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Biomedical subjects

J B Luntley

Publications and source records attributed to J B Luntley.

7 recordsLinked to original sources
PubMed2000

Evaluation of a pilot regimen for postoperative pain control in patients receiving oral morphine pre-operatively.

Postoperative analgesia in patients who receive regular oral opioids pre-operatively is frequently suboptimal. To improve management we introduced a regimen using subcutaneous diamorphine infusions with incremental doses. Infusion doses were calculated as half the daily pre-operative dose of oral morphine with the increments as one-sixth of the infusion dose. Results were recorded on the first two postoperative days before (n = 13) and after (n = 23) commencing the new regimen. The percentage of patients reporting severe pain at rest and on movement were significantly reduced by the new regimen (54% and 69% vs. 13% and 40%, respectively) since the opioid dose as a percentage of the pre-operative dose was significantly higher (160% vs. 352%). There were no instances of excessive sedation or slow respiratory rate in any patient. The use of the regimen has resulted in greater doses of opioids being administered with fewer patients in severe pain without significant complications.

Adult↗
PubMed1998

Remifentanil in combination with propofol for spontaneous ventilation anaesthesia.

We have investigated the effect of four doses of remifentanil on the incidence of respiratory depression and somatic response at incision. Remifentanil was administered as a loading dose of 0.125, 0.25, 0.375 or 0.5 microgram kg-1 and at a maintenance infusion rate of 0.025, 0.05, 0.075 or 0.1 microgram kg-1 min-1, respectively, with an infusion of propofol 6 mg kg-1 h-1. Responses occurred in 88% of patients with remifentanil 0.025 microgram kg-1 min-1 compared with 30-40% in the other groups. Respiratory depression after incision increased from 6% with remifentanil 0.025 microgram kg-1 min-1 to 73% with 0.1 microgram kg-1 min-1. Increases in propofol infusion rate to 7.2-8.4 mg kg-1 h-1 produced adequate maintenance of anaesthesia. Reductions in remifentanil doses to 0.025-0.05 microgram kg-1 min-1 resulted in adequate respiration at the end of surgery in 88% of patients. Maintenance infusions of the two drugs for spontaneous ventilation are likely to be in these ranges. However, the ideal loading doses and infusion rates for induction remain to be established.

Adolescent↗
PubMed1995

Lifting and handling of patients by anaesthetists.

The process of transferring patients from the operating table was assessed in a district general hospital. The survey was conducted in two parts; a confidential questionnaire was sent to all members of the department and a month long assessment of three anaesthetists' caseload was undertaken. All the anaesthetists questioned had scanty knowledge of the relevant manual handling regulations. Although 70% of anaesthetists questioned lift and transfer patients on a regular basis, none had received any relevant training. Ninety-six percent of patient transfers were performed by two staff alone, even though there were five or more staff available to assist at 95% of transfers. Difficulty in transferring patients occurred in 32% of cases. Improvement of training anaesthetists in safe manual handling procedures is recommended.

Anesthesiology↗
PubMed1992

Bleeding time: is it a useful clinical tool?

The bleeding times of five volunteers were assessed individually by each of 12 observers. The reliability of the measurements obtained was examined by comparing statistically the variability between subjects and between observers. This variability was found to be similar for both groups. Consequently, we suggest that the bleeding time estimation is an unreliable test and should not be used in isolation without reference to the salient features of a history and examination, when determining if an individual patient is at risk of haematoma formation as a complication of regional anaesthetic techniques.

Bleeding Time↗