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Biomedical subjects

D F Murphy

Publications and source records attributed to D F Murphy.

At least 19 recordsLinked to original sources
PubMed1991

Nurse-controlled intravenous analgesia. Effective control of pain after thoracotomy.

Nurse-controlled continuous intravenous opioid analgesia was evaluated prospectively in 60 patients after thoracotomy. The rate of opioid infusion was adjusted, and bolus does were administered, as required to maintain patient comfort. The patients evaluated their pain using a visual analogue scale on 10 occasions during the first 48 hours after surgery. Pain scores remained consistently low throughout the period of measurement. Over the study period there was a 30-fold difference between the least and greatest requirement for opioid to achieve adequate analgesia. No major side effects were encountered. The study indicates that nurse-controlled intravenous analgesia can be successfully used for pain relief after thoracotomy.

Analgesia↗
PubMed1991

Antireflux valves in intravenous opioid analgesia: are they necessary?

A study was conducted in patients receiving intravenous opioid analgesia to determine the incidence and degree of retrograde flow along the parallel gravity-driven infusion line. From 1187 hours of observations retrograde flow was found in 2.5% of the total time. In 70% of these cases this was equivalent to less than 1 mg of pethidine and in 96% this was equivalent to less than 5 mg of pethidine. The need for routine use of antireflux valves during intravenous opioid analgesia is therefore questioned.

Humans↗
PubMed1991

An evaluation of one method of ventilation for laser therapy to the tracheobronchial tree.

Laser therapy has been used extensively for surgery to the respiratory tract since its first application in 1971. At this hospital, the surgeon's preferred technique for laser surgery to the tracheobronchial tree is to use the Nd-YAG laser through a fibreoptic bronchoscope passed through a rigid bronchoscope. General anaesthesia is employed and ventilation is controlled using jet-ventilation by the Sanders technique. Review of the literature failed to locate adequate information on the effect of manoeuvres such as insertion of instruments and the presence of a tracheal obstruction distal to the bronchoscope on the quality of ventilation using this technique. A bench study was undertaken, therefore, in an attempt to mimic such clinical situations and to assess the effect of such manoeuvres on the adequacy and pattern of ventilation. Under all conditions tested 'end-tidal' CO2 concentrations accurately reflected distal 'tracheal' concentrations. The lowest inspired O2 concentration was 50% while entraining air through the bronchoscope. The highest was 86% while entraining oxygen.

Anesthesia, Intravenous↗
PubMed1991

A study of the relationship among body position, bladder function and urine variables in spinal cord injured subjects.

Clinical observations of nurses working with spinal cord patients describe positional changes affecting diuresis. Research has not documented this phenomenon in detail. Knowledge of the timing of diuresis may allow more control over bladder management. The purpose of this descriptive pilot study was to determine the relationship among body position, timing of diuresis, urine volume, and fluid intake in spinal cord injured subjects. A convenience sample of six subjects with varying levels of spinal cord injury were studied. For five consecutive days, positional changes were determined during bed, wheelchair, and tilt activities. Fluid intake and urine volume, specific gravity, and colony count were measured. Data analysis using correlation and regression statistics revealed head and foot elevation and fluid intake may account for some variance but do not predict total variance in urine output. Future research to validate findings in a controlled setting may provide a scientific basis for bladder management.

Adolescent↗
PubMed1990

Effect of indomethacin on pain relief after thoracotomy.

The effect of indomethacin on postoperative pain was studied in 60 adult patients undergoing thoracotomy in a prospective, randomized, double-blind manner. Patients receiving indomethacin required significantly less opioid after operation and had significantly lower pain scores compared with the control group. Pain on movement and on coughing were reduced also. No major adverse effects were encountered.

Double-Blind Method↗
PubMed1987

Intractable angina pectoris: management with dorsal column stimulation.

This case report gives the first published description of the use of dorsal column stimulation in the management of a patient with intractable angina pectoris that was unresponsive to maximal medical therapy, who was unsuitable for coronary artery revascularization surgery.

Angina Pectoris↗
PubMed1987

Autotransfusion: quality of blood prepared with a red cell processing device.

The quality of blood salvaged at operation and prepared with the Dideco Autotrans BT 795 autotransfusion device was compared with that of donor blood in 41 patients having cardiac surgery involving cardiopulmonary bypass. Saved blood had a higher haemoglobin concentration (17.3 v. 13.1 g dl-1; P less than 0.001), a higher 2,3-diphosphoglycerate concentration (5.3 v. 1.1 mmol litre-1; P less than 0.00001), higher white cell count (17.1 X 10(9) litre-1 v. 4.1; P less than 0.00001), higher pH (7.5 v. 6.6; P less than 0.00001) and a more physiological potassium concentration (5.4 v. 8.8 mmol litre-1; P less than 0.00001) than donor blood. Saved blood platelet count was 34.5 X 10(9) litre-1 compared with 146.24 X 10(9) litre-1 (P less than 0.00001) and its heparin concentration was 0.64 u. ml-1. We conclude that this autotransfusor is a useful aid to blood conservation, producing good quality red cells with relatively normal pH and potassium values. However, modification of the centrifugation and washing is required to lessen the high white cell count and heparin concentrations found in the saved blood.

Adolescent↗
PubMed1987

Displaced olecranon fractures in adults. Biomechanical analysis of fixation methods.

Four commonly used methods of internal fixation for displaced olecranon fractures were analyzed in a biomechanical model to determine strength of fixation. A transverse osteotomy in fresh cadaver specimens was internally fixed and was tested to failure by rapid loading. Screw plus wire in combination provided the greatest strength of fixation. Energy to failure averaged 31.0 Nm for cancellous screw, 32.0 Nm for figure-of-eight wire, 35.3 Nm for Arbeitsgemeinschaft fur Osteosynthesefragen (AO) tension band, and 39.4 Nm for screw-plus-wire combination. Comparison of screw and wire in combination to screw alone or to figure-of-eight wire demonstrated a significant difference (p less than 0.05). The difference between screw plus wire and AO tension-band fixation did not achieve statistical significance (0.2 greater than p greater than 0.1).

Biomechanical Phenomena↗
PubMed1987

Displaced olecranon fractures in adults. Clinical evaluation.

Displaced fractures of the olecranon in adults were analyzed for pain, function, range of motion, and roentgenographic appearance. With one exception, the 38 transverse or oblique fractures were treated by reduction and internal fixation. Results were best in the group treated by screw plus wire in combination (average rating, 17.7 points). Other ratings averaged 17.2 for the intramedullary screw, 16.8 for figure-of-eight wire, and 16.7 for Arbeitsgemeinschaft fur osteosynthesefragen (AO) tension-band wire. Factors associated with poorer results included postoperative displacement or malreduction greater than or equal to 2 mm and articular involvement greater than or equal to 60%. Symptomatic metal prominence was particularly common after AO tension-band wiring, occurring in 80%. All seven comminuted fractures were treated by primary excision. The one comminuted fracture with greater than or equal to 60% articular involvement that was treated by excision had a poor result because of instability.

Adolescent↗
PubMed1986

Intravenous lignocaine pretreatment to prevent intraocular pressure rise following suxamethonium and tracheal intubation.

Intravenous lignocaine (1.5 mg kg-1) was evaluated in patients undergoing intraocular surgery as a means of preventing the rise in intraocular pressure which accompanies tracheal intubation. In patients given either suxamethonium or pancuronium to facilitate tracheal intubation, lignocaine pretreatment conferred no benefit over placebo in preventing the intraocular hypertensive response.

Aged↗
PubMed1985

Neutralising antibody against type 1 and type 2 herpes simplex virus in cervical mucus of women with cervical intra-epithelial neoplasia.

Patients with cervical intra-epithelial neoplasia had significantly increased neutralising antibody activity to type 2 herpes simplex virus in the cervical mucus. While patients differed from control subjects with respect to their number of sexual partners and socio-economic class, there were significant differences in neutralising antibody activity for case control comparisons within the same number of sexual partners or socio-economic groupings. The results lend support to the putative association between type 2 herpes simplex virus infection and pre-invasive and invasive carcinoma of the uterine cervix.

Adult↗