PubMed Health⌕ Search

Biomedical subjects

C D Hanning

Publications and source records attributed to C D Hanning.

At least 19 recordsLinked to original sources
PubMed1990

Review of the rectal use of opioids.

The rectal route for the administration of opioid analgesics is often forgotten by physicians seeking alternatives to the oral route. This article reviews the physiology of rectal drug absorption and such data as exists on the different opioids that have been administered by this route. Conventional fatty-based suppositories have a place in the management of chronic pain but the variability in dissolution and drug absorption limit their usefulness. Recently, sustained release vehicles have become available that offer the prospect of the attainment of steady analgesic drug concentrations with once or twice daily dosing. Early studies with the morphine hydrogel suppository suggest that it may be capable of fulfilling this prospect. Their inherent safety, as dose-dumping is impossible, will make them suitable for use in the home.

Administration, Rectal↗
PubMed1990

Comparison of four pulse oximeters: effects of venous occlusion and cold-induced peripheral vasoconstriction.

The ability of four pulse oximeters (the Ohmeda 3700, Nellcor N100 and N200 and the Datex Oscar) to detect hypoxaemia was determined in the presence of venous obstruction and cold-induced peripheral vasoconstriction. Significant increases in detection time for hypoxaemia were found in both cases. There were no significant differences in detection time between the instruments, although the Ohmeda 3700 displayed smaller values of SaO2 under certain conditions. Peripheral vasoconstriction was induced using three differing methods which gave differing results, thus emphasizing the importance of methodology in assessments of pulse oximetry.

Body Temperature↗
PubMed1990

Effect of motion artefact on pulse oximeters: evaluation of four instruments and finger probes.

The ability of the Ohmeda 3700, Nellcor N200, Datex Satlite Plus and Simed S100 pulse oximeters to detect induced hypoxaemia in the presence of motion artefact was assessed, under conditions of controlled vibration using an industrial vibration facility. Vibration at 4 Hz and 8 Hz induced increases in detection time for hypoxaemia and spurious decreases in the displayed SaO2 in some of the oximeters tested. Finger-dependent differences in oximeter performance and pulse rate registration were noted especially in those oximeters without ECG linkage (Ohmeda 3700 and Simed S100). Subsequently, eight different pulse oximeter finger probes were assessed for those characteristics that may predispose to motion artefact. There were marked differences in the mass of the probes, the forces exerted on the test finger and in the force required to displace the probes from the subject's finger. Differences in both the microprocessor programmes and the physical characteristics of the finger probes may explain the observed differences in function. Similar studies should form part of the standard evaluation of new pulse oximeters.

Adult↗
PubMed1990

Further development of a morphine hydrogel suppository.

1. A sustained release monolithic morphine hydrogel suppository (MHS) was developed and administered to five volunteers. 2. The MHS delivered a mean of 55 mg morphine over 12 h. The mean plasma morphine concentration was 15 ng ml-1 from 2 to 12 h after administration. 3. Plasma morphine concentrations were comparable with those reported for the same dose given orally over the same time period. 4. The morphine hydrogel suppository appears to be an effective means of delivering morphine and may be of value in the management of chronic pain.

Administration, Rectal↗
PubMed1990

A comparison of the effects of zolpidem and placebo on respiration and oxygen saturation during sleep in the healthy elderly.

1. In a double-blind placebo controlled trial, zolpidem 10 mg, a new imidazopyridine hypnotic drug, was administered to 10 elderly female patients and placebo to 11, all recovering from hip and knee replacement surgery. Respiratory monitoring with an inductance plethysmograph and pulse oximeter showed that treatment over a 4 night period did not increase significantly the severity, frequency or duration of hypoxaemic episodes leading to SaO2 less than 90% or less than 85% when compared with placebo. Confidence intervals (corrected for baseline differences) for the median differences between the two groups on night 7, the fourth night of treatment, were from -1.85 to 0.480 and from -1.07 to 0 respectively for the frequency, and from -0.76 to 0.15 and -0.5 to 0 for the duration of the hypoxaemic episodes. The incidence of sleep related respiratory disturbances was not significantly increased compared with placebo on any night. 2. Respiratory monitoring using a simple inductance plethysmograph and pulse oximeter is acceptable to patients and staff. 3. The evaluation of all hypnotic and sedative drugs should include their effects on respiration during sleep.

Aged↗
PubMed1990

How to insert a peripheral venous cannula.

Peripheral venous cannulation is the commonest vascular surgical procedure. It is usually performed by a junior doctor who has learnt the skill from a colleague only marginally more skilled. Correct technique will improve the chances of success and patient comfort and safety.

Antisepsis↗
PubMed1989

Maternal oxygenation during normal labour.

Arterial oxyhaemoglobin saturation (SaO2) was monitored continuously during normal labour in 33 healthy parturients receiving pethidine and nitrous oxide for analgesia. Sixteen (49%) had episodes exceeding 10 s duration when SaO2 was less than 90% (mean 83.7%, range 89-60%). Two women had multiple episodes of profound hypoxia with SaO2 less than 70%.

Female↗
PubMed1989

Comparison of pulse oximeters: effects of vasoconstriction and venous engorgement.

The effects of cold-induced vasoconstriction and venous occlusion on the detection of induced hypoxaemia by four pulse oximeters were examined in 10 volunteers. In three further subjects vasoconstriction was maintained until at least one instrument failed to detect the induced hypoxaemia. Time taken to detect hypoxaemia was increased for all instruments to between two and three times the instrument's own control value for both vasoconstriction and venous engorgement (P less than 0.01). There was highly significant variation in detected minimum saturation between the instruments (P less than 0.001). One instrument failed to detect the full extent of desaturation under the experimental conditions and was more likely to fail completely to detect desaturation than the other test instruments when influenced by vasoconstriction (P less than 0.05). Significant impairment in the performance of all the instruments tested occurred in the presence of normal pulse signals. The duration of detected reductions in oxygen saturation was not significantly affected.

Blood Circulation↗
PubMed1989

Analgesia-induced respiratory depression: comparison of meptazinol and morphine in the postoperative period.

Forty-nine patients undergoing elective total hip replacement received either morphine or meptazinol for postoperative analgesia from a patient-controlled analgesia apparatus. Ventilatory rate and volume and arterial oxyhaemoglobin saturation were recorded continuously for the first 24 h following surgery. Episodic hypoxaemia was seen in both groups, associated with disturbances in ventilatory pattern. There was no significant difference in the incidence or severity of observed hypoxia between the groups, or with respect to the class of ventilatory disturbance. Mean linear analogue scores for pain and nausea were significantly (P less than 0.05) greater in the meptazinol group than in the morphine group 8 h after operation, but did not differ significantly at any other time. The mean number of demands for analgesic drugs was similar in the two groups. The meptazinol group had a greater requirement for anti-emetic drugs than the morphine group (P less than 0.05). It was concluded that meptazinol and morphine in equianalgesic doses had similar effects on ventilation in the postoperative period.

Aged↗
PubMed1989

Sleep apnoea.

Explore the source record for details and available documents.

Anesthesia↗
PubMed1988

Double-blind comparison of the efficacy and safety of single doses of meptazinol as a suppository and morphine by i.m. injection.

The analgesic efficacy of a 150-mg meptazinol suppository was compared with that of morphine 10 mg i.m. in the treatment of moderate postoperative pain. Two groups of 15 female patients took part in a 4-h, randomized double-blind, double-dummy study on the first day after elective abdominal hysterectomy. Meptazinol did not provide satisfactory analgesia in five patients (P less than 0.05). A decrease in mean pain scores (linear analogue scale and verbal rating scale) was seen after the administration of meptazinol, but this was not as great as that produced by morphine i.m., nor was it as long in duration. Significant changes in arterial pressure, heart rate and ventilatory rates were not seen in association with the administration of meptazinol, but were observed after the administration of morphine.

Administration, Rectal↗
PubMed1988

The morphine hydrogel suppository. A new sustained release rectal preparation.

The morphine hydrogel suppository (MHS), a monolithic sustained release rectal preparation, has been developed and evaluated in three pilot studies. Two release profiles have been prepared. The first, MHS(B), has a high initial release rate followed by a constant release for the remainder of a 12-h period. The second, MHS(S), has the same constant release rate for 12 h. MHS(B) is intended to attain and maintain analgesic or near analgesic plasma concentrations of morphine, and MHS(S) to maintain that concentration for successive 12-h periods. The pilot studies suggest that MHS may be of value in the management of postoperative pain.

Adult↗