Biomedical subjects

P Vichitvejpaisal

Publications and source records attributed to P Vichitvejpaisal.

9 recordsLinked to original sources

PubMed2001

Does computer-assisted instruction really help to improve the learning process?

OBJECTIVES: We have developed both a computer-assisted instruction (CAI) multimedia program and a textbook on arterial blood gas interpretation with the same content as formal didactic instruction. A prospective, randomized study was designed to compare the outcomes of self-learning using the software and using the textbook. METHODS: 80 third-year medical students were randomly allocated to two groups: the CAI (n=40) and text group (n=40). A 30-item, type-K examination was administered as the pre-test. After the pre-test, the volunteers in the CAI group studied the software program, whereas those in the text group spent their time reading the textbook covering the same material. The post-test was held immediately at the end of a full day of study, and 3 weeks later, the final test was performed without prior notice. A P value of <0.05 was considered to be a statistically significant difference. RESULTS: Students in the text group seemed to fulfil their assignments and improved their scores post-test better than those in the CAI group. After 3 weeks, the final test scores of both groups demonstrated a significant decrease, but showed an insignificant difference between the two groups. CONCLUSION: Text-based learning seems to be a convenient method of education where time is limited. However, with more time available, use of software may be as good as the conventional learning method and can be an alternative tool. The computer-assisted instruction program seems to enhance the learning process.

Computer-Assisted Instruction↗

PubMed1997

Effect of severity of pulmonary disease on nitrous oxide washin and washout characteristics.

The influence of chronic obstructive pulmonary disease (COPD) on the nitrous oxide (N2O) washin and washout characteristics was evaluated in 90 (ASA II-III) males undergoing elective peripheral surgery under general anaesthesia with controlled ventilation. Patients were classified by preoperative bedside pulmonary function testing into three groups. Group I (n = 30), patients without COPD (FEV1/FVC > 80% predicted values; control group); Group II (n = 30), patients with mild COPD (FEV1/FVC = 65-79% of predicted values); and Group III (n = 30), patients with moderate COPD (FEV1/FVC = 50-64% of predicted values). The anaesthetic technique was standardized for all patients. The Datex Capnomac Ultima monitor was used to measure the inspired and expired concentrations of nitrous oxide (N2O), carbon dioxide (CO2), and isoflurane. The duration of both N2O washin (time from start of N2O administration to equilibrium of inspired and expired N2O concentrations) and 5 per cent washout (time from discontinuation of N2O to an expired N2O concentration of 5 per cent of the equilibrium value) were recorded. The duration of N2O washin and washout were significantly prolonged in Groups II and III (P < 0.001) as compared to the control group (Group I). The end-tidal CO2 concentration decreased significantly during N2O washout without causing oxygen desaturation (SpO2 < 90%). We conclude that the duration of N2O washin and washout were significantly prolonged in anaesthetized patients with COPD which may delay the induction and recovery from N2O anaesthesia.

Aged↗

PubMed1996

Effects of nebulized beta 2-adrenergic agonists on pulmonary mechanics in anesthetized patients with chronic obstructive pulmonary disease.

We evaluated the effects of nebulized beta 2-adrenergic agonists on pulmonary mechanics in patients with COPD undergoing peripheral surgery with a standardized general anesthetic technique. Thirty males with COPD were randomized into one of three groups. Group I (control group; n = 10) received nebulized saline 3 ml, Group II (n = 10) received nebulized albuterol (2.5 mg in 3 ml), and Group III (n = 10) received nebulized metaproterenol (15 mg in 3 ml). At 20 min after tracheal intubation, the study drugs were nebulized over 20 min. Datex Capnomac Ultima monitor was used to measure pulmonary mechanics on a breath-by-breath basis. There was no difference between the three groups with respect to demographic data and preoperative respiratory parameters. A similar degree of DPH occurred with the initiation of mechanical ventilation in all three groups. Patients receiving nebulized bronchodilators (Groups II and III) displayed a significant decrease in DPH and an increase in total dynamic compliance. However, there were no differences in DPH and total dynamic compliance between Groups II and III. We conclude that nebulization of either albuterol or metaproterenol can alleviate DPH resulting from mechanical ventilation in anesthetized patients with COPD.

Administration, Intranasal↗

PubMed1995

Comparative effects of lidocaine, esmolol, and nitroglycerin in modifying the hemodynamic response to laryngoscopy and intubation.

STUDY OBJECTIVE: To compare the safety and efficacy of lidocaine, esmolol, and nitroglycerin in modifying the hemodynamic response to laryngoscopy and intubation. DESIGN: Randomized, placebo-controlled, double-blind study. SETTING: University-affiliated VA medical center. PATIENTS: 40 ASA physical status I and II patients undergoing electric surgery with general endotracheal anesthesia. INTERVENTIONS: Anesthesia was induced with thiopental sodium 5 mg/kg, and intubation was facilitated with vecuronium 0.15 mg/kg. Isoflurane (0.5% to 1%) and 50% nitrous oxide in oxygen were used for maintenance of anesthesia. In addition, patients received one of the following four study drugs intravenously (i.v.) prior to laryngoscopy: Group 1 (control) = saline 5 ml; Group 2 = lidocaine 1.5 mg/kg; Group 3 = esmolol 1.4 mg/kg; Group 4 = nitroglycerin 2 micrograms/kg. MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure (MAP) and heart rate (HR) were recorded every minute for 20 minutes following induction of anesthesia. Following laryngoscopy and intubation, MAP increased significantly in all four treatment groups (control 49% +/- 19%, lidocaine 55% +/- 26%, esmolol 25% +/- 11%, nitroglycerin 45% +/- 21%) compared with preinduction baseline values. In the esmolol-pretreated patients, the increase in HR was significantly lower (20% +/- 3%) compared with the nitroglycerin (37% +/- 8%), lidocaine (52% +/- 8%), and control (29% +/- 4%) groups. CONCLUSIONS: Lidocaine 1.5 mg/kg i.v. and nitroglycerin 2 micrograms/kg i.v. were ineffective in controlling the acute hemodynamic response following laryngoscopy and intubation. Esmolol 1.4 mg/kg i.v. was significantly more effective than either lidocaine or nitroglycerin in controlling the HR response to laryngoscopy and intubation (p < 0.05). Esmolol also was significantly more effective than lidocaine in minimizing the increase in MAP (25% vs. 55%).

Adrenergic beta-Antagonists↗

PubMed1993

Preoperative autologous blood collection and haemodilution with gelatin solution (gelifundol).

Autologous blood collection and haemodilution with gelatin solution had an effect on the decrease in red blood cells, haemoglobin, haemotocrit, fibrinogen and platelets; however, this technique had no effect on coagulograms, platelet function and haemostasis. In conclusion, this technique is suitable and possibly practical in obtaining sufficient blood for elective surgical patients and is without any undesirable side effects.

Adolescent↗

PubMed1992

A comparative study of isobaric and hyperbaric solution of bupivacaine for spinal anaesthesia in caesarean section.

Though hyperbaric solution of bupivacaine following intrathecal injection had satisfactory spread of analgesia, it regressed rapidly with more side effects. Isobaric bupivacaine seemed to provide a slow regression of analgesia with fewer undesirable effects except for its inadequate spread of analgesia. As a result, if the dosages as well as the time of administration of isobaric solution are well adjusted, we believe that it is safe and reliable with an excellent level of analgesia for caesarean section.

Adult↗

PubMed1991

The use of nebulized salbutamol in patients with bronchospasm during anaesthesia: a clinical trial.

The 2.5 mg salbutamol in 2.5 ml normal saline (Ventolin nebules) was used in 22 patients with unexpected bronchospasm via a nebulizer connected to an inspired limb of an anaesthetic machine. Recording of cardiovascular effects, specific notes of breath sound according to symptom severity (clinical lung score), arterial blood gases and airway pressure, was made every 5 minutes up to 30 minutes. The PaCO2 decreased and a/A ratio appeared to increase (improved shunt effect) significantly. However, the cardiovascular effects showed no statistical significance. The airway pressure as well as the clinical lung score appeared to decrease significantly to normal limits 20 minutes after the therapy. We conclude that the use of nebulized beta 2 selective bronchodilator is suitable in the treatment of unexpected bronchospasm without any cardiovascular disturbances.

Administration, Inhalation↗

PubMed1990

Bedside evaluation of the respiratory function in abdominal surgery with a simplified instrument a controlled study.

Though total prevention of postoperative pulmonary abnormalities after upper abdominal surgery does not seem to be possible, appropriate application of treatment to restore VC and FRC. The pulmonary function test helps the physician to predict postoperative respiratory disorders. Nevertheless, by using a simple respirometer and mini Wright's peak flow meter to evaluate the pulmonary functions perioperatively, it shows close relationship to the conventional test. Both FRC and SVC decreased to approximately 50-55 per cent of the preoperative values one day after surgery and yet, they increased significantly to 70-75 per cent of the preoperative levels on the fifth postoperative day. It is evident from this study that this simple test can serve as a reliable screen of pulmonary function. It can be performed economically and does not require complex equipment.

Abdomen↗

PubMed1989

.5 per cent plain bupivacaine for spinal anaesthesia effects of posture.

0.5 per cent plain bupivacaine following intrathecal injection in the lateral position seems to be lower than that in the sitting position. The dosages of the drug according to the patients' height and the time for injection were shown to yield a desirable spread of analgesia. Provided that strict attention is paid to volume replacement, the technique is safe quick and reliable and provides excellent analgesia. It is satisfactory for use in orthopaedic surgery and abdominal surgery that does not take more than 2 hours.

Adolescent↗