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Biomedical subjects

H A Aitken

Publications and source records attributed to H A Aitken.

8 recordsLinked to original sources

Effects of ketorolac trometamol on renal function.

We have compared the renal effects of ketorolac trometamol 10 mg administered 4-hourly by intermittent i.m. injection or by continuous i.m. infusion with placebo in a double-blind study in 67 patients who had undergone upper abdominal surgery. Ketorolac was supplemented during the 48-h postoperative study period with bolus doses of morphine delivered by a patient controlled analgesia system. The only significant effect of ketorolac on renal function compared with patients who received placebo was reduced excretion of potassium. The overall changes caused by surgery alone were of much greater magnitude. Bleeding time was increased with ketorolac, but there were no adverse events related to this.

Adult

Comparison of the Finapres and direct arterial pressure monitoring during profound hypotensive anaesthesia.

The Finapres was compared with direct intraarterial pressure monitoring in 10 patients undergoing local resection of choroidal melanoma, an operation that requires a period of profound hypotension. Good agreement was recorded for systolic arterial pressure and heart rate over a range of pressures. However, agreement of mean and diastolic pressures was poor, with the Finapres tending to overestimate these values. In cases requiring profound hypotension, direct arterial pressure monitoring remains the method of choice.

Anesthesia, General

Double-blind comparison of the morphine sparing effect of continuous and intermittent i.m. administration of ketorolac.

The morphine sparing effect of ketorolac 10 mg administered 4-hourly by intermittent i.m. injection was compared with a continuous i.m. infusion in a double-blind, placebo-controlled trial in patients undergoing upper abdominal surgery. During the 48-h postoperative period, each patient was provided with a patient-controlled analgesia (PCA) system which delivered bolus doses of morphine and administered the intermittent i.m. doses automatically via a computer controlled pump. In the first 24 h after surgery, there was a significant reduction in morphine demanded by both groups receiving ketorolac compared with placebo. Patients who received a continuous infusion of ketorolac after abdominal surgery required a median dose of morphine by PCA which was 49% less than controls. In the second 24 h and over the entire 48 h of the study, patients in the continuous group required significantly less morphine than those in the placebo group. The intermittent group used less than the placebo group, but this was not significant.

Abdomen

Use of patient controlled analgesia in postoperative cardiac surgical patients--a survey of ward staff attitudes.

Staff who worked regularly on a postoperative cardiac surgical ward were asked to complete a questionnaire regarding the use of patient controlled analgesia, which had recently been introduced to the ward. Fifty-five per cent found that the machines reduced their workload, mainly by relieving them of the task of checking and administering controlled drugs. The benefits noted were increased patient confidence (noted by 74%) and improved analgesia (41%). However it was felt by 61% that some postoperative cardiac patients seemed reluctant to use the machines properly or did not fully understand the technique.

Analgesics

Evaluation of two formulations of dihydrocodeine using patient-controlled analgesia.

A randomised, double-blind study of 90 patients after cardiac bypass surgery was undertaken to assess the relative analgesic efficacies of normal- and controlled-release oral dihydrocodeine. Patients received either placebo, normal-release dihydrocodeine, or controlled-release dihydrocodeine at regular intervals on the first to third days after operation. This was supplemented in all groups by intravenous morphine administered on demand by a patient-controlled analgesia system. Morphine requirements in the control group were significantly greater during this 48-hour period than in either of the active groups (p less than 0.01), but there was no statistically significant difference between the two active preparations.

Adolescent