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Biomedical subjects

J P Fee

Publications and source records attributed to J P Fee.

68 records · Page 4Linked to original sources

Prospective study of liver function following repeat halothane and enflurane.

In a prospective study of liver function following repeat anaesthesia, patients who received repeat halothane had a higher frequency of abnormal liver enzyme results than a similar group who received repeat enflurane. Obesity and short intervals between administrations increased the likelihood of abnormal liver enzyme activity in the halothane group. Enflurane would seem to be the volatile agent of choice for repeat anaesthesia in such circumstances.

Adult↗

Changes in serum enzyme levels following ketamine infusions.

The levels of four serum enzymes, known to be elevated in toxic hepatitis, were measured preoperatively and on the 3-4th and 13-15th postoperative days in patients anaesthetised with ketamine infusions (54) or with a standard technique (64). Significant elevations in enzyme levels were considered to have occurred when the postoperative levels were outside the accepted normal range and had increased by more than 3 X SD from controls. About half the patients in each group had minor gynaecological operations and 2/20 in the ketamine series had postoperative elevation of enzyme levels, with no changes in the non-ketamine group. Following intermediate operations 14/34 anaesthetised with ketamine showed abnormal enzyme levels compared with 7/34 who had standard operations. None of the latter had more than one abnormal test as compared with six in the ketamine series. The causes and significance of these findings are not known.

Adult↗

Frequency of atopy, allergy, and previous general anaesthesia in surgical specialties.

This paper reports part of a large survey of atopy, allergy, and previous anaesthesia in 10 000 preanaesthetic patients. The occurrence of these risk factors in the various surgical specialties has been assessed. Obstetric patients have a significantly higher frequency of atopy and allergy than the total female population studied. Among males cardiothoracic patients are the only group to have a significantly higher frequency of atopy and allergy than the overall figure for their sex.

Anesthesia, General↗

Methodology of a prospective study of changes in liver enzyme concentrations following repeat anaesthetics.

The methodology of a large prospective study on the influence of repeated anaesthetics on liver function is reported and the problems involved are discussed. The most suitable patients were those presenting for endoscopic examination of the bladder and urethra, for urethral dilatation and for cervical implantation of radium. Blood samples were taken immediately before induction of anaesthesia and on days 3-4 and 13-15 after operation, when a clinical assessment of the patient was also carried out. The concentrations of six enzymes (lactate dehydrogenase, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, serum cholinesterase and gamma glutamyl transpeptidase) werechosen specifically as indices of liver function. The eosinophil count was measured to reflect any hypersensitivity reaction. The non-Gaussian distribution of these necessitated using appropriate non-parametric tests together with parametric tests on logarithmic transformed data. In addition a quantal method was used to measure the frequency of patients showing an "abnormal" increase in enzyme concentrations.

Anesthesia, Inhalation↗

A prospective study of liver enzyme and other changes following repeat administration of halothane and enflurane.

A prospective study of liver enzymes and other measurements following repeat administrations of halothane or enflurane was carried out in patients undergoing minor urological operations. The patient populations were similar with respect to frequency of factors which might influence liver function, social habits, drug therapy and time intervals between administrations. Sixty-three received two or more administrations of halothane and 66 received two or more administrations of enflurane, both drugs given with nitrous oxide in oxygen. There was a greater frequency of increased enzymatic activity following repeat administrations of halothane than following enflurane and the average alanine aminotransferase and gamma glutamyl transpeptidase concentrations were increased to a greater degree following halothane than enflurane. There was no change in the eosinophil count and no significant postoperative morbidity. Change in alanine aminotransferase, lactate dehydrogenase and gamma glutamyl transpeptidase occured more frequently in obese patients receiving halothane.

Aged↗

Frequency of atopy and allergy in an anaesthetic patient population.

Ten thousand patients presenting for anaesthesia in the British Isles were questioned about a possible history of atopic or allergic disorders. The overall percentage frequency of atopy was 8.5, comprising eczema 2.4, hay fever 3.8 and asthma 3.5. The frequency of allergies was 13.5, of which penicillin was the most common (6.2). Females had a significantly greater frequency of atopy or allergy than males. Patients with a history of atopic disorders had a higher frequency of allergies than the non-atopic group (36.2% compared with 11.4%) and vice versa.

Adolescent↗

Frequency of previous anaesthesia in an anaesthetic patient population.

Ten thousand patients presenting for anaesthesia were questioned about their anaesthetic history; 6672 had received an anaesthetic previously, 19.2% in the preceding 4 weeks. Of 2780 in whom the agents were known, 80.4% had received thiopentone, 18.1% Althesin and 57.4% halothane. Thirty-seven per cent of the total survey population had received two or more anaesthetics.

Adolescent↗

Ketamine sequelae. Evaluation of the ability of various premedicants to attenuate its psychic actions.

The ability of a number of drugs to abolish the emergence delirium and unpleasant dreams which follow anaesthesia induced with 2 mg/kg ketamine was studied. These included three benzodiazepines, droperidol and 'neurolept' combinations and four commonly-used premedicants. When given intravenously 10 min before induction of anaesthesia flunitrazepam and lorazepam gave best results. In a subsequent study, these two benzodiazepines and diazepam were given intravenously 30-40 min before induction of anaesthesia. There was no doubt that 4 mg lorazepam gave the greatest protection and is worthy of further study in this respect.

Analgesics, Opioid↗