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Biomedical subjects

P D McIlroy

Publications and source records attributed to P D McIlroy.

13 recordsLinked to original sources
PubMed1983

Cardiovascular and biochemical evidence of stress during major surgery associated with different techniques of anaesthesia.

The relative merits of a potent narcotic and a spinal analgesic to affect the stress response to a standard operation have been assessed. Forty-five fit patients scheduled for abdominal hysterectomy were allocated at random to three groups, referred to as standard (i.v. anaesthesia alone), spinal (spinal plus i.v. anaesthesia) and fentanyl (fentanyl plus i.v. anaesthesia) groups. In the doses used, fentanyl produced the most effective attenuation of the cardiovascular, hormonal and metabolic responses to stress, but had the disadvantage of prolonged respiratory depression. Spinal anaesthesia gave only a modified blockade of the response to stress and did not obtund the response to intubation.

Adult↗
PubMed1981

Liver enzyme studies with continuous intravenous anaesthesia.

A battery of liver function tests was carried out before operation and on the 3rd--5th and 13th--15th postoperative days in patients anaesthetised with continuous infusion of thiopentone, Althesin or etomidate for an intermediate operation. Some derangement of enzyme activity was found in one quarter to one third of the patients, and was most marked after Althesin. The findings are compared with published data on ketamine, which had an effect on enzyme activities similar to that of Althesin. On pooling data from different studies it became very apparent that large doses of intravenous anaesthetics cause a greater derangement of liver function than that which occurs using a balanced technique for the same operation.

Adult↗
PubMed1981

Prospective study of liver function following repeat halothane and enflurane.

In a prospective study of liver function following repeat anaesthesia, patients who received repeat halothane had a higher frequency of abnormal liver enzyme results than a similar group who received repeat enflurane. Obesity and short intervals between administrations increased the likelihood of abnormal liver enzyme activity in the halothane group. Enflurane would seem to be the volatile agent of choice for repeat anaesthesia in such circumstances.

Adult↗
PubMed1980

Changes in serum enzyme levels following ketamine infusions.

The levels of four serum enzymes, known to be elevated in toxic hepatitis, were measured preoperatively and on the 3-4th and 13-15th postoperative days in patients anaesthetised with ketamine infusions (54) or with a standard technique (64). Significant elevations in enzyme levels were considered to have occurred when the postoperative levels were outside the accepted normal range and had increased by more than 3 X SD from controls. About half the patients in each group had minor gynaecological operations and 2/20 in the ketamine series had postoperative elevation of enzyme levels, with no changes in the non-ketamine group. Following intermediate operations 14/34 anaesthetised with ketamine showed abnormal enzyme levels compared with 7/34 who had standard operations. None of the latter had more than one abnormal test as compared with six in the ketamine series. The causes and significance of these findings are not known.

Adult↗
PubMed1979

Methodology of a prospective study of changes in liver enzyme concentrations following repeat anaesthetics.

The methodology of a large prospective study on the influence of repeated anaesthetics on liver function is reported and the problems involved are discussed. The most suitable patients were those presenting for endoscopic examination of the bladder and urethra, for urethral dilatation and for cervical implantation of radium. Blood samples were taken immediately before induction of anaesthesia and on days 3-4 and 13-15 after operation, when a clinical assessment of the patient was also carried out. The concentrations of six enzymes (lactate dehydrogenase, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, serum cholinesterase and gamma glutamyl transpeptidase) werechosen specifically as indices of liver function. The eosinophil count was measured to reflect any hypersensitivity reaction. The non-Gaussian distribution of these necessitated using appropriate non-parametric tests together with parametric tests on logarithmic transformed data. In addition a quantal method was used to measure the frequency of patients showing an "abnormal" increase in enzyme concentrations.

Anesthesia, Inhalation↗
PubMed1979

A prospective study of liver enzyme and other changes following repeat administration of halothane and enflurane.

A prospective study of liver enzymes and other measurements following repeat administrations of halothane or enflurane was carried out in patients undergoing minor urological operations. The patient populations were similar with respect to frequency of factors which might influence liver function, social habits, drug therapy and time intervals between administrations. Sixty-three received two or more administrations of halothane and 66 received two or more administrations of enflurane, both drugs given with nitrous oxide in oxygen. There was a greater frequency of increased enzymatic activity following repeat administrations of halothane than following enflurane and the average alanine aminotransferase and gamma glutamyl transpeptidase concentrations were increased to a greater degree following halothane than enflurane. There was no change in the eosinophil count and no significant postoperative morbidity. Change in alanine aminotransferase, lactate dehydrogenase and gamma glutamyl transpeptidase occured more frequently in obese patients receiving halothane.

Aged↗
PubMed1977

Estimation of plasma lorazepam by gas-liquid chromatography and a benzene extraction.

Plasma lorazepam can be easily and reliably estimated using a simple single stage benzene extraction and gas-lizuid chromatography with flunitrazepam as the internal standard. Reproducible results within the clinical range of plasma levels were obtained. This method permits the extraction and chromatographing of 40 samples in approximately 7 1/2 hours.

Anti-Anxiety Agents↗