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V Loughlin

Publications and source records attributed to V Loughlin.

14 recordsLinked to original sources
PubMed1998

Pain after vasectomy.

We studied the influence of the timing of injection of bupivacaine into the vas deferens on the intensity and duration of scrotal pain following vasectomy. Forty-two patients undergoing vasectomy under general anaesthesia were randomly allocated to have the operation performed on either the left or the right side first. On the first side to be operated upon, 5 ml bupivacaine 0.5% was infiltrated along the line of the scrotal incision. The vas deferens was identified and 1 ml bupivacaine 0.5% was injected into its lumen, with 0.5 ml directed proximally and 0.5 ml directed distally. After completion of the procedure on that side, the operation continued on the other side. On this occasion, the same dose of bupivacaine was injected into the vas deferens after division and ligation, and subcutaneously along the scrotal incision after skin closure. Median [interquartile range] visual analogue pain scores on the first side to be operated upon were significantly lower than on the second side on day 1 (7 [1.5-19] vs. 11 [2.5-47]) (p < 0.01) and day 7 (0 [0-8.5] vs. 0 [0-18.8]) (p < 0.05) postoperatively. The median [interquartile range] duration of postoperative discomfort was less on the first side operated upon than on the second (3 [1-7] vs. 6 [2-7]) (p < 0.01). Although statistically significant differences occurred between the treatment groups, the actual differences were small and may not be clinically significant.

Adult↗
PubMed1995

Intra-vas deferens bupivacaine for prevention of acute pain and chronic discomfort after vasectomy.

We have studied the use of intra-vas deferens local anaesthesia in 70 patients undergoing vasectomy as day-case patients. Patients were allocated randomly to either a control or treatment group. In the treatment group, 0.5% bupivacaine 1 ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas deferens in a randomized blinded design. The control group did not receive an injection. Patients were discharged with a questionnaire for recording visual analogue scores (VAS) for both the right and left sides to be scored on days 1 and 7 after operation. One year after the procedure a second questionnaire was sent out asking about the presence or absence of chronic testicular discomfort, its duration and any surgical intervention required to relieve it. There were no differences between the control group and the saline side of the treatment group in VAS scores on both day 1 and day 7 after operation or in the incidence and duration of chronic testicular discomfort (mean 30 (SD 53) and 34 (50) days, respectively). The VAS scores were, however, significantly less (P < 0.005) and testicular discomfort was absent on the bupivacaine-treated side.

Adult↗
PubMed1993

Consensus statements.

Explore the source record for details and available documents.

Consensus Statements as Topic↗
PubMed1990

Comparison of risk factor and left ventricular stroke work index as predictors of cardiac complications in vascular surgery.

The peak left ventricular stroke work index developed in response to rapid volume infusion was calculated in 34 patients undergoing either aorto-iliac or peripheral vascular surgery. The average preoperative maximum stroke work index in patients recovering without cardiac complication was 0.47 (+/- 0.2) J/m2 compared with a mean value of 0.28 (+/- 0.14) J/m2 in patients with perioperative cardiac complications. This difference was significant (P less than 0.01). Clinical cardiac risk analysis identified a group of high risk patients in which more than half developed cardiac complications and a low risk group in which no cardiac complications were observed. There was a significant difference in maximum stroke work indices in these two groups.

Aged↗
PubMed1985

Prevention of free radical-induced myocardial reperfusion injury with allopurinol.

Growing evidence supports the concept that oxygen free radicals are an important cause of myocardial ischemic and reperfusion injury. This study was designed to determine if toxic oxygen metabolites may exacerbate ischemic injury upon reoxygenation. Left ventricular function was studied in a group of seven dogs receiving intermittent, 4 degrees C, hyperosmolar, hyperkalemic (KCI 25 mEq/L) saline cardioplegic solution. This group was compared to a group (n = 7) receiving a hyperkalemic (KCI 25 mEq/L) cardioplegic solution designed to scavenge superoxide anion and hydroxyl radical: superoxide dismutase (3,000 U/ml) and mannitol (325 mOsm/L). A third group of five animals received allopurinol pretreatment (50 mg/kg/day) for 72 hours and hyperkalemic saline cardioplegic solution. After 60 minutes of ischemia (10 degrees to 15 degrees C) and 45 minutes of reperfusion, left ventricular mechanical function was better in the groups receiving free radical scavengers and allopurinol pretreatment than in the group receiving only hyperkalemic saline cardioplegic solution. Free radical scavengers preserved myocardial function in this model of hypothermic global ischemia and reperfusion. Our data support the concept that injury occurs primarily during reperfusion with the generation of oxygen free radicals via the hypoxanthine-xanthine oxidase reaction. Allopurinol has potential clinical application in the prevention of reperfusion injury.

Allopurinol↗
PubMed1983

Operative removal of misplaced Greenfield vena caval filters.

Operative retrieval has not been necessary in our experience, though interest has been expressed by other surgeons. Specifically, during removal the hooks of the filter may become attached to adjacent structures, making manipulation and eventual extraction difficult. Because the occasion for late removal of a misplaced filter may arise, we have developed this method using readily available materials. We anticipate that this technique will be most useful for removal of filters that have been in place for more than 7 days. A method to retrieve filters in place less than 1 week has already been reported [4]. We have found the technique quite satisfactory in experimental animals.

Filtration↗
PubMed1983

Inhibition of surgically induced ischemia/reperfusion injury by oxygen free radical scavengers.

Recent experimental work implicates oxygen free radicals as mediators of ischemia/reperfusion injury. A simple cardioplegic solution was designed to scavenge superoxide anion and hydroxyl free radical with superoxide dismutase (10 micrograms/ml), mannitol (325 mOsm/L), and KCl 25 mEq/L (FRS). Hemodynamic and subcellular functions were studied in seven in situ canine models of hypothermic global ischemia receiving FRS, compared to a group (n = 7) receiving hyperosmolar, hyperkalemic saline (HSK) and to a standard model of topical hypothermia (TH, n = 5). Following 60 minutes of ischemia (10 degrees to 15 degrees C), hearts were reperfused and rewarmed. After 45 minutes of reperfusion, left ventricular peak systolic pressure (LVPSP), developed pressure (LVDP), dP/dt max, -dP/dt max, compliance, and elastic stiffness constant (K) were improved in the FRS group and not significantly different from control. Sarcoplasmic reticulum (SR) calcium transport in the FRS group was significantly improved (control = 1.077 +/- 0.022, TH = 0.754 +/- 0.018, HSK = 0.725 +/- 0.05, and FRS = 0.966 +/- 0.05 mumol/mg-min). Calcium adenosine triphosphatase (ATPase) activity did not differ significantly from control at pH 7.0. In this model of hypothermic global ischemia and reperfusion, free radical scavengers provide significant protection of mechanical and subcellular function. These findings support the hypothesis that oxygen free radicals are important mediators of myocardial ischemia and reperfusion injury.

Animals↗
PubMedDate not supplied

Post-traumatic brachial artery aneurysm and arteriovenous fistulae.

A case of penetrating metal fragment injury to the cubital fossa with subsequent development of a false aneurysm of the brachial artery with a fistulae to the vena comitans and median basilic vein is described. Surgical management involved aneurysmectomy, interposition cephalic vein graft and lateral repair of the vena comitans. Early angiography should be considered in penetrating injuries near major limb vessels, as the initial signs and symptoms of vascular injury may be minimal.

Adult↗