Biomedical subjects
M C Mushambi
Publications and source records attributed to M C Mushambi.
Extradural haematoma in a patient following manual removal of the placenta under spinal anaesthesia: was the spinal to blame?
A postpartum patient with a history of epilepsy and lack of compliance with anticonvulsant medication presented with seizures following removal of the placenta under spinal anaesthesia. An acute posterior fossa extradural haematoma was diagnosed and evacuated uneventfully. The aetiology of the seizures and possible association of the haematoma with spinal anaesthesia are discussed.
Patients' assessment of sensory levels during epidural analgesia in labour.
Thirty women in established labour and with epidurals in situ were asked to assess the sensory level of the epidural using loss of light touch sensation with their own finger. This dermatomal level was then compared to the sensory level assessed by an anaesthetist using loss of cold sensation with ethyl chloride spray. A total of 88 assessments were made. The mean dermatomal difference was 0.20 and 95% of the differences lay between 3.5 and -3.1 dermatomes. This large variation in dermatomal differences between the two methods of sensory assessment means that patient light touch is not an acceptable method of assessing epidural sensory level when compared to ethyl chloride.
Post-anaesthesia recovery care on the labour ward.
We conducted a questionnaire survey amongst midwives working in the labour wards of two hospitals within the Trent region. The results show that most of these midwives undertake the care of postoperative patients infrequently and have received little, if any, training. Also, most had not received any guidelines on which to base their practice. Over 80% observed respiratory rate, pulse rate, colour and manual blood pressure with approximately half measuring body temperature. In one hospital, over 90% used an automated blood pressure monitor and pulse oximeter. In the second hospital this happened in only 50% of cases. There appears to be some confusion regarding the monitors used postoperatively in that 11% of midwives said that they routinely used a capnometer in this situation.
"Walking extradurals" in labour: a step forward?
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Maternal death following epidural anaesthesia.
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Recent developments in the pathophysiology and management of pre-eclampsia.
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Accidental insertion of an extradural catheter.
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Complications of hysteroscopic treatments of menorrhagia.
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Ovarian hyperstimulation syndrome.
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Effect of alcohol on gastric emptying in volunteers.
We have examined the effect of alcohol on the gastric emptying rate of a liquid meal in 10 volunteers. Each volunteer was allocated randomly to receive, on three occasions, no alcohol, 3 units or 6 units of alcohol. Gastric emptying was measured using applied potential tomography. The rate of gastric emptying as measured by the time to 50% emptying (T50) was delayed significantly (P < 0.01) after alcohol 6 units (median 45.0 min (range 19-90 min)) compared with control (23.0 min (13-36 min)) and there was little change after alcohol 3 units (25.5 min (10-65 min)) [corrected].
Gastric emptying after minor gynaecological surgery. The effect of anaesthetic technique.
Gastric emptying was measured using the paracetamol absorption method in 30 patients immediately after a general anaesthetic for minor gynaecological surgery and in 10 female controls. Anaesthesia was induced with either propofol alone, propofol and alfentanil (4.5 micrograms.kg-1) or propofol and fentanyl (1.4 micrograms.kg-1) and maintained with intermittent propofol and 66% nitrous oxide in oxygen. Gastric emptying was delayed significantly in all patient groups when compared with volunteers. However, the delay in gastric emptying was similar in the three patient groups.
A comparison of gastric emptying rate after cimetidine and ranitidine measured by applied potential tomography.
Gastric emptying was measured using applied potential tomography (APT) after crossover administration of 800 mg cimetidine and 300 mg ranitidine orally. Ten volunteers were studied, each on two occasions. Two hours after taking ranitidine or cimetidine, the volunteer was given a liquid and gastric emptying was measured over 60 min. There was a small but statistically significant delay in gastric emptying following ranitidine compared with cimetidine (P less than 0.04). The median (range) time to 50% emptying (t50) was 24 (15-60) min after ranitidine compared with 22 (15-46) min after cimetidine.
Effect of sublingual buprenorphine on gastric emptying of a liquid meal.
The effect of buprenorphine 0.2 mg sublingually on gastric emptying of a liquid meal in 10 volunteers was compared with placebo. Gastric emptying was measured by applied potential tomography and was delayed significantly by buprenorphine (P less than 0.001).