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Biomedical subjects

R Traill

Publications and source records attributed to R Traill.

4 recordsLinked to original sources

Carotid endarterectomy in a neurosurgical unit: a retrospective review.

A retrospective survey of 262 carotid endarterectomies performed in the Neurosurgical Unit at Royal Prince Alfred Hospital over a 15 year period was conducted. A total of 141 patients were operated on for transient ischaemic attacks referable to stenosis of the ipsilateral internal carotid artery. Eighty-eight percent of patients had angiographic evidence of greater than 80% stenosis of the affected internal carotid artery. A postoperative new permanent neurological deficit of 1.9% and death rate of 0.6% was achieved. No deaths and two postoperative strokes were recorded after 1987. These results are comparable with published series. The use of barbiturate therapy with electroencephalography changes on cross clamping of the internal carotid artery is described. Copyright 1999 Harcourt Publishers Ltd.

Journal Article↗

Clonidine premedication for craniotomy: effects on blood pressure and thiopentone dosage.

The purpose of this study was to determine whether oral clonidine premedication improves cardiovascular stability and/or reduces the requirements for drugs used to control systolic blood pressure (SBP) during elective craniotomies. We performed a double blind randomized trial involving 77 normotensive, ASA physical status I or II adults. Clonidine 4 micrograms/kg or placebo was given as oral premedication. The patient's mean SBP on the day before surgery was used as the baseline. SBP was controlled between the baseline and 30% below it (but not < 90 mm Hg). Anesthesia was induced with thiopentone, N2O, and fentanyl; maintenance was with N2O. Further doses of thiopentone were administered to control rises in SBP until skin incision. After skin incision trimethaphan (TMP) was used to control the SBP and isoflurane only added if TMP was insufficient. Isoflurane was discontinued as soon as SBP control allowed. The induction dose of thiopentone was the same in both groups but subsequent usage for blood pressure control was significantly lower in the clonidine group. There were no differences in trimethaphan dose, or the incidence and duration of isoflurane use. The clonidine group had lower SBP on arrival in the operating room, preinduction, and postintubation. There were no differences in mean "intraoperative" SBP, their coefficients of variation, or recovery room values. Two subgroups were analyzed, based on the study groups mean age and baseline SBP. Three-way analysis of variance revealed that the blood pressure effects of clonidine were almost entirely confined to patients older than 45 years. Baseline SBP had no independent effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

One-way valve.

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Anesthesia, Intravenous↗