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Biomedical subjects

N W Goodman

Publications and source records attributed to N W Goodman.

At least 19 recordsLinked to original sources
PubMed1997

The hypertensive response to intubation. Do researchers acknowledge previous work?

PURPOSE: To see whether investigators of a circumscribed research topic, the haemodynamic response to orotracheal intubation, review and cite previous work. A 1989 editorial about the response was critical to investigators for measuring physiology but not outcome; for nonetheless making recommendations; for studying only patients not at risk; and for implying patients are at risk when this is not certain. METHODS: A systemic Medline search was made for English language reports published during or after 1990, and their citation lists read for missed reports. All retrieved papers were read for citation of the editorial and for acknowledgement of its criticisms. Citations were tabulated, and cross-referenced between papers, to see whether blocks of citations had been obtained from other investigators' reports. RESULTS: Eighty-one full reports, from 48 groups of investigators, were obtained. The 1989 editorial was cited twice. All studies included physiological measurements, but none reported long-term outcome. There was no comment on the need to know outcome in 39 reports. Pre-existing risk factors were exclusions in 65 studies. In 56 papers, complications of the response were given as the reason for the study; in 41 of these papers only healthy subjects were studied. In total, 249 references about the response were identified from the 81 papers. There was no obvious evidence that citations were obtained from others' papers. CONCLUSION: Recognised deficiencies in research method were not acknowledged. When submitting work for publication, investigators should provide evidence of how they searched for previous work.

Bibliographies as Topic↗
PubMed1996

Abstract values.

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Abstracting and Indexing↗
PubMed1995

Denial of effective treatment and poor quality of clinical information in placebo controlled trials of ondansetron for postoperative nausea and vomiting: a review of published trials.

OBJECTIVE: To determine how many patients were deprived of treatment by being given placebo as comparator in trials of ondansetron for postoperative nausea and vomiting. DESIGN: Review of published trials of ondansetron during 1991 to July 1994. SETTING: Medline search in a university department of anaesthesia. SUBJECTS: 8806 patients who had been included in 18 indexed placebo controlled trials of ondansetron as prophylaxis against or treatment of postoperative nausea and vomiting. RESULTS: Five studies (1236 patients) had been published by July 1992. All were placebo controlled trials. By July 1994, 8806 patients had been included in 18 indexed placebo controlled studies of prophylaxis or treatment. Only 462 patients had been in studies that compared ondansetron with other drugs, and there were no indexed comparative trials of treatment of nausea and vomiting. Roughly 2180 patients had been given placebo as prophylaxis and 440 had been given placebo when already experiencing postoperative nausea or vomiting. CONCLUSIONS: Around 2620 patients in the reviewed studies were denied existing drugs, which, though not completely effective or without side effects, do bring some relief from postoperative nausea and vomiting. Drug regulatory bodies should collaborate with drug companies to ensure better comparison of new with established drugs. This would avoid placebos being given to more than the fewest patients necessary to confirm effect and would allow doctors to be informed more quickly about relative efficacies.

Anesthesia Department, Hospital↗
PubMed1995

Bimodality of expiratory time in patients anaesthetized with propofol.

In the records of breathing from five of 32 patients in two previous studies, the distribution of expiratory times appeared bimodal. Records of breathing from another 40 patients anaesthetized for up to 1 h with propofol infusions were examined; there was clear evidence of bimodality in the distribution of expiratory time in 14 records. The bimodality was independent of tidal volume or inspiratory time, and seemed to be caused largely by differing durations of expiratory pause. In six records there was a change of state between unimodality and bimodality. There was no obvious common factor to explain the bimodality or why a change of state should occur.

Adult↗
PubMed1995

Effect of i.v. lignocaine on the breathing of patients anaesthetized with propofol.

Local anaesthetics are ventilatory depressants, but previous investigators have not commented on the effects on ventilatory timing. There is concern about the possible ventilatory depression caused by systemic absorption of local anaesthetics injected extradurally. We have studied ASA grade I patients anaesthetized with a propofol infusion and breathing spontaneously; they were given in random order lignocaine 1.5 mg kg-1 i.v. and an equivalent volume of 0.9% saline. Breathing was analysed using respiratory inductance plethysmography in 30-s periods for 4 min after injection, each period scaled to the 30-s period preceding injection. Lignocaine reduced minute ventilation. The greatest mean reduction in the 4 min was to 85%, occurring 2.5-3 min after injection; the greatest individual reduction was to 60-65%, which occurred by 30-60 s. Lignocaine decreased tidal volume and ventilatory rate by prolonging expiratory time. Lignocaine had no effect on or promoted bimodality of expiratory time. End-tidal carbon dioxide increased by a mean of 0.1%; the largest individual change was 0.3%. This suggests that lignocaine may have reduced the metabolic rate, affecting ventilation indirectly, but we conclude that lignocaine in a normal extradural dose should not be an important ventilatory depressant.

Adult↗