1 and 5 years to assess the efficacy of EMLA 5% cream in the alleviation of venepuncture pain at intravenous induction of general anaesthesia using 27-gauge needles. Pain assessment was made by an operating department assistant using both verbal rating scale and visual analogue scale methods. Seventy-five children, of whom 24 were premedicated, were treated with EMLA cream and 36 with placebo, 14 of whom were premedicated. Significantly lower pain scores were recorded in the children treated with EMLA cream (verbal rating scale: premedicated p less than 0.05, unpremedicated p less than 0.001; visual analogue scale: premedicated p less than 0.0005, unpremedicated p less than 0.0002). No variation in analgesia was found for application times between 30 and 300 minutes and there were no serious side effects.

Anesthesia, General↗
PubMed1987

Deaths in children with a diagnosis of acute appendicitis in England and Wales 1980-4.

Thirty five children died of acute appendicitis in England and Wales in 1980-4 compared with 204 in 1963-7. Thirteen of the 35 deaths in 1980-4 took place at home or on the day of admission to hospital before operation and a further 18 on the day of operation or the first day after it. Thirty one of the children had peritonitis. A third of the deaths were in children aged 0-4 years, and the hospital fatality rate in this age group was one death in 320 cases compared with one death in 4760 cases in children aged 5-14 years. The fall in the number of deaths between the 1960s and the 1980s was due to improvements in medical care, a reduction in the incidence of appendicitis, and changes in the age structure of the child population. Difficulty and delay in diagnosis and inadequate intravenous therapy are now the main factors contributing to death.

Acute Disease↗
PubMed1986

All that wheezes is not asthma.

A case is presented in which the inhalation of a foreign body caused a respiratory arrest and was subsequently diagnosed and treated as an attack of acute asthma. The presentation, diagnosis, investigation and treatment of this condition is discussed and a review of the literature is presented.

Asthma↗
PubMed1985

Anaesthesia and progressive muscular dystrophy.

The presentation and features of Duchenne's progressive muscular dystrophy (Duchenne's PMD) are described and the increased risks associated with anaesthesia are considered. Hazards associated with induction of anaesthesia and immediate postoperative recovery have been stressed in recent case reports, and these are summarized. Features of a hyperpyrexia-like response including cardiac arrest, increased serum creatine phosphokinase concentration, myoglobinuria and metabolic acidosis following suxamethonium or halothane, or both, have been described in patients with Duchenne's PMD. Subsequent in vitro muscle tests have suggested that it is possible that a malignant hyperpyrexia response to general anaesthesia may occur. Six children known to have Duchenne's PMD who developed delayed respiratory insufficiency following anaesthesia and required controlled pulmonary ventilation are reported. In five of the children, cardiac arrest occurred despite apparently adequate respiratory support. Suxamethonium was common to the anaesthetic received by all six patients. In one of these patients subsequent anaesthetics, without suxamethonium, were uneventful and delayed muscle weakness did not occur.

Adolescent↗
PubMed1984

Endoscopic diathermy obliteration of recurrent tracheoesophageal fistulae.

Recurrence of tracheoesophageal fistula after surgical repair for esophageal atresia occurs in approximately 5% to 15% of cases. Further surgery may be hazardous and mortality rates of up to 50% have been reported. We report two patients in whom successful obliteration of a recurrent fistula has been achieved by diathermy at bronchoscopy. This experience is compared to previous reports of fistula obliteration using tissue adhesives.

Bronchoscopy↗