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Biomedical subjects

R Cooling

Publications and source records attributed to R Cooling.

7 recordsLinked to original sources
PubMed1998

The systemic absorption of adrenaline from posterior segment infusion during vitreoretinal surgery.

BACKGROUND/PURPOSE: Adrenaline infused into the posterior segment of the eye during vitreoretinal surgery may be absorbed and give rise to unwanted cardiovascular effects. We sought to establish whether significant amounts of adrenaline are systematically absorbed. METHODS: This study was prospective and double-masked, with patients randomised into two groups. The first group received a posterior segment infusion containing Hartmann's solution alone (Hs group) and the second group received a posterior segment infusion of Hartmann's solution containing 0.5 ml of 1:1000 (0.5 mg) adrenaline per 500 ml (Hs + Ad group). Pre-medication and anaesthetic techniques were standardised for all patients. Venous blood samples were collected prior to induction, 5 min following intubation and 5, 10, 15 and 30 min following the commencement of the infusion. Samples were analysed for adrenaline levels using high-performance liquid chromatography. RESULTS: Ten patients were studied: 4 in the Hs group and 6 in the Hs + Ad group. The mean dose of adrenaline administered in the Hs + Ad group was 655.08 nmol (0.12 mg). The median serum adrenaline level following infusion for the Hs + Ad group was 0.15 nmol/l (LQ = 0.100, UQ = 0.360) and the median serum adrenaline level for the Hs group was 0.10 nmol/l (LQ = 0.100, UQ = 0.350). There was no overall statistical difference in the levels of serum adrenaline between the two groups, and furthermore adrenaline levels remained within physiological parameters for both groups. CONCLUSION: There does not appear to be significant adrenaline absorption from posterior segment infusion. Continued caution should be exercised, however, as idiosyncratic reactions may still occur.

Absorption↗
PubMed1991

Pseudophakic retinal detachment.

A total of 93 cases of pseudophakic retinal detachment are reported. The present study showed that vitreous loss had occurred during cataract surgery in 28% of eyes, indicating that anterior segment complications are an important contributory factor to aphakic retinal detachment in these cases. There was impairment of the retinal view in 46% of eyes, and in 22.5% no retinal breaks could be identified. The main factor responsible for poor visibility was inadequate pupillary dilatation, which was found particularly in association with the use of iris-supported lenses. Detachment of the macula was unexpectedly found to occur in as many as 88% of cases. Reattachment of the retina either by conventional detachment procedures or by pars plana vitrectomy was achieved in 76.3% of eyes. Complications directly attributable to the presence of an intraocular lens (such as dislocation or haemorrhage) are described. Failure of surgery was more likely to occur in eyes exhibiting a poor fundal view, in which the detection of retinal breaks was difficult. The best results were achieved in eyes in which posterior-chamber lenses had been implanted.

Adult↗
PubMedDate not supplied

Audit of cost and clinical outcome of cataract surgery.

An audit of routine cataract surgery in our hospital was carried out by examining records of 340 adult patients who underwent such surgery during October 1990. The category of intended accommodation (day case or inpatient), operative details, post-operative course and management were recorded, along with the outcome measures of visual acuity (unaided and corrected) and refractive error (spherical equivalent and cylinder). The costs of treatment, including post-operative management, were calculated for each patient. The results indicate that day case surgery under local anaesthesia was the most cost-effective method of cataract surgery, with no detrimental effect on clinical outcome.

Ambulatory Surgical Procedures↗