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Biomedical subjects

H C Husegaard

Publications and source records attributed to H C Husegaard.

At least 19 recordsLinked to original sources

Spinal analgesia with plain 0.5% bupivacaine administered at spinal interspace L2-3 or L4-5.

Forty patients (age range 60-79 yr) undergoing transurethral surgery were allocated randomly to receive 0.5% plain bupivacaine 4 ml at the L2-3 (n = 20) or L4-5 (n = 20) space. The solution was injected over 30 s with the patient in the sitting position. The patient was kept sitting for 2 min, then placed supine and, 5 min later, placed in the lithotomy position. No significant differences were found in onset time, extent and duration of analgesia or duration of motor block.

Aged↗

Spinal anaesthesia with plain 0.5% bupivacaine at 19 degrees C and 37 degrees C.

Forty-five men aged 50-80 yr undergoing urological surgery under spinal anaesthesia were allocated randomly to three groups. All patients received 0.5% plain bupivacaine 3 ml injected at the L2-3 interspace. The temperature of the solution in group 1 was 19 degrees C, in groups 2 and 3 37 degrees C. In groups 1 and 2 the injection was performed with the patient sitting; in group 3 the patient was in a lateral horizontal position. Spread of block, intensity of motor block and cardiovascular stability were measured. Warming the solution from 19 degrees C to 37 degrees C before spinal injection with the patient in the sitting position did not significantly affect these variables. However, the extent of analgesia was reduced significantly when the 37 degrees C solution was injected with the patient in the lateral horizontal compared with the sitting position.

Aged↗

Plain bupivacaine: 0.5% or 0.25% for spinal analgesia?

Plain 0.5% bupivacaine 3 ml was compared with plain 0.25% bupivacaine 6 ml for spinal anaesthesia during transurethral surgery in 40 patients. The solutions were injected over 30 s at the L3/4 space with the patient in the sitting position. The patient was kept sitting for 2 min, supine for 5 min and then placed in the lithotomy position. No significant differences were found in onset time, extent of cephalad spread, duration of sensory or motor blockade, or side effects. The use of a 0.5% plain solution of bupivacaine did not appear to confer any advantage over the 0.25% solution.

Aged↗

Respiratory depression following postoperative analgesia with epidural morphine.

Eighteen healthy patients subjected to operation for duodenal ulcer were allocated randomly to one of two regimes of analgesic treatment with epidural morphine. The analgesic regime was started either per- or postoperatively. Epidural morphine in doses of 4 mg was given until satisfactory pain relief was achieved. PaCO2 and respiratory rate were measured hourly for 10 h and a nearly identical respiratory depression was found in the two groups. Peak PaCO2-values were seen in the 5th and 6th postoperative hour. The respiratory rate was initially high and declined during the first postoperative hours. Only one patient in each group had a pathologically low respiratory rate (8 min-1), but this was transient and seen in the 10th postoperative hour. The needs for epidural morphine on the first postoperative day were highest in the peroperative group. It is concluded that a peroperative start of pain treatment with epidural morphine does not affect the degree of respiratory depression or reduce the postoperative analgesic requirements.

Adult↗

Effect of postoperative extradural morphine on lower urinary tract function.

The effect of postoperative extradurally administered morphine on lower urinary tract function was studied in female patients undergoing uterine surgery. Urodynamic measurements were made on the day before and on the day after the operation, using a DISA 2-channel carbon dioxide (CO2) cystomictrograph. In ten patients without postoperative urinary retention no changes in cystometry were found during morphine administration, while two patients who developed acute urinary retention had a marked increase in bladder capacity and of detrusor pressure. In contrast, the urethral pressure profile was unchanged in both groups of patients. Intravenously administered naloxone tended to normalize the bladder capacity in the patients with urinary retention. These findings seem to indicate a marked effect in some patients of extradurally administered morphine and the acute urinary retention, following morphine administration, may be treated with naloxone.

Adult↗

Prevention of postoperative deep venous thrombosis. Low-dose heparin versus graded pressure stockings.

In a prospective, controlled clinical study prevention of postoperative deep venous thrombosis by low-dose heparin (Heparin Leo 5 000 I.U. subcutaneously twice daily) was compared with graded compression stockings (TED stockings, Kendall Co.). One hundred and twelve patients, admitted during a period of one year for elective major surgery, were allocated to one of the two treatment groups. In order to detect deep venous thrombosis the 99mTc-plasmin test was performed before the operative procedure and again 5 days later. Ninety-seven patients completed the study (45 patients in the heparin group and 52 patients in the stocking group). Venous thromboembolism was detected in 4 patients (8.9%) in the heparin group and in 3 patients (5.8%) in the stocking group (p greater than 0.05). In 6 patients the plasmin test was positive and one patient in the heparin group died following pulmonary embolism. It is concluded that graded compression stockings can be used as an alternative to low-dose heparin for prophylaxis against deep venous thrombosis in elective general surgery.

Adult↗

Heparin-induced increase in serum levels of aminotranferases. A controlled clinical trial.

Sixty-four patients over the age of 40 years, undergoing elective surgery of at least one hour's duration, were randomized to treatment with either a thromboembolic deterrent ( TED ) stocking (Kendall Co.) or subcutaneous low-dose heparin 5 000 IU every 12 hours. Serum levels of alanine aminotransferase (S-ALAT), aspartate aminotransferase (S-ASAT), gamma-glutamyl transpeptidase (S-gamma-GT) and alkaline phosphatase (S-ALP) were measured. S-ALAT increased significantly on the 5th and 10th postoperative day, from 27 +/- 2 (x +/- SE) to 40 +/- 4 (p less than 0.01) and 55 +/- 7 U/l (p less than 0.001), respectively, in the heparin group and was significantly higher in the heparin than in the TED group both on the 5th (p less than 0.01) and 10th (p less than 0.05) postoperative day. S-ASAT and S-gamma-GT increased significantly during heparin treatment, but did not differ significantly from the values of the TED group. No change in S-ALP was registered in either group. It is concluded that prophylactic treatment with low-dose heparin induces a significant increase in S-aminotransferase levels, especially in S-ALAT. The phenomenon has profound differential diagnostic implications in conditions such as pulmonary embolism and acute myocardial infarction.

Adult↗