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Biomedical subjects

V H Larsen

Publications and source records attributed to V H Larsen.

29 records · Page 2Linked to original sources
PubMed1986

Postoperative pain relief and respiratory performance after thoracotomy: a controlled trial comparing the effect of epidural morphine and subcutaneous nicomorphine.

Twenty patients scheduled for lateral thoracotomy were randomly allocated to receive either epidural morphine at regular intervals or subcutaneous nicomorphine on demand for postoperative pain relief. The daily dose of opiate administered was greater in the group receiving subcutaneous nicomorphine than in the epidural group although four patients in the latter needed additional subcutaneous injections of opiate. During the first three days of the postoperative course, a profound decrease of the forced vital capacity (FVC), the forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF) and the arterial oxygen tension (PaO2) was found in both groups, whereas the visual analogue pain score showed a marked increase, and the arterial pH and carbon dioxide tension (PaCO2) remained unchanged. No significant difference could be demonstrated between the group;s. The conclusion is that epidural morphine may produce sufficient pain relief after thoracotomy, but compared with conventional pain treatment the benefits are limited.

Adult↗
PubMed1985

Postoperative pain treatment after upper abdominal surgery with epidural morphine at thoracic or lumbar level.

Thirty patients undergoing upper laparotomy were entered into a randomized trial, comparing the effect of midthoracic (T) and lumbar (L) epidural morphine on postoperative pain and pulmonary function. Five mg morphine was injected through the catheter at the end of the operation, and subsequently three times a day. Six, 30 and 54 h postoperatively, the following tests were performed: linear analogue pain score, arterial gas tensions (PaO2, PaCO2 and pH), forced ventilatory capacity (FVC), forced expiratory volume in 1s (FEV1) and peak expiratory flow rate (PEF). The changes in pain score (increase of the median): T: 21, 6, 5, and L: 24, 15, 8 per cent of full scale), PaO2 (decrease of the tension: T: 1.7, 2.1, 2.4, and L: 2.0, 2.8, 2.0 kPa), PaCO2, pH, FVC (decrease of the volume: T: 1.3, 1.1, 0.9, and L: 1.3, 1.3, 1.21), FEV1 and PEF from the preoperative tests were not significantly different. It is concluded that the clinical effect of epidural morphine for postoperative pain treatment is the same or little different whether the administration takes place at the thoracic or lumbar level.

Abdomen↗
PubMed1985

Spontaneous progression of valvular aortic stenosis.

In 11 adult patients with isolated valvular aortic stenosis, the progression of the disease was assessed by two heart catheterisations without intervening aortic valve surgery. Four patients had bicuspid valves, whereas the remaining seven were considered to have acquired aortic stenosis. Significant differences between the two catheterisations were found for left ventricular peak systolic pressure (LVPSP), left ventricular aortic mean pressure gradient (LV-AO gradient), and for aortic valve area (OA). The rate of progression varied considerably. In one case the pressure gradient increased 43 mm Hg in 68 months, whereas in another case it remained almost unchanged for 103 months. One patient developed aortic valve regurgitation. ECG, chest X-ray and phonocardiography gave only poor estimates of the degree of progression. Thus having established a mild aortic stenosis at heart catheterisation, recatheterisation usually remains necessary to give the final indication for operation.

Adolescent↗
PubMed1984

Impedance pneumography for long-term monitoring of respiration during sleep in adult males.

Impedance pneumography is based on the relationship between respired volume (delta V) and changes of transthoracic impedance (delta/Z/) during breathing. The impedance signal, the relationship between delta V and delta/Z/ and the success rate during long-term recording was studied in 11 healthy adult males, aged 21-46, by a portable tape recorder (Oxford Medilog 4-24). The signals from the tape recorder (delta/Z/), and from a spirometer (delta V) were recorded simultaneously on a mingograph during normal breathing, apnoea, deep sighs, and coughs. The relationship between delta V and delta/Z/ was also analysed on an X-Y recorder. Delta/Z/ was delayed in relation to delta V and during one respiratory cycle the relationship was not linear. The time constant of delta/Z/ was 6 s. A significant correlation was found between peak values of delta V and delta/Z/ for 0 less than delta V less than 2.5 litres. Long-term recording of delta/Z/ during one night's sleep resulted in a success rate of 63-100%, mean 90%. Invalidation of the impedance signal was caused by overloading (81%) and interference (19%). It is concluded that the Medilog respiratory recorder enables determination of respiratory frequency, periods of apnoea and a semiquantitative estimate of volume, but artifacts may invalidate the signal.

Adult↗
PubMed1983

Oesophageal peristalsis in normal subjects. Influence of pH and volume during imitated gastro-oesophageal reflux.

Acid gastro-oesphageal reflux in normal human subjects is followed by oesphageal peristalsis. The aim of the present study was to investigate the influence of pH and volume during imitated reflux on oesophageal peristalsis. Fluid volumes of 2.5, 5, 10, and 15 ml (pH 1.0, 4.0, or 7.0) were instilled randomly in the lower end of the oesophagus in eight healthy subjects. Further, repeated instillations were carried out in one subject. Oesophageal pressures were measured 5, 10, and 15 cm oral to the gastro-oesophageal sphincter and in the pharynx, and pH 5 cm oral to the sphincter. Peristalsis confined to the oesophagus was found to be related to the volume of the instilled fluid, whereas pharynx-mediated peristalsis seemed to be related to the acidity of the fluid. It is concluded that peristalsis after imitated gastro-oesophageal reflux is influenced by both the volume and the acidity of the instilled fluid. Volume seems to initiate a local clearing mechanism, whereas low pH initiates pharynx-mediated peristalsis.

Adult↗
PubMed1982

Spontaneous peristaltic activity in the oesophagus after imitated acid gastro-oesophageal reflux. A study in normal subjects.

Prolonged measurements of pH and peristalsis in the oesophagus do not enable quantitation of the reflux material. Eight healthy subjects underwent 12-h continuous pH and pressure recording in the oesophagus and, subsequently, recording of pH and spontaneous peristaltic activity after instillation of 0.1 N HCl. Volumes of 2.5, 5, 10, and 15 ml were instilled in the lower end of the oesophagus in randomized order. No relationship between volume and peristaltic activity could be demonstrated. A direct relationship between the change in pH after instillation and the peristaltic activity was demonstrated (r = 0.8052; p less than 0.001). The clearing efficiency was 0.3 pH units per peristaltic contraction. A similar relationship could be found between the change of pH during a spontaneous reflux episode and the following peristaltic activity (r = 0.5993; p less than 0.002). The clearing efficiency was 0.37 pH units per peristaltic contraction. It is concluded that low pH is the determining factor for eliciting oesophageal peristalsis.

Adult↗
PubMed1980

Weight reduction before hip replacement.

Weight reduction before surgery on obese patients has been widely recommended, but its practical possibilities have not been elucidated so far. Operation for osteoarthrosis of the hip was offered to 130 obese patients on the condition that they reduced their weight to normal. After a minimum observation period of 1 year the weight had returned to normal, and operation was performed, in 73%. Only 5% gave up losing weight. The weight reduction averaged 8.6 kg (1-25 kg). A weight reduction of up to 15 kg was achieved within less than year by eating less (94%) or changing the dietary habits (88%), and only 3% had to be admitted to hospital.

Body Weight↗