PubMed Health⌕ Search

Biomedical subjects

J C van Drie

Publications and source records attributed to J C van Drie.

2 recordsLinked to original sources

[Premedication in ENT operations under local anesthesia].

Midazolam 15 mg orally, was compared with the combination of pentobarbital, promethazine, opial and scopolamine as premedication for ear surgery under local anaesthesia in the first of a series of three double blind clinical trials. Sedation, pain sensation and appreciation by patient and surgeon alike were in favour of the pentobarbital regime. Anxiolysis was the same for both regimes. The number of actions needed to administer the medication was basically lower for midazolam. Comparing in a similar, second study midazolam 15 mg with higher doses of 20 mg and 25 mg, the results were satisfactory with the highest dose. Pain during the administration of the local anaesthesia was felt in 16% of the patients. Adding 10 mg morphine intramuscularly in a third study did not prove to diminish the percentage of patients with pain complaints. It is concluded that 25 mg midazolam taken orally 45 minutes pre-operatively is a satisfactory premedication for ear surgery and less troublesome than the pentobarbital, promethazine, opial, scopolamine we used before. In day-care surgery this short acting premedication in our opinion is quite useful.

Adolescent↗

[Causes and results of reoperations following stapedectomy].

The records of 145 patients who underwent revision stapedectomy were analysed to determine the causes of failure of the previous operation, the hearing results and the postoperative complaints. Displacement of the prosthesis was the most common cause of failure (49%). Other surgical findings, sometimes in combination, were a short prosthesis (35%), middle ear adhesions (23%), otosclerotic regrowth (14%) and eroded incus (10%). No specific cause of failure was identified in 6% of the revisions. Thirty-eight per cent of revision operations resulted in a hearing gain to a level less than 10 dB conduction loss and 61% to less than 20 dB. Slight sensorineural hearing loss after revision surgery occurred in 5%. 'Dead ears' were encountered in 2% as against 0.6% in the primary cases. Tinnitus was the most common complaint (21%) at the 3 week postoperative follow-up, declining to 7% four months postoperatively.

Adolescent↗