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Biomedical subjects

R H McLaren

Publications and source records attributed to R H McLaren.

4 recordsLinked to original sources
PubMed1995

Continuous epidural anesthesia after ureteroneocystostomy in children.

We retrospectively reviewed the records of 101 pediatric patients who underwent uncomplicated ureteral reimplantation and were treated with postoperative epidural catheters for pain management. A total of 50 pediatric patients treated without epidural anesthesia was used as the control group. Length of hospital stay, time to first bowel activity, doses of narcotics, incidence of postoperative fever and evidence of epidural catheter related morbidities were documented. The costs of postoperative epidural anesthesia versus standard analgesics were compared. There was no significant difference in length of hospital stay or return of bowel function between treatment groups. Total doses of narcotics given during the hospital stay were significantly less for the epidural group (p < 0.05). The children given epidural anesthesia also had a significant increase in the incidence of postoperative fever (p < 0.05) and 25% had catheter related problems that often resulted in early removal of the epidural catheter. The cost of pain management using an epidural catheter was significantly greater than that of the standard narcotic regimen ($708 versus $14, p < 0.001). Continuous epidural infusion provides satisfactory pain control after ureteroneocystostomy in children without delaying hospital discharge. This technique of pain management is associated with a significant increase in the incidence of postoperative fever and overall cost compared to standard methods of postoperative pain management.

Adolescent↗
PubMed1993

Rectal injury occurring at radical retropubic prostatectomy for prostate cancer: etiology and treatment.

Of 2,212 patients who underwent radical retropubic prostatectomy for the treatment of prostate cancer, 27 had documented rectal injuries. All but one were detected immediately at the time of surgery and were repaired; a temporary diverting colostomy was established in 6 patients. Follow-up on these patients ranged from nine to one hundred eighty-five months (mean, 68 months). Four patients had fistulas between the rectum and the urinary tract that required additional surgery. Factors that predisposed patients for intraoperative injury to the rectum include a history of previous pelvic radiation therapy, previous rectal surgery, and previous transurethral resection of the prostate (P < 0.01). Higher local tumor stage did not significantly increase the risk of rectal injury at the time of radical retropubic prostatectomy. Preoperative bowel preparation may obviate colostomy; it may still be necessary in high-risk patients with suboptimal local repair.

Aged↗
PubMed1992

Patient and partner satisfaction with the AMS 700 penile prosthesis.

Patient and partner satisfaction with the use of an AMS 700 inflatable penile prosthesis was evaluated by reviewing the records from 387 patients and questionnaires completed by 272 of these patients. The evaluation demonstrated that 83% of the patients and 70% of the partners were satisfied with use of this device. Couples who reported the lowest levels of satisfaction were characterized by men who required more than 1 procedure for prosthesis implantation. Pain and appearance of the penis were the most common causes for dissatisfaction with the device. Results from this evaluation recognize the importance of careful surgical technique to avoid any surgical complications but, more importantly, they emphasize the need for physician-manufacturer interaction to maximize mechanical reliability of the prosthesis.

Erectile Dysfunction↗