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Biomedical subjects

E McGrady

Publications and source records attributed to E McGrady.

6 recordsLinked to original sources
PubMed1998

Comparison of epidural bolus administration of 0.25% bupivacaine and 0.1% bupivacaine with 0.0002% fentanyl for analgesia during labour.

We have compared analgesia during labour provided by two epidural drug regimens, in a double-blind, randomized, controlled study. Group A received 10-ml bolus doses of 0.1% bupivacaine with fentanyl 2 micrograms ml-1 while group B received 0.25% plain bupivacaine 10 ml. Analgesia provided by both techniques was similar, but women in group A retained motor power in their legs and 60% chose to get out of bed. Duration of labour and time from insertion of the epidural to delivery was similar in both groups, but in group A, duration of the second stage was significantly shorter (P = 0.0003; 95% confidence interval (CI) -1.17, -0.27 h) and the incidence of forceps delivery was lower (P = 0.032). Maternal satisfaction with epidural analgesia, as assessed by VAS, was higher in group A (P = 0.04; 95% CI -0.001, 10.001).

Analgesia, Epidural↗
PubMed1997

Patient-controlled analgesia following caesarean section: a comparison of morphine and meptazinol.

Forty-eight women were investigated in a prospective double-blind study and randomised to receive intravenous patient-controlled analgesia (PCA) with meptazinol or morphine following elective caesarean section. Women received PCA boluses of 1 mg morphine or 10 mg meptazinol with no background infusion. Total drug consumption measured over a 24 h period, pain (visual analogue scores), sedation scores, incidence of nausea and vomiting, and requests for rescue analgesia were compared. Both meptazinol and morphine delivered via PCA provide satisfactory analgesia after caesarean section. There was no statistically significant difference in pain scores (P = 0.47) or the incidence of side-effects (nausea/vomiting P = 0.076, sedation P = 0.63) between the two drugs. Meptazinol is more expensive and offers no clinical advantages in this group of patients.

Clinical Trial↗
PubMed1997

Combined spinal-extradural anaesthesia for preterm and term caesarean section: is there a difference in local anaesthetic requirements?

In a non-blinded observational study, we have tested the null hypothesis that there is no difference in local anaesthetic requirements for subarachnoid anaesthesia between women presenting for Caesarean section at term or preterm (38-42 and 28-35 weeks' gestation, respectively). Using a combined spinal-extradural technique, 2.25 ml of 0.5% hyperbaric bupivacaine was given, in the sitting position, to 50 women presenting for Caesarean section. In 21 of 25 preterm women, adequate sensory block for surgery did not develop (P < 0.001) and they required supplementary extradural local anaesthetic (median 8 ml of 2% lignocaine with 1:200,000 adrenaline (interquartile range 4-12 ml)); preterm women not requiring extradural supplementation were at the upper end of the gestational range. There was a strong linear correlation between increasing gestation and block height in the preterm group (Spearman rank correlation coefficient = 0.74; 95% confidence intervals 0.49, 0.88). All women in the term group developed adequate anaesthesia with the subarachnoid dose alone. Onset of anaesthesia was slower in the preterm group (median 15 vs 5 min) with a lower incidence of hypotension (P = 0.0005).

Adult↗
PubMed1995

Maternal position during induction of spinal anaesthesia for caesarean section. A comparison of right lateral and sitting positions.

Forty women presenting for elective Caesarean section under spinal anaesthesia were randomly assigned to have anaesthesia induced in either the sitting or right lateral positions; 2.5 ml 0.5% hyperbaric bupivacaine was injected over 10 s before the mother was placed in a supine position with a 20 degree lateral tilt. The onset time and height of the subsequent analgesic and anaesthetic block was measured. It took longer to site spinal needles in the lateral position (240 vs 115 s, p < 0.001). There was a faster onset of sensory block to the sixth thoracic dermatomal level (8 vs 10 min, p < 0.001), in the lateral group, although onset time to T4 was comparable. There was no difference in maximum block height or degree of motor block. Mothers in the lateral group required more ephedrine in the first 10 m after siting the spinal (13.5 vs 10.5 mg, p < 0.05).

Adult↗
PubMed1994

Speed of onset of sensory block for elective extradural caesarean section: choice of agent and temperature of injectate.

We have studied the effects of choice of local anaesthetic and temperature of extradural injectate on speed of onset of sensory block for elective extradural Caesarean section in a double-blind trial in 120 women allocated randomly to one of four groups to receive either plain 0.5% bupivacaine or 2% lignocaine with 1:200,000 adrenaline at either room temperature or 38 degrees C. The onset time of lignocaine with adrenaline was shorter than that of bupivacaine regardless of temperature (P < 0.01). Warmed lignocaine produced the most rapid block overall (P < 0.025). The incidence of hypotension, ephedrine requirement, shivering, quality of analgesia and additional analgesic requirements were similar for all groups.

Anesthesia, Epidural↗