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Biomedical subjects

R Vijayan

Publications and source records attributed to R Vijayan.

11 recordsLinked to original sources
PubMed1999

Spinal cord stimulation for treatment of failed back surgery syndrome--two case reports.

Severe, persistent back pain following back surgery is often referred to as Failed Back Surgery Syndrome (FBSS). Conservative measures such as physiotherapy, back strengthening exercises, transcutaneous electrical nerve stimulation and epidural steroids may be inadequate to alleviate pain. Spinal Cord Stimulators were implanted into two patients suffering from FBSS. Both patients responded successfully to spinal cord stimulation with reduction of pain and disability.

Adult↗
PubMed1995

Continuous spinal anaesthesia--early experience in University Hospital, Kuala Lumpur.

Continuous spinal anaesthesia using the incremental technique was used in nineteen high risk patients with multiple medical problems, seventeen of whom were elderly, for lower limb orthopaedic and pelvic surgery. An intrathecal catheter (18G/28G) was inserted under local anaesthesia via the lumbar interspinous space. Spinal anaesthesia was induced with small incremental doses of 0.5% bupivacaine hydrochloride through the intrathecal catheter to achieve the level of analgesia required for surgery. The duration of surgery ranged from 45 to 300 minutes (mean + S.D 100 + 37 min). The initial volume of 0.5% bupivacaine required for surgery ranged from 0.8 ml-2.0 ml (1.2 + 0.7 ml) and the total volume ranged from 0.9 ml to 3.1 ml (mean + S.D 1.4 + 0.7 ml). Haemodynamic stability was well maintained perioperatively. Only two patients required 6 mg of ephedrine and 1 mg of aramine respectively for a greater than 25% reduction in systolic blood pressure with induction of spinal anaesthesia. Intrathecal morphine 0.1-0.3 mg was administered to 15 patients at the end of surgery for postoperative pain relief with good effect. One patient developed late respiratory depression from an inadvertent overdose of intrathecal morphine. No neurological sequelae were noted and no patient developed a postdural puncture headache. The use of the microcatheter was discontinued in the U.S.A and Australia following four case reports of cauda equina syndrome with this technique. Current opinion, however, is that the reported cauda equina syndrome was due to the neurotoxic effects of lignocaine 5% that was used and not due to the microcatheter per se. Continuous spinal anaesthesia is now used widely in Europe when cardiovascular stability is desired in poor risk patients undergoing lower limb and lower abdominal surgery.

Adult↗
PubMed1994

First year's experience with an acute pain service--University Hospital Kuala Lumpur.

An Acute Pain Service (APS) was started in University Hospital, Kuala Lumpur by the Department of Anaesthesiology in October 1992 for more effective control of postoperative pain. The main modalities of treatment included patient controlled analgesia (PCA) using morphine or pethidine with PCA devises, epidural opiate analgesia (EOA) using tramadol or fentanyl/bupivacaine mixture and subcutaneous administration of morphine or pethidine. Five hundred and fifty-one patients were managed in the first year, with an overall patient satisfaction score of 83%. The majority (98.5%) of them were after abdominal or major orthopaedic surgery. Eighty per cent of patients scored < 3 on the verbal numeric pain scale, where 0 is no pain and 10 is the worst imaginable pain, on the first postoperative day. Nausea and vomiting was an unpleasant side effect in 20% of patients.

Analgesia, Epidural↗
PubMed1994

Survey of postoperative pain in University Hospital Kuala Lumpur.

One hundred and eighty-three patients undergoing surgery were interviewed twenty-four hours following surgery to assess the quality of pain relief they received in the immediate postoperative period. Interviews were conducted using a standard questionnaire for all patients. They were asked to (1) rate the quality of pain relief they obtained on a Visual Pain Analogue Scale (VPAS-0 being no pain and 10 being the worst imaginable pain); (2) state whether they were happy and satisfied with the pain relief they received; (3) if dissatisfied, they were asked to give their reasons. 37.7% (69 patients) had moderate to severe pain--pain score greater than 6 on the VPAS. Most of these patients had undergone abdominal or major orthopaedic surgery. 32.7% (60 patients) were unhappy with their postoperative pain control. The main reasons for complaint from the patients were that analgesic injections were either not given promptly or were not given at all. The survey also highlighted the inadequate under-administration of narcotic injections in the postoperative period despite orders being written up. It showed there is an urgent need for setting up an Acute Pain Service for better postoperative pain control. An anaesthesiology based Acute Pain Service was started in October 1992.

Adolescent↗
PubMed1993

Epidural tramadol for postoperative pain relief.

The efficacy of epidurally administered tramadol hydrochloride, a weak centrally acting analgesic, was studied for the relief of postoperative pain. Sixty patients undergoing abdominal surgery were randomly allocated to three treatment groups to be given the following agents by the epidural route: group 1 tramadol 50 mg; group 2 tramadol 100 mg; group 3 10 ml of bupivacaine 0.25%. The drugs were administered at the patients' request with each patient being allowed four doses in the first 24 h following surgery. Blood pressure, pulse rate, respiratory rate, arterial blood gas analyses, pain scores, the interval between doses and the occurrence of any side effects were recorded. Pain scores (assessed using a visual analogue scale) were significantly less (p < 0.05) at 3, 12, and 24 h in patients receiving tramadol 100 mg than in those receiving tramadol 50 mg or bupivacaine. The mean interval between doses for groups 1, 2 and 3 was 7.40 h, 9.36 h and 5.98 h respectively. The mean interval in group 2 was significantly longer than in group 3 (p < 0.05). The incidence of nausea and vomiting in group 2 was significantly higher than in group 3 (p < 0.05).

Abdomen↗
PubMed1989

Effect of chlorine pollution on three fruit tree species at Ranoli near Baroda, India.

This paper describes the effect of chlorine pollution from an alkalies and chemical plant at Ranoli, near Baroda, on three tropical fruit tree species-Mangifera indica L. (mango) Manilkara hexandra Dubard. (rayan) and Syzygium cumini Skeels (Jamun). As compared to controls growing in a less polluted area, trees growing close to the plant showed reduced mean leaf area, a higher percentage of leaf area damaged, a reduction in fruit yield, chlorophyll pigments, protein and carbohydrate content, and higher accumulation of chloride in the foliar tissues. The accumulation of pollutaant, chloride, in the foliar tissues was very high in mango and jamun. Based on the degree of damage to the plants, the species studied were arranged in decreasing order of their sensitivity to chlorine pollution-mango, jamun and rayan.

Journal Article↗
PubMedDate not supplied

Efficacy of ultrasonic tissue dissector and tissue glue for laparoscopic partial nephrectomy in a porcine model.

The purpose of this study was to evaluate the efficacy and long-term tissue effects of ultrasonic dissector and cyanoacrylate glue during laparoscopic partial nephrectomy in a porcine model. Nine domestic pigs underwent laparoscopic left lower pole partial nephrectomy without vascular control. An ultrasonic tissue dissector was used to assist in the parenchymal incision, and the raw surfaces of the kidneys, including the exposed urinary system, were sealed with cyanoacrylate glue. No internal stents or additional sutures were placed. Intraoperative hemorrhages and urinary extravasation were recorded. The animals were humanely killed 28 days after undergoing the operations. The long-term effects of ultrasonic dissector and cyanoacrylate glue on the healing process of urothelium and renal parenchyma were determined histologically. All pigs survived the laparoscopic partial nephrectomy, and the blood loss ranged from 0 to 120 ml (mean, 60 ml). The average operative time was 89 +/- 10 min. The severity of the bleeding was minimal in six animals and moderate in three animals. No urinary extravasation was found using intravenous urography at the 28th postoperative day. No urinary fistula or renal abscess formation was found histologically. Cyanoacrylate glue infiltrated into the tissue defects and did not dissolve. The glue was encased by fibrotic tissue with minimal foreign body inflammatory reaction. Ultrasonic dissector was effective in achieving hemostasis during laparoscopic partial nephrectomy without the need of vascular control in pigs. Cyanoacrylate glue achieved good long-term adhesive power. The sealing effects provided by cyanoacrylate glue were adequate to prevent urinary extravasation from urothelial defects at least for 1 month.

Animals↗