Biomedical subjects

R S Edmondson

Publications and source records attributed to R S Edmondson.

5 recordsLinked to original sources

PubMed1987

Comparison of recovery after halothane or alfentanil anaesthesia for minor surgery.

Recovery after anaesthesia was assessed using the Maddox Wing Test (MW), Critical Flicker Fusion Threshold (CFF), Choice Reaction Time (CRT), Line Analogue Rating Scales (LARS), a Tracking Test and a test of Semantic Memory in 44 patients who had undergone minor gynaecological surgery. The patients were allocated randomly to one of two groups and received either methohexitone, nitrous oxide, oxygen and halothane or methohexitone, alfentanil, nitrous oxide and oxygen. Immediate recovery was more rapid in the alfentanil group (P less than 0.01), but apnoea (P less than 0.05) and hiccups (P less than 0.05) were more common. Except for the CFF test, which showed the alfentanil patients to be less sedated than the halothane patients on the morning after anaesthesia (P less than 0.05), the results of the tests were similar in both groups and showed, initially, substantial impairment of psychomotor functions which gradually returned to baseline values. This comparison with halothane anaesthesia indicates that a technique using methohexitone and alfentanil is suitable for day-case surgery.

Adult↗

PubMed1987

Isoflurane for anaesthesia in the dental chair. a comparison of the incidence of cardiac dysrhythmias during anaesthesia with halothane and isoflurane.

A randomised single-blind trial was performed to compare the effects on cardiac rhythm of isoflurane and halothane in 100 dental outpatients having extractions under general anaesthesia in the dental chair without tracheal intubation. The incidence of supraventricular dysrhythmias did not differ significantly. No patient in the isoflurane group developed a ventricular dysrhythmia, whilst nine of those who received halothane did so (p = 0.0013). The quality of anaesthesia was acceptable in the isoflurane group, but induction time was longer (p less than 0.05) and the maximum heart rate was faster (p less than 0.01). There was no difference in the maximum end tidal carbon dioxide concentrations measured in a further 20 cases.

Adolescent↗

PubMed1980

Long-term recovery from tetanus: a study of 50 survivors.

A follow-up study of 50 patients treated in the tetanus unit of the General Infirmary at Leeds from 1961 to 1977 showed that 29 patients had regained normal health, nine were still improving, but 12 considered that their health had been permanently impaired. In only two of these 12, however, was the deterioration serious and unequivocally linked to their illness and treatment. All but five of those previously working had returned to full employment. Sixteen patients had unpleasant memories of the illness and treatment, 19 had psychological after effects, and one suffered serious damage to mental function. Little evidence was found of pulmonary dysfunction after the disease and its treatment, and although all the patients showed a tracheal stricture of some degree, few had directly associated disabilities. The cause of stricture is multifactorial, the surgical technique being only one. A formal surgical closure of the trachea (if a flap has been used) and of the tissue of the neck in layers should lessen residual disability from the scar and strictured areas.

Aged↗

PubMed1980

Tetanus.

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Diagnosis, Differential↗

PubMed1979

Intensive care in tetanus: management, complications, and mortality in 100 cases.

One hundred cases of tetanus were treated in the intensive care unit of Leeds General Infirmary during during 1961--1977. In 90 patients disease was severe enough to require paralysis and artificial ventilation; a further three needed tracheostomy but not paralysis; and in seven the condition was mild, requiring sedation only. Ten patients died, but all deaths were attributable to complications of treatment rather than to the disease itself and were theoretically avoidable. No evidence of permanent neurological damage from tetanus was found. In 65 patients a wound was the source of infection, most of which were minor, often receiving no medical attention. In five patients the source was probably varicose ulcers of the leg. Such patients, if lacking immunity, are at risk, particularly when farming or gardening. Only two patients had received a full course of tetanus toxoid, in one case eight years and in the other three years before injury; neither received a booster dose at the time of injury and in the second tetanus was mild. Of the 35 patients who did seek medical attention at the time of wounding, 21 received prophylactic antibiotics and 25 tetanus toxoid, but none received equine or human antitetanus serum. Early resort to tracheostomy and paralysis in severe tetanus resulted in a favourable mortality of 10% in the series. To implement such a policy full intensive-care facilities, with a trained nurse to care for each patient, must be available at all times.

Adolescent↗