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Biomedical subjects

J M Nicoll

Publications and source records attributed to J M Nicoll.

10 recordsLinked to original sources
PubMed1994

Use of ketorolac in the prevention of suxamethonium myalgia.

We have evaluated the effect of ketorolac in the prevention of suxamethonium myalgia. Sixty ASA I patients who presented for extraction of wisdom teeth as day cases were allocated randomly to one of three equal groups. Patients received either 0.9% saline (placebo), atracurium 0.05 mg kg-1 i.v. or ketorolac 10 mg i.v., 3 min before induction of anaesthesia. Follow-up postal questionnaires (97% response rate) at 48 h showed no reduction in the incidence of myalgia after ketorolac pretreatment compared with saline. The use of atracurium reduced the incidence of myalgia by 60% (P < 0.001) and the severity of fasciculations (P < 0.001). There was no difference in the severity of fasciculations between the saline and ketorolac groups. Intubating conditions were comparable in the three groups.

Adolescent↗
PubMed1993

Retrobulbar hemorrhage after 12,500 retrobulbar blocks.

To determine the incidence of hemorrhage after retrobulbar nerve block, 12,500 consecutive cases were reviewed. Fifty-five retrobulbar hemorrhages occurred after retrobulbar injection, a prevalence of 1 in 227 (0.44%). This compares favorably with the quoted prevalence of 1%-3% in the literature. Acquired vascular disease was a significant risk factor (P < 0.017). Surgery was postponed in 41 (75%) of the cases in which a hemorrhage developed. Although retrobulbar hemorrhage is considered a serious complication of retrobulbar anesthesia, the eventual visual outcome after surgery in these patients was not significantly different from the control group.

Aged↗
PubMed1987

Central nervous system complications after 6000 retrobulbar blocks.

Six thousand consecutive patients in whom retrobulbar anesthesia was performed by an anesthesiologist before ophthalmic surgery were studied. Sixteen patients (1 in 375) developed signs and symptoms presumed to be caused by the direct spread of the local anesthetic agents to the central nervous system. These signs and symptoms ranged from drowsiness, blindness of the contralateral eye, abnormal shivering, or vomiting, through to respiratory depression, apnea, hemiplegia, aphasia, convulsions, unconsciousness, and cardiopulmonary arrest. The severity of the symptoms was unrelated to the dose of anesthetic administered. The time of the onset of symptoms after the retrobulbar injection was variable (average 8 min, range 2 to 40 min). The possibility of a life-threatening complication occurring was rare (1 in 750) but unpredictable. The need for closely monitored anesthesia care of all patients having surgery under retrobulbar anesthesia is stressed.

Anesthetics, Local↗
PubMed1986

Status epilepticus following enflurane anaesthesia.

Two patients had generalised convulsions which occurred several hours after anaesthesia supplemented with enflurane. One patient had to be treated for life threatening status epilepticus 7 hours after anaesthesia and the other had a myoclonic convulsion 17 hours after recovery from anaesthesia. Neither had any relevant pre-operative history of epilepsy or convulsions. Possible synergistic roles of the metabolite of atracurium, laudanosine, as well as of cephazolin and photic stimulation, are discussed.

Adolescent↗
PubMed1986

Retrobulbar anesthesia: the role of hyaluronidase.

The present study was conducted in 100 patients receiving retrobulbar block for ophthalmic surgery to compare the efficacy of local anesthetic solutions with and without hyaluronidase. All patients received 3.5 ml of a mixture of 3 ml of 0.5% bupivacaine and 2 ml of 2% lidocaine. Seventy-five international units of hyaluronidase were diluted in 5 ml of the local anesthetic mixture and used for 50 of the blocks. The remainder did not receive hyaluronidase. A consistently better motor blockade was achieved with hyaluronidase (P less than 0.001 at 10, 15, and 20 min). This finding has not been conclusively demonstrated before.

Anesthesia, Local↗
PubMed1985

Anaesthetic management of glucagonoma.

Alpha cell tumours of the pancreatic islets of Langerhans are rare. The glucagonoma syndrome is caused by excess glucagon secretion from such a tumour. Physiologically, glucagon is important in the control of the homeostatis of glucose and certain amino acids. Pharmacologically, it has been used to treat heart failure. Problems with both glucose homeostasis and myocardial function could, therefore, theoretically be anticipated following resection of a glucagonoma. This paper describes the peri-operative management of such a case, where, despite measured changes in glucagon, no problems of this nature were encountered.

Adenoma, Islet Cell↗