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Biomedical subjects

I H Lewis

Publications and source records attributed to I H Lewis.

27 records · Page 2Linked to original sources

Recovery from day-case anaesthesia: comparison of total i.v. anaesthesia using propofol with an inhalation technique.

A prospective, double-blind study was conducted to compare postoperative recovery after either total i.v. anaesthesia (TIVA: propofol and alfentanil) or an inhalation technique (propofol and alfentanil followed by nitrous oxide and isoflurane) in 50 patients undergoing day-case gynaecological surgery. Psychomotor performance was assessed at 1 and 2 h after surgery using the Critical Flicker Fusion Threshold (CFFT), Simple Reaction Time (SRT) and Choice Reaction Time (CRT). Subjective recovery and side effects after discharge from hospital were assessed using a postal questionnaire. Recovery occurred significantly earlier in the TIVA group as assessed by CFFT and SRT (P less than 0.01); there were no significant differences (P greater than 0.05) between the two groups in CRT, subjective duration of recovery or side effects.

Adolescent↗

Upper respiratory tract infections and general anaesthesia in children. Peri-operative complications and oxygen saturation.

Conflicting reports regarding the hazards of anaesthesia in children presenting for surgery with an upper respiratory tract infection have appeared in the literature. In the present study 130 children undergoing general anaesthesia with face mask for myringotomy and grommet insertion were graded as having either an acute or recent upper respiratory tract infection or were asymptomatic according to predetermined clinical symptoms and signs. The severity of respiratory and related complications were scored during induction, emergence and recovery. The peripheral oxygen saturation was recorded during induction, emergence, transfer to the recovery ward and in the recovery ward itself. There were no significant differences (p greater than 0.05) in the complication scores between the three groups of children. However, the incidence of hypoxaemia (oxygen saturation less than or equal to 93%) was significantly greater during transfer in the acute infection group (p = 0.001) and the recent infection group (p = 0.02), as well as during recovery in the acute group (p = 0.03) compared with asymptomatic children.

Anesthesia, General↗

Effect of P6 acupressure on postoperative vomiting in children undergoing outpatient strabismus correction.

A prospective, double-blind study was conducted to compare the effect of pressure at the P6 (Neikuan) point with placebo as an antiemetic in children. Sixty-six patients, ages 3-12 yr, undergoing outpatient surgery for correction of strabismus, were allocated randomly to receive either bilateral P6 acupressure or placebo during the perioperative period. The study was designed to detect a 50% difference in the incidence of postoperative vomiting between the two groups, with a 90% power of achieving a statistically significant result at the 5% level (two-tailed). The incidence of postoperative vomiting for the placebo group was 58% before discharge from hospital, 73% at home and 82% in the first 24 h after surgery. The corresponding results for the acupressure group were 58% before discharge, 71% at home and 94% in the first 24 h. These differences were not significant; P6 acupressure did not reduce the incidence of postoperative vomiting in children undergoing strabismus surgery.

Acupuncture Therapy↗

Anesthesia and mental illness.

Although drug interaction probably remains the most potentially serious problem, current evidence suggests that psychiatric medication need not be discontinued prior to anesthesia and surgery, discontinuation of medication may constitute its own hazards. Most interactions can be predicted and appropriate precautions taken, the use of meperidine is now absolutely contraindicated for patients receiving MAOI's.

Anesthesia, General↗