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Biomedical subjects

J D Alderson

Publications and source records attributed to J D Alderson.

16 recordsLinked to original sources
PubMed2004

Epidural analgesia for acute symphysis pubis dysfunction in the second trimester.

We report a case of severe symphysis pubis dysfunction in a parturient during her second trimester of a twin pregnancy. Symphysis pubis dysfunction produces pain, instability and limitation of mobility and function, of the symphysis pubis during pregnancy and labour. It is often under-treated. We provided lumbar epidural analgesia with intermittent top-ups of bupivacaine 0.1% with fentanyl 2 micrograms/mL for 72 h. This provided initial analgesia, breaking a vicious cycle of pain and muscle spasm. The benefits extended into the remainder of her pregnancy. Subsequently, simple analgesics and physiotherapy allowed control of pain until vaginal delivery 15 weeks later.

Adult↗
PubMed2001

Epidural analgesia in labour for a patient with hereditary neuropathy with liability to pressure palsy.

Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare but probably under-diagnosed disorder of peripheral nerves in which individuals suffer from repeated motor and sensory neuropathies (pressure palsies) following brief nerve compression or mild trauma. A seemingly trivial insult such as sitting or kneeling may result in a focal neurological deficit lasting for hours to months. Despite the growing recognition of this problem, information regarding the anaesthetic management of labour is sparse. We present a woman with HNPP who was provided with a modified epidural regimen (low concentration bupivacaine and fentanyl) for analgesia in labour and delivery. Labour progressed uneventfully and there were no neurological sequelae following delivery.

Journal Article↗
PubMed1996

Anaesthetic management of labour in two patients with Klippel-Feil syndrome.

Two patients with Type I Klippel-Feil syndrome presented at the antenatal clinic. The first patient, who suffered from sleep apnoea, was delivered of a healthy infant by vacuum extraction. The second, who was profoundly deaf and had marked kyphoscoliosis, developed pregnancy-induced hypertension and urinary tract infection and was delivered at 38 weeks by vacuum extraction. In both cases epidural analgesia was employed to allow pain relief during labour. Anaesthetic management of Klippel-Feil syndrome is discussed and the benefits of early anaesthetic assessment and continued involvement of senior anaesthetic and obstetric staff emphasized.

Journal Article↗
PubMed1996

The anaesthetic management of a labouring woman with pulmonary arterio-venous malformations.

Epidural analgesia is recommended for many medical conditions in labouring women. We describe a case where it was used successfully in a parturient with multiple pulmonary arterio-venous (a-v) malformations. It has been noted that pregnancy can cause marked deterioration in the condition of such patients. We support the suggestion that pulmonary a-v malformations can be added to the list of conditions for which epidural analgesia should be considered.

Journal Article↗
PubMed1978

Underlying immunopathology as a cause of adverse responses to two intravenous anaesthetic agents.

A patient who had shown some evidence of immunological sensitivity underwent several operations under general anaesthesia for otitis media without ill effect. On his second exposure to Althesin, however, he suffered a severe reaction. Facial angioneurotic oedema was accompanied by peripheral vasodilatation and sweating, and C3 conversion was observed in his plasma. Subsequent anaesthetics produced no reactions until four years later, when thiopentone and suxamethonium were given. This reaction was much milder, but C3 conversion again occurred. Although the clinical signs indicated an anaphylactoid reaction, the laboratory findings suggested that this patient had an underlying immunopathological condition involving complement activation, which could be triggered by any intravenous agent that activated complement. The judgment that a reaction to a particular drug is anaphylactic cannot be made on the basis of clinical signs alone. Simple laboratory analysis will show whether the reaction is due to an underlying immunopathological condition that may be triggered by any of several drugs.

Adult↗
PubMed1976

Althesin infusion for cardiac catheterisation.

A trial of a continuous intravenous infusion of Althesin is described for sedation during cardiac catheterisation, both for children and adults. The conditions produced for the procedure were very satisfactory. The advantages and problems of its use are discussed. The technique justifies further trials.

Adolescent↗