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Biomedical subjects

K S Koss

Publications and source records attributed to K S Koss.

6 recordsLinked to original sources
PubMed2002

High-dose diclofenac for postoperative analgesia after elective caesarean section in regional anaesthesia.

Although the use of non-steroidal anti-inflammatory drugs (NSAIDs) is well established in the postoperative setting, their use after caesarean sections is still controversial. In a randomised, double-blinded, placebo controlled study we have estimated the opioid-sparing effect of diclofenac suppositories after elective caesarean sections in spinal anaesthesia. Eighty-two women ASA class I or II scheduled for caesarean section were randomised to receive either diclofenac suppositories 100 mg or placebo every 12 h after the operation. The diclofenac group (n = 40) consumed significantly less morphine in the postoperative period (14.0 +/- 1.5 mg in 32 h) compared with the placebo group (21.5 +/- 1.6 mg in 32 h, P < 0.05). The average level of postoperative pain as estimated by a visual analogue scale (VAS) and a verbal scale tended to be lower in the diclofenac group, but this was not significant. There were no differences in demographic data, perioperative bleeding, side-effects or discharge time between the groups. Diclofenac suppositories 100 mg given twice daily after caesarean section are opioid sparing.

Clinical Trial↗
PubMed1999

Bupivacaine 2.5 mg/ml versus bupivacaine 0.625 mg/ml and sufentanil l microg/ml with or without epinephrine 1 microg/ml for epidural analgesia in labour.

We have compared three different methods of epidural analgesia in labour, bupivacaine 2.5 mg/ml (group B), bupivacaine 0.625 mg/ml + sufentanil 1 microg/ml (group BS) and bupivacaine 0.625 mg/ml + sufentanil 1 microg/ml + epinephrine 1 microg/ml (group BSE). One hundred and forty parturients with a singleton fetus with cephalic presentation were randomly allocated to one of the three groups. Group BSE had significantly less pain than groups B and BS. Group B had a significantly higher degree of motor blockade assessed on the Bromage scale. Significantly, more women in group B required urinary bladder catheterization than in the two other groups and they also had significantly less urge to push during active delivery. The incidence of mild pruritus was 18% in group BS and 36% in group BSE. The frequency of instrumental delivery and caesarean section was low (12% and 6.4%, respectively) with no significant differences between the groups. All women were highly satisfied with the method of analgesia and 97% would prefer the same kind of pain alleviation at the next delivery. We conclude that epidural analgesia with low-dose bupivacaine and sufentanil is as good an analgesic method as high-dose bupivacaine. Addition of low-dose epinephrine improves the analgesia.

Clinical Trial↗
PubMed1985

Blood velocities in the uterine artery in humans during labour.

Blood velocities in the uterine arteries were measured during labour in humans, by means of the pulsed ultrasound Doppler velocity meter (UNIDOP). The uterine arteries were approached through the abdominal wall at the lateral border of the uterus and through the lateral vaginal fornix. At a depth of 0.5-1.5 cm from the lateral vaginal fornix there were three different arteries in each woman. One of these arteries had similar velocity spectra to the uterine artery as measured through the abdominal wall higher up along the uterus, and the velocities were in the same range. The mean velocities were high and the velocities in diastole were high compared to those in systole. During uterine contractions the velocities were reduced during diastole, reducing mean velocities by 20-40% as measured through the vagina and by 50-60% when measured higher up through the abdominal wall. A second artery, which we believe is a branch of the uterine artery traversing the myometrium, had lower mean velocities and a greater difference between systole and diastole. During contractions the velocities were reduced by 100%. A third artery, which we believe is the descending branch of the uterine artery, supplying the cervix and vagina, had the lowest mean velocities, with backflow during diastole. During contractions the velocities increased 100-140%.

Arteries↗
PubMed1985

Blood velocities to the female breast during lactation and following oxytocin injections.

A heterodyne pulsed doppler velocitymeter was used to measure blood velocities in the mammary branch of the lateral thoracic artery during breast-feeding and after oxytocin injections. A few heart beats before the mother felt the milk-ejection reflex, blood velocities fell rapidly by 40-50%, and then increased during the next 1-2 min. Synthetic oxytocin was given intravenously to lactating women, both in doses believed to be physiological in milk-ejection and larger, and the same velocity changes occurred. Synthetic oxytocin was also given to non-lactating women who had never been pregnant or who had breast-fed previously and to one man. In these a rapid increase in velocity was observed after about a half a minute, lasting for 1-2 min. In addition to the short-term effects of breast-feeding, blood velocity increased rapidly towards the end of nursing or a few minutes afterwards, with a maximal increase of 25-50%. It then slowly returned to pre-nursing values during the following 30-60 min. This pattern was seen in both breasts, independent of which breast the infant had been sucking.

Blood Flow Velocity↗
PubMed1982

Interindividual variation in vaginal examination findings during labor.

A series of 99 paired vaginal examinations before or during labor were analysed. For each single comparison two observers recorded his or her findings independently. In about 90% there was either complete agreement or a difference of 1 cm, both for the dilatation of the cervix and the station of the presenting fetal part along the pelvic axis.

Cervix Uteri↗