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J J Church

Publications and source records attributed to J J Church.

6 recordsLinked to original sources
PubMed1992

Extradural diamorphine for postoperative analgesia: audit of a nurse-administered service to 800 patients in a district general hospital.

We report the use of extradural diamorphine for postoperative analgesia as a nurse-based service on selected surgical wards in a district general hospital. Eight hundred patients received lumbar or thoracic extradural diamorphine analgesia for postoperative or traumatic pain. Diamorphine was administered in bolus form by suitably trained nursing staff. Satisfactory analgesia, recorded on a verbal rating scale at the conclusion of the service, was achieved in 94.6% of patients. The technique was considered by medical and nursing staff to be a safe and acceptable method of analgesia. Respiratory depression, defined as a ventilatory frequency of less than 10 b.p.m., occurred in seven patients (incidence of 0.9%). All occurred in the theatre recovery area or in the intensive care unit. Retrospectively, each was predictable and all responded to naloxone 0.4 mg.

Adolescent↗
PubMed1983

Continuous infusion of meptazinol and pethidine in the relief of post-operative pain.

Thirty patients who had undergone major abdominal surgery were randomly assigned to a continuous infusion of either 0.45 mg meptazinol/kg/hr or 0.3 mg pethidine/kg/hr. Analgesia was assessed by rating scale, ranging from 0 (no pain) to 10 (unbearable pain), and by questionnaire. Respiration rate was closely monitored and end-tidal PCO2 measured. Both drugs provided effective analgesia. The median rating of pain over the 24 hr post operation was 2.6 with meptazinol and 2.9 with pethidine, a difference that was not statistically significant. No patient in either group reported a distressing degree of discomfort. Although no patients exhibited clinically significant respiratory depression or sleep apnoea, high (greater than 6 Kpa) end-tidal PCO2 values were significantly more frequent in the pethidine than in the meptazinol group (P less than 0.01). This suggests a greater margin of safety with the use of meptazinol. The smaller effect of meptazinol on respiratory activity might make it especially appropriate for administration by continuous infusion--a technique which has practical advantages over intermittent intramuscular injection and which has been shown to be more effective in the control of post-operative pain. Patients' responses in the present study demonstrate the efficacy of continuous infusion as a means of relieving post-operative pain and confirm previous findings that 0.5 mg/kg/hr meptazinol provides a good degree of analgesia.

Abdomen↗
PubMed1979

Continuous narcotic infusions for relief of postoperative pain.

Relief of acute pain after surgery or trauma is still inadequate in many centres, most patients being treated with intermittent intramuscular injections of narcotic analgesics. Over the past three years continuous intravenous narcotic infusions have been used at this hospital to treat postoperative pain; recently a system has been devised whereby an hourly dose is given and the dispenser recharged every hour. The method used is cheap and reliable, and signs of overdosage may be easily checked by nursing staff. Side effects rarely occur. Fifty patients who had received intravenous infusions after undergoing major abdominal surgery were sent a questionnaire to assess postoperative pain, and the results were compared with those from 50 matched controls who had received intramuscular injections. Of those who replied, only four patients who had received the infusion had found the pain distressing compared with 13 controls. Continuous narcotic infusions are most effective in relieving postoperative pain and may be given cheaply and reliably.

Abdomen↗