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Biomedical subjects

M J Parr

Publications and source records attributed to M J Parr.

42 records · Page 3Linked to original sources
PubMed1992

Patient-controlled epidural analgesia following post-traumatic pelvic reconstruction. A comparison with continuous epidural analgesia.

A randomised, single-blinded study was conducted to compare patient-controlled epidural analgesia with continuous infusion epidural analgesia for the treatment of pain following post-traumatic pelvic reconstruction. The patient-controlled group (n = 11) received a background infusion of 4 ml.h-1 of bupivacaine 0.125% with fentanyl 1 microgram.ml-1, and 3-6 ml bolus doses, self administered, as required (with a 15 min lockout interval). The continuous infusion group (n = 12) received a continuous infusion of the same solution through an identical apparatus, but with the demand button deactivated. This was started at 10 ml.h-1 and adjusted by the anaesthetist, as required, up to a maximum of 25 ml.h-1. Pain scores, side effects, and the volumes of drug infused were recorded over the first 3 postoperative days. One patient from each group was withdrawn because of catheter-related problems. Pain scores were similar and the incidence of nausea and pruritus was low in both groups. There was no recorded instance of respiratory depression or hypotension and there was no significant difference between the groups in the volumes of drug solution received. Patient satisfaction was equally very good in both groups. Patient-controlled epidural analgesia is an effective means of providing pain relief after post-traumatic pelvic reconstruction, but did not significantly reduce analgesic requirements in comparison with continuous infusion epidural analgesia.

Adult↗
PubMed1990

Theophylline poisoning--a review of 64 cases.

Sixty-four cases of theophylline poisoning were reviewed. All but two cases represented international self poisoning. The majority of patients were young females who presented acutely after ingestion of sustained release preparations prescribed for asthma. Serum theophylline levels (mean 365 mumol/l, SD 177) indicated a high risk of toxicity. Electrolyte and metabolic abnormalities (hypokalaemia, hypomagnesaemia, hypophosphataemia, hyperglycaemia, acid-base disturbances and leucocytosis) were common. Serum potassium, serum glucose, leucocyte count and length of stay in the intensive care unit all correlated strongly with maximum serum theophylline level (p less than 0.001). The low incidence of life-threatening manifestations of severe toxicity (hypotension, serious arrhythmias or seizures) and excellent outcome, contrasts with many previous reports. The results support the use of a management regimen which emphasizes intensive supportive therapy and restricts the use of charcoal haemoperfusion.

Adolescent↗