Limitations of pulse oximetry: respiratory insufficiency--a failure of detection.
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Biomedical subjects
Publications and source records attributed to H E Hosie.
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We have compared the rates of absorption and efficacies of temazepam 30 mg in elixir and capsule formulations in 100 patients before surgery. Both formulations provided anxiolysis and sedation, but there was wide variation in plasma concentrations of temazepam between individuals and between formulations. The presence or absence of anxiety did not influence the absorption of the preparations. It is suggested that plasma concentrations in excess of 200 ng ml-1 are required for sedation and anxiolysis, and that this may be achieved more reliably using the elixir formulation.
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Temazepam elixir 30 mg by mouth was compared with i.v. Diazemuls titrated to a maximum dose of 20 mg in a double-blind study of 50 patients undergoing elective minor oral surgery. The treatments produced a similar reduction in anxiety score and similar degrees of patient relaxation and co-operation. The diazepam group had greater amnesia during surgery, but also showed significant slowing of reaction time at the time of discharge. Patients given temazepam elixir showed wide variations in plasma concentrations. Patients with low plasma temazepam concentrations at the time of surgery showed no significant reduction in anxiety scores.
The performance of a pocket spirometer was compared with that of the Vitalograph to assess the extent of agreement between the instruments and the repeatability of measurements with each instrument. Both instruments showed a similar level of accuracy when measurements were repeated and in the estimation of forced vital capacity, but there was a mean difference of 201 ml in measurements of forced expiratory volume in one second, for which the Vitalograph gave the larger reading.
The spread of solutions injected to the intercostal space was studied in 10 healthy volunteers. Up to 20 ml of a 50:50 mixture of local anaesthetic solution and a radiopaque dye was injected through a modified extradural catheter placed in an intercostal space at the posterior angle of the rib. Radiographic films demonstrated spread by an extrapleural route into adjacent intercostal spaces and this was confirmed by the occurrence of analgesia in the corresponding dermatomes. The relevance of these results to clinical practice is discussed.