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Biomedical subjects

I D Ward

Publications and source records attributed to I D Ward.

6 recordsLinked to original sources
PubMed1982

Effects of extradural analgesia and vagal blockade on the metabolic and endocrine response to upper abdominal surgery.

The effect of thoracic extradural analgesia and vagal blockade on the metabolic and endocrine responses to cholecystectomy was investigated. In comparison with a control group of patients, extradural analgesia and vagal blockade abolished the glycaemic response but had no effect on the increase in plasma cortisol. Circulating insulin values were significantly decreased in the extradural group of patients, confirming the importance of autonomic innervation in maintaining basal insulin output. there is, at present, no satisfactory local analgesic technique for controlling the endocrine response to upper abdominal surgery.

Anesthesia, Epidural↗
PubMed1982

Laparoscopy--a stressful procedure.

The metabolic and hormonal response to laparoscopy was investigated in 22 patients, in whom nitrous oxide-oxygen anaesthesia was supplemented with either 150 micrograms fentanyl or an Althesin infusion. There were significant increases in plasma cortisol (p less than 0.05) from 303 to 458 mmol/litre and prolactin from 1869 to 3918 mU/litre (p less than 0.01) at the end of laparoscopy in both groups of patients; these were sustained during the first hour of the recovery period. The blood glucose concentration increased significantly (p less than 0.05) from 4.48 to 5.28 mmol/litre at the end of laparoscopy in the Althesin patients and remained increased 1 hour postoperatively at 5.54 mmol/litre (p less than 0.01). The blood glucose concentration increased significantly (p less than 0.05) from 4.43 to 5.36 mmol/litre in the fentanyl patients only during the recovery period. There was no significant difference between the metabolic and hormonal changes observed with the two anaesthetic techniques.

Adult↗
PubMed1981

Fentanyl and the metabolic response to gastric surgery.

The effect of the supplementation of nitrous oxide-oxygen anaesthesia with either 50 micrograms fentanyl/kg body weight or 0.5-1.0% halothane on the metabolic and hormonal response to gastric surgery was investigated in 16 patients. Those patients who received fentanyl showed a significant decrease (p less than 0.05) in the hyperglycemic response to surgery after 30 and 90 minutes and a significant decrease (p less than 0.05) in the plasma cortisol response after 30 minutes. Profound respiratory depression occurred at the end of surgery in all patients who were given fentanyl. This required the intravenous administration of naloxone and careful supervision in the early postoperative period. It is concluded that the transient metabolic and endocrine benefits produced by fentanyl do not compensate for the severe respiratory problems postoperatively and thus 'high-dose fentanyl' cannot be recommended for upper abdominal surgery.

Alanine↗