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Biomedical subjects

B Samson

Publications and source records attributed to B Samson.

11 recordsLinked to original sources
PubMed1991

A dose-response study of nalbuphine for post-thoracotomy epidural analgesia.

The analgesic efficacy and side-effects of epidural nalbuphine (0.075-0.3 mg.kg-1) were compared with epidural morphine 0.1 mg.kg-1 in a randomised double-blind study in post-thoracotomy patients. The drugs were administered via a lumbar epidural catheter one hour before the end of surgery. Efficacy was assessed using visual analogue pain scores and supplementary iv fentanyl requirements; respiratory function was studied with an inductive plethysmograph and arterial blood gas analysis; and plasma nalbuphine levels were measured. Pain scores and fentanyl supplementation were lowest in the morphine group (P less than 0.01). No dose-response effect was apparent in the nalbuphine dose-range studied. Respiratory depression was more common in patients receiving morphine (higher mean PaCO2P less than 0.01, more frequent apnoeas greater than 15 sec P less than 0.05, and incidence of PaCO2 greater than 50 mmHg requiring naloxone P less than 0.01). There were no differences in haemodynamic variables, sedation, or other side-effects among the groups. The pharmacokinetic profile of epidural nalbuphine was similar to that seen with rapid iv injection. The results indicate that, relative to morphine, lumbar epidural nalbuphine is an ineffective analgesic after thoracotomy. Despite the lower incidence of respiratory depression its administration by this route cannot be recommended.

Adult↗
PubMed1989

Prevention of epidural morphine-induced respiratory depression with intravenous nalbuphine infusion in post-thoracotomy patients.

The efficacy of nalbuphine, an agonist/antagonist opioid, in preventing respiratory depression from epidural morphine analgesia after thoracotomy, was assessed in a randomized double-blind placebo controlled trial. After a standardized general anaesthetic and 0.15 mg.kg-1 of epidural morphine, patients received a bolus and then a 24 h infusion of nalbuphine (200 micrograms.kg-1 + 50 micrograms.kg-1.hr-1, 100 micrograms.kg-1 + 25 micrograms.kg-1.hr-1, or 50 micrograms.kg-1 + 12.5 micrograms.kg-1.hr-1) or placebo. Blood gases, analgesia, sedation, side effects, and blood nalbuphine concentrations were assessed every two hours for the next 24 h. Fifty-three per cent of placebo-treated patients had a PaCO2 greater than 50 mmHg and 89 per cent of these received naloxone. A 200 micrograms.kg-1 bolus of nalbuphine followed by a 50 micrograms.kg-1.hr-1 infusion achieved a mean steady state blood level of 38.2 ng.ml-1 and prevented CO2 retention greater than 50 mmHg in all but two patients, neither of whom required naloxone. There was no difference in the incidence of side effects among groups, and analgesia appeared to be unaffected by nalbuphine.

Adult↗
PubMed1988

Reversal of epidural morphine-induced respiratory depression and pruritus with nalbuphine.

The effect of nalbuphine on the respiratory depression, pruritus and analgesia induced by epidural morphine was determined in a randomized, prospective, double-blind, placebo-controlled fashion. Twenty ASA physical status I women received 0.1 mg.kg-1 epidural morphine at induction of general anaesthesia for elective total abdominal hysterectomy. Group 1 (n = 14) received 0.3 mg.kg-1 nalbuphine intravenously six hours after the epidural morphine administration. Group 2 (n = 6) received saline. Prior to agent administration, six patients from the nalbuphine group and four patients from the saline group had respiratory depression indicated by a PaCO2 greater than 45 mmHg. After nalbuphine administration the PaCO2 (mean +/- SE) decreased from 49.5 +/- 1.2 mmHg to 42.5 +/- 0.7 mmHg (p less than 0.005) while there was no significant change after saline administration. Nine of the 14 patients receiving nalbuphine appeared to become more sedated, despite an improvement in ventilation. Pruritus was antagonized by 0.1 mg.kg-1 nalbuphine (p less than 0.006). There was no reversal of analgesia after administration of 0.3 mg.kg-1 nalbuphine.

Adult↗
PubMed1981

Inflatable bath for external cooling.

The authors describe an inflatable bath which can be used rapidly and safely, with a minimum of patient manipulation, for external cooling of hyperthermic patients or in the elective induction of hypothermia. This device permits ready access to the patient so that monitoring and treatment can be carried on while cooling is in progress and is particularly adopted to use in the operating room.

Anesthesiology↗
PubMed1980

Comparison of fixation of spinal fractures.

Mechanical failure was induced in cadaver spines by applying flexion, extension, and lateral bending loads with continuous recordings of moment and rotation. Each spine was then stabilized with Harrington distraction rods, compression rods, and titanium mesh in sequence, and tested in a similar manner. The spines stabilized with mesh appeared stronger but less stiff than spines stabilized with Harrington rods.

Adult↗
PubMed1976

Population cancer screening.

Controlled trials to evaluate mass screening programs for cancer detection have been singularly lacking. High cost, lack of medical manpower, and low yield have contributed to this problem. A new program in cancer detection (CANSCREEN) has been developed jointly by The Fox Chase Cancer Center in Philadelphia and the Preventive Medicine Institute in New York City. This program attempts to provide a quality cancer-detection examination with increased cost effectiveness. Features include: 1) a self-administered questionnaire on medical history, symptoms, and risk factors; 2) nonphysican examiners; 3) risk-facotr analysis with a predetermined decision logic to determine type and periodicity of examination; and 4) primary intervention (health education). This collaborative program between two institutions in two cities demonstrates the feasibility of introducing similar programs elsewhere. A data base shared by cooperating centers permits information on all patients to be used for evaluation of new techniques, end results, etc. A randomized controlled trial has been designed to evaluate the effectiveness and efficiency of the questionnaire alone and of the questionnaire and examination.

Breast Neoplasms↗