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Biomedical subjects

M D Vickers

Publications and source records attributed to M D Vickers.

At least 55 records · Page 3Linked to original sources
PubMed1987

Comparison of temazepam elixir and trimeprazine syrup as oral premedication in children undergoing tonsillectomy and associated procedures.

Temazepam 0.5, 1.0 and 1.5 mg kg-1 in an elixir formulation (Euhypnos Elixir), was compared with trimeprazine tartrate 3 mg kg-1 in a syrup (Vallergan Forte Syrup), as premedication in 220 children (ASA grade I) undergoing tonsillectomy and associated procedures. Each patient was randomly allocated to one of the four treatments. The administration was blind to the observers in theatre, recovery room and postoperative ward, who assessed each patient according to a total of 14 criteria. A modelling technique allowed account to be taken of the effects of concomitant variables (e.g. age and duration of anaesthesia) where appropriate. No statistically significant difference was found between the efficacy of the treatments. The only statistically significant differences were that temazepam was associated with more ectopic beats under anaesthesia (P = 0.03 or 0.002, depending on the test applied), more postoperative vomiting (P = 0.04) and more postoperative restlessness (P less than 0.0001).

Adolescent↗
PubMed1986

Respiratory function following nalbuphine and morphine in anaesthetized man.

In 40 patients anaesthetized with thiopentone, 66% nitrous oxide and 1% halothane, the effects of a single i.v. dose of nalbuphine 4.5, 8, 15, 25 or 50 mg/70 kg or morphine 3, 5, 10 or 17.5 mg/70 kg on total ventilation and end-tidal carbon dioxide concentration have been measured. Depression of respiration occurred with both drugs and with all doses. The lower doses of nalbuphine produced more depression than equianalgesic doses of morphine. Conventional equianalgesic doses produced similar degrees of depression. With the highest dose of morphine, respiratory impairment progressed to apnoea whereas, with nalbuphine, apnoea did not occur in any patient. With increasing dosage of nalbuphine there appeared to be a limit to the extent of respiratory depression. The highest dose of nalbuphine produced less depression than some lower doses, suggesting a reversal effect.

Adolescent↗
PubMed1985

Effect of premedication with controlled-release oral morphine on postoperative pain. A comparison with intramuscular morphine.

Thirty fit patients presenting for elective total hip replacement were randomly allocated to receive a premedication of 60 or 90 mg controlled-release oral morphine or 15 mg intramuscular morphine. Postoperative analgesia was assessed using on-demand intravenous pethidine supplementation requirements. In 15 patients free plasma morphine concentrations were measured. Both 60 and 90 mg controlled-release oral morphine led to a reduced pethidine requirement compared to the intramuscular group but the reduction was not statistically different.

Administration, Oral↗
PubMed1985

Self-administered nalbuphine, morphine and pethidine. Comparison, by intravenous route, following cholecystectomy.

In a double-blind clinical trial of 48 patients, nalbuphine, morphine, and pethidine were compared by on-demand intravenous analgesia during the first 24 hours after cholecystectomy. Overall pain relief (visual analogue score) was recorded by the patients as 50 (SEM 4) for nalbuphine, 44 (SEM 4) for morphine and 53 (SEM 5) for pethidine. These scores were not significantly different. The mean demand for each drug over the 24-hour period was 70 (SEM 12) mg for nalbuphine, 46 (SEM 6) mg for morphine and 614 (SEM 49) mg for pethidine. Pain on movement, either during deep breathing or turning, was found to be less well controlled after nalbuphine (70, SEM 2), and pethidine (67 SEM 7) than after morphine (52, SEM 5; p less than 0.01). The incidence of side effects was similar with each drug. Nalbuphine is a useful postoperative analgesic, as effective as pethidine. Nalbuphine 15 mg is apparently equipotent with morphine 10 mg or pethidine 120 mg by this mode of administration.

Adult↗
PubMed1984

Chronic cannulation of the intradural or extradural space in the rat.

An animal preparation has been developed to test therapeutic agents in the extradural and intradural spaces. Under anaesthesia a hole was drilled in the penultimate lumbar vertebra of male Wistar rats and the appropriate space cannulated. The catheter was tunnelled subcutaneously to emerge at the neck. There was no spinal cord or meningeal reaction after 1 month. Catheters remained patent for 3 months. The method of cannulation allowed free rostral spread of drugs. Using plain 2% lignocaine, paralysis and anesthesia of the hind limbs required an intradural volume of 32 +/- 3 mulitre: the required volume on extradural injection was 46 +/- 2 mulitre (P less than 0.01). Paralysis of all limbs required an intradural volume of 115 +/- 12 mulitre. Respiratory arrest and death required a mean intradural volume of 179 +/- 15 mulitre.

Anesthesia, Epidural↗
PubMed1984

Histopathology of the spinal cord after intrathecal cocaine, bupivacaine, lignocaine and adrenaline in the rat.

Repeated intrathecal injections were given through catheters which had been chronically implanted in the subarachnoid space of rats. Injections were made of cocaine 0.25%, 0.125% and 0.0625%; bupivacaine 0.5%; lignocaine 2% and 0.5%; adrenaline 0.01% (1 in 10 000) and 0.002% (1 in 200 000); and sodium chloride 0.9%. Five injections of 35 microliter of each concentration of each drug were given hourly each day for two days to three rats. No clinical nerve damage was detectable in any rat. The only pathological change found in any rat was the development of cytoplasmic vacuolation in the neurones of the anterior and posterior horns. The changes were most prominent after injection of 0.9% sodium chloride and bupivacaine, whilst lignocaine (0.5 and 2%) showed the least number of vacuoles, which were also the smallest in size. Adrenaline and cocaine were intermediate in effect. There was no evidence of cell death. These changes were not seen in control animals in which catheters had been implanted but no injections had been given. The changes were mild and it is concluded that the agents tested caused no significant damage.

Animals↗
PubMed1983

Intramuscular on demand analgesia: double blind controlled trial of pethidine, buprenorphine, morphine, and meptazinol.

An on demand intramuscular analgesic system using the Cardiff Palliator was tested. Forty consenting patients were studied after cholecystectomy in a double blind trial using increments of buprenorphine (0.15 mg), meptazinol (50 mg), morphine (5 mg), and pethidine (50 mg). Most patients attained good levels of pain relief (mean analogue pain score 36.5), comparable to intravenous on demand analgesia. There were no technical complications. Significant differences were found between drugs in dizziness (pethidine produced the worst score) but not with other side effects. Buprenorphine produced longer lasting analgesia than meptazinol or pethidine and also gave the lowest pain scores. Patterns of analgesic consumption were the same as with intravenous on demand systems, but larger amounts of drug were generally used. Relative analgesic potencies derived from drug consumption rates were also consistent with those from intravenous on demand studies. An on demand intramuscular analgesic system offers a simple but effective means of relieving severe postoperative pain.

Adolescent↗
PubMed1983

Comparison between buprenorphine and pentazocine given i.v. on demand in the control of postoperative pain.

A double-blind comparison between buprenorphine and pentazocine was performed in 20 patients using an on demand analgesic system to provide analgesia after operation. The quality of analgesia, assessed subjectively, was good with both drugs and drug consumptions were compatible with previous potency estimates. The mean doses demanded in 24 h of buprenorphine (1.68 mg) and of pentazocine (382 mg) are consistent with those found in other trials although the between-patient variation was five- or six-fold. There was no significant difference in side-effects between the two groups. Buprenorphine and pentazocine may be used successfully in an on demand system to provide relief of severe pain after operation.

Adolescent↗
PubMed1983

Cardiff Palliator.

Explore the source record for details and available documents.

Analgesics, Opioid↗
PubMed1983

The efficacy of face masks.

Photographs of smoke particles expelled by coughing showed that the filtration type of face mask effectively prevents them from spreading far from the wearer.

Cough↗
PubMed1983

An open comparison between routine and self-administered postoperative pain relief.

Patients receiving staff-administered analgesics after upper abdominal surgery had higher pain scores than similar patients having self-administered analgesics, but this was associated with a considerably smaller average amount of analgesic given. This survey was subject to observer and patient bias and it was necessary to use 'pethidine equivalents' to enable comparisons to be made between drugs with effects of different duration; thus the striking differences in pain scores and grades can be considered indicative only. They nevertheless support the continued investigation of on-demand systems and make a strong case for a double-blind controlled trial.

Abdomen↗
PubMed1982

A new anaesthetic record.

Record-keeping is part of the proper practice of anaesthesia and a record should be able to be quickly and easily completed. Two types of information need to be recorded: clinical, for use both immediately or subsequently and epidemiological, for detailed study of a large number of anaesthetics. A design which answers both these aims is described.

Anesthesia, Obstetrical↗