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Biomedical subjects

D G Bogod

Publications and source records attributed to D G Bogod.

At least 19 recordsLinked to original sources
PubMed2004

Cerebrospinal fluid-cutaneous fistula and pseudomonas meningitis complicating thoracic epidural analgesia.

We report a case of delayed cerebrospinal fluid-cutaneous fistula that developed in a patient following removal of a thoracic epidural catheter used for perioperative analgesia. It was further complicated by the development of bacterial meningitis. Predisposing factors and management of this rare iatrogenic complication are discussed and the literature reviewed for similar reports.

Adult↗
PubMed2002

A pilot study of patient-led identification of the midline of the lumbar spine.

The midline of the lumbar spine is usually identified by palpation of the spinous processes. Placement of an epidural or spinal needle is more difficult when these bony landmarks are impalpable. This pilot study investigated the ability of 50 healthy volunteers to identify the midline of their own backs, using light touch or proprioception. The midline as identified in this manner was compared with the 'gold standard' as defined by the interspinous line. Sensation to light touch was the most accurate, with 90% of the volunteers able to identify the midline to within 6.5 mm. Proprioception using a finger to touch the midline was less accurate. This study was carried out on volunteers with palpable spinous processes but suggests that, in certain circumstances, a patient-led identification of the midline may be of value.

Adult↗
PubMed1996

Intrathecal administration of morphine for elective Caesarean section. A comparison between 0.1 mg and 0.2 mg.

This study compared the quality of analgesia and incidence of adverse effects with two doses of intrathecal morphine in patients undergoing elective Caesarean section. Fifty patients were randomly allocated to receive either morphine 0.1 mg or 0.2 mg in addition to a standard intrathecal dose of 2.5 ml bupivacaine 0.5% in 8% dextrose. The quality of analgesia was assessed using visual analogue scores and the incidence of nausea, vomiting and itching were recorded during the first 24 h postoperatively. There was no statistically significant difference in the quality of analgesia nor in the incidence and severity of itching between the two groups. Fewer patients in the 0.1 mg morphine group experienced postoperative nausea and vomiting (7 versus 14, p < 0.05). We conclude that the use of 0.1 mg morphine intrathecally produces comparable analgesia to 0.2 mg after Caesarean section with significantly less nausea and vomiting.

Analgesia, Obstetrical↗
PubMed1995

Effect of demand frequency on lockout period. The Abbott Provider 5500 Patient-Controlled Analgesia machine.

An Abbott Provider 5500 Patient Controlled Analgesia machine was noticed to have developed a prolonged lockout period when frequent analgesic demands were being made. This study tested five other machines and demonstrated that the duration of the lockout period was influenced by the frequency of analgesic demands. This finding could have clinical implications and we recommend that the duration of the lockout period should be specifically examined during the testing of patient-controlled machines.

Analgesia, Patient-Controlled↗
PubMed1995

Caesarean section in chronic renal failure.

A 22-year-old woman presented for Caesarean section at 34 weeks' gestation. She had chronic renal failure, with a glomerular filtration rate of 14 mL min-1 and was treated with twice weekly dialysis. We describe the potential problems of the case including cardiovascular instability, fluid balance and some of the effects of uraemia. We also describe the anaesthetic management of the case.

Adult↗
PubMed1992

Appropriate use of local anaesthetic for venous cannulation.

A departmental survey indicated that the large majority of anaesthetists believed that injection of local anaesthetic before insertion of an intravenous cannula was unnecessary if a cannula of 18 gauge or smaller was used, because injection of local anaesthetic would be more painful than insertion of the cannula. A study was undertaken to test this hypothesis. The results showed that intravenous cannulation with a cannula of 18, 20 or 22 gauge was significantly (p less than 0.006) more painful than a subcutaneous injection of 1% lignocaine. We recommend that subcutaneous injection of local anaesthetic should be considered before insertion of any size of intravenous cannula.

Adult↗
PubMed1991

Diagnostic and management dilemmas in a patient with tracheal trauma.

A patient with a foreign body penetrating the neck and chest was found to have physical signs which were consistent with serious tracheal injury and included a large movement of air through the lower part of the neck. The subsequent management of the patient and the difficult problem of securing an airway are described. At operation, the tracheal damage was found to be less severe than anticipated and the observed air flow was a result of penetration of the foreign body into the pleural cavity. The management of the patient is discussed and the potential for misinterpretation of the physical signs in this type of trauma is emphasized.

Adult↗
PubMed1990

Isoflurane with either 100% oxygen or 50% nitrous oxide in oxygen for caesarean section.

Two hundred mothers undergoing general anaesthesia for Caesarean section were allocated randomly to receive either 100% oxygen (group 100) or 50% nitrous oxide in oxygen (group 50), both supplemented with isoflurane. In each group the concentrations of isoflurane were chosen to deliver 1.5 MAC for the first 5 min after induction and 1.0 MAC thereafter. The mean umbilical venous PO2 was greater in group 100 for emergency sections (P = 0.001). Babies born to mothers in group 100 required less resuscitation than those in group 50 (P = 0.04) and there was a tendency to higher Apgar scores at 1 min in group 100, although this was not statistically significant. There were no instances of awareness, although two patients in group 100 and three in group 50 reported dreaming. This study confirms earlier findings that the use of 100% oxygen can significantly improve fetal oxygenation during Caesarean section, with particular benefit in emergency cases. This is associated with a lower incidence of neonatal resuscitation.

Anesthesia, General↗
PubMed1990

Detecting awareness during general anaesthetic caesarean section. An evaluation of two methods.

Seventy-four patients received general anaesthesia for Caesarean section. Seven percent of the elective group and 28% of the emergency patients reported dreaming or recall of voices during the procedure (p less than 0.05) at postoperative interview. One patient from each group reported feeling pain or suffocation. All patients were monitored for awareness using the isolated forearm technique and lower oesophageal contractility. Provoked lower oesophageal contractility was the most effective of the different indices. A value greater than 35 mmHg on at least one occasion had a false negative rate of 33%, a false positive rate of 28% and a predictive value of 25%. A value greater than 13 mmHg picked up all patients who dreamed, with a false positive rate of 68%. Both of the 'aware' patients had provoked lower oesophageal contractility response of greater than 70 mmHg, an attribute shared by only 8% of the rest. The isolated forearm was particularly ineffective.

Anesthesia, General↗