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Biomedical subjects

J A Wildsmith

Publications and source records attributed to J A Wildsmith.

At least 37 records · Page 2Linked to original sources
PubMed1999

Haemodynamic effects of diaspirin crosslinked haemoglobin (DCLHb) given before abdominal aortic aneurysm surgery.

We studied 34 patients undergoing elective repair of an abdominal aortic aneurysm under combined general anaesthesia and epidural block to evaluate the acute effects of diaspirin crosslinked haemoglobin (DCLHb) 50, 100 and 200 mg kg-1 i.v. Haemodynamic variables were measured continuously using pulmonary and radial artery catheters, and oxygen delivery and consumption were calculated at regular intervals. DCLHb was shown to be vasoactive, producing an increase in mean arterial pressure of approximately 25% with each dose, with small decreases in cardiac index and calculated oxygen delivery. These effects persisted beyond the end of infusion and provided a degree of cardiovascular stability during the operative procedure. The effects of DCLHb on oxygen consumption at these doses were minimal.

Aged↗
PubMed1998

Alleged allergy to local anaesthetic drugs.

OBJECTIVE: To identify the true nature of an acute reaction in 25 patients initially diagnosed as allergic to local anaesthetic drugs. SETTING: University General and Dental Hospitals. INTERVENTIONS: Detailed review of each patient's previous exposure to local anaesthetic drugs and of the history of the acute event was followed up with challenge testing by intradermal injection. RESULTS: One patient was subsequently found to be genuinely allergic to a local anaesthetic drug of the amide type. A wide range of conditions had actually precipitated the other adverse reactions, but all could be classified under three major headings: an immunological condition to a different antigen; a manifestation of anxiety; or an iatrogenic problem. CONCLUSION: Local anaesthetic allergy is rare, but does occur. All reactions to local anaesthetic drugs must be assessed carefully and specialist referral may be appropriate.

Acute Disease↗
PubMed1998

Comparison of continuous and intermittent administration of extradural bupivacaine for analgesia after lower abdominal surgery.

We have compared intermittent bolus and continuous infusion of extradural local anaesthetic for pain relief in a randomized, double-blind study of 48 patients who underwent major abdominal gynaecological surgery. Each patient received 5 ml of 0.375% bupivacaine hourly, either as a bolus over 5 min or as a constant infusion. Patients who received the intermittent administration technique maintained a more extensive sensory block, reported marginally better analgesia and had a lower requirement for rescue medication. The intermittent bolus technique was not associated with an increase in side effects.

Adult↗
PubMed1997

Anaphylaxis associated with, but not caused by, extradural bupivacaine.

Identifying anaphylaxis and determining its cause during anaesthesia can be very difficult. We describe a patient who suffered a life-threatening reaction which was diagnosed originally as being caused by bupivacaine. Subsequent investigation and enquiry showed that this was not so and suggested latex as the likely true cause.

Adult↗