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Biomedical subjects

D Murrell

Publications and source records attributed to D Murrell.

24 records · Page 2Linked to original sources
PubMed1990

The perioperative effects of oral premedication in children.

The pre- and postoperative effects of oral diazepam (0.5 mg/kg), trimeprazine (4 mg/kg), pentobarbitone (3 mg/kg) and a placebo were compared in a randomized double-blind clinical trial in 149 children, aged one to ten years, undergoing adenotonsillectomy. The anaesthetic was standardised and each patient received intraoperative intramuscular papaveretum (0.3 mg/kg). Preoperative sedation was assessed in the ward before transfer onto the theatre trolley, on leaving the ward, on arrival on the theatre floor, on arrival in the induction room and on induction of anaesthesia. There was no significant difference in sedation between the four drug groups except for the placebo group which had a significantly greater unsatisfactory rating at the stage of induction of anaesthesia (P = 0.001). There were no differences in waking times between the diazepam, pentobarbitone and placebo groups, but the trimeprazine group's waking times were significantly prolonged (P less than 0.001). However, the trimeprazine group exhibited significantly less distress in the recovery unit (P = 0.02) and had half the incidence of vomiting (P less than 0.001) than did the other premedication groups.

Adenoidectomy↗
PubMed1990

A study of preoperative fasting in infants aged less than three months.

The effects of preoperative fasting on plasma glucose and gastric emptying was studied in 62 infants aged less than three months after a feed of either breast milk or an infant milk formula. Prior to induction of anaesthesia no infant was hypoglycaemic, defined as plasma glucose less than 2.2 mmol/l. Five per cent of infants had a significant volume of residual gastric contents. The mean intraoperative plasma glucose levels rose significantly and this was not influenced by the use of intravenous Hartmann's solution or low dose opioids. Infants in this age group tolerate three- to four-hour preoperative fasts well as no infant became hypoglycaemic intraoperatively. They demonstrate a hyperglycaemic response to the stress of anaesthesia and surgery, and may not need routine intraoperative glucose supplements although plasma glucose should still be monitored.

Acid-Base Equilibrium↗
PubMed1988

Motor preparation aspects of cardiovascular reactivity to psychological challenge.

Neural control of the circulation has evolved in such a way that behavioral responses to psychological stress may be accompanied by a dramatic activation of the cardiovascular system. This study was designed to address the hypothesis that such instances of cardiovascular mobilization reflect a functional motor preparation response. Twenty-four healthy young men participated in reaction time (RT) tasks which involved responding by squeezing a handgrip dynamometer. Motor preparation demands were manipulated by varying the temporal predictability of response requirements as well as the physical effort involved in responding, while controlling for other factors previously established to influence cardiovascular reactivity to psychologically challenging tasks. Physiological response measurements included heart rate, blood pressure and oxygen consumption. Increases in heart rate and systolic blood pressure during the RT tasks showed a general pattern which was consistent with the predictions of the motor preparation hypothesis, with the greatest elevations occurring in association with low temporal predictability and high physical effort. The possibility is discussed that factors such as incentives and elements of uncertainty may influence cardiovascular reactivity by accentuating behavioral arousal, of which motor preparation may be an inextricable component.

Adaptation, Psychological↗