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Biomedical subjects

E T Hudes

Publications and source records attributed to E T Hudes.

6 recordsLinked to original sources

A comparison of morphine-perphenazine and midazolam on preoperative sedation and arterial oxygen saturation.

The effectiveness of midazolam and a mixture of morphine-perphenazine premedication to produce sedation and their effects on preoperative oxygen saturation (SaO2) were examined. Eighty-five patients whose SaO2 measured with a pulse oximeter was greater than 90% and who were not receiving narcotic sedatives or oxygen were randomized to three groups. Each patient had his SaO2 recorded before premedication with placebo (saline), midazolam 0.08 mg.kg-1 or morphine 0.15 mg.kg-1 with perphenazine 2.5-5.0 mg im. From 30-90 min later, prior to anaesthesia SaO2 was repeated, and a sedation score was obtained by a blinded observer using a seven point scale. Median sedation scores were greater for midazolam (4) than for morphine-perphenazine (2) and placebo (1) (P less than 0.0001). As well, there was a decrease in the SaO2 in the morphine-perphenazine group (1.7 +/- 2.7%, P less than 0.001) but not in the midazolam and placebo groups (0.1 +/- 2.3%, -0.8 +/- 2.1%). In conclusion midazolam produced greater sedation than morphine-perphenazine and placebo without effect on SaO2 whereas morphine-perphenazine showed a decrease in SaO2 preoperatively.

Adult↗

Recovery room oxygenation: a comparison of nasal catheters and 40 per cent oxygen masks.

One hundred and sixty-one ASA physical status I-III patients undergoing elective surgery were evaluated using nasal catheters versus 40 per cent O2 venturi masks. Twenty-one per cent of the patients arrived in the recovery room with hypoxia as measured with a pulse oximeter (SaO2 less than 90 per cent). Fifteen minutes later all patients who arrived hypoxic were well oxygenated on their chosen oxygen therapy. Only one patient that arrived normoxic became hypoxic using a nasal catheter 15 minutes later. There was no statistical difference between patients given 40 per cent O2 by mask versus patients given oxygen by nasal catheter. The mean SaO2 for the group given 40 per cent O2 at 15 minutes was 96.7 +/- 2.15 per cent versus 96.6 +/- 2.48 per cent for nasal catheters. Nasal catheters are as effective as 40 per cent O2 masks for treating hypoxia in the recovery room. Obesity and age were statistically significant risk factors in the patients that arrived hypoxic. Patients were 47.4 +/- 15.6 years in the hypoxic group versus 38.3 +/- 15.6 years in the non-hypoxic group (p less than 0.001). Patients having an endotracheal tube with intermittent positive pressure ventilation or having a premedication were more apt to be hypoxic on arrival. These last two factors were closely associated and may reflect bias. The patient's gender, history of smoking, presence of obstructive lung disease, not including asthma, location of incision, or type of anaesthetic were not statistically significant risk factors.

Adolescent↗

Hydropneumothorax--an unusual complication of lung lavage.

Hydropneumothorax is an uncommon but potentially fatal complication for a patient undergoing positive pressure ventilation. The case of a 23-year-old woman with severe asthma requiring lung lavage is described. Twenty minutes after an uneventful left lung lavage, the patient experienced increased peak airway pressure, decreased oxygen saturation and hypercarbia, despite ventilation with 90 per cent oxygen. A chest x-ray revealed mediastinal shift and a left sided pneumothorax. Drainage was carried out, revealing air and clear fluid in the pleural space. The importance of technical problems such as patient and endotracheal tube positioning, elimination of cross-spilling and cardiopulmonary effects of lavage are discussed.

Adult↗