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Biomedical subjects

J P Payne

Publications and source records attributed to J P Payne.

At least 19 recordsLinked to original sources
PubMed1989

The use of pulse oximetry in post-operative hypoxaemia in patients after propofol induction of anaesthesia.

Pulse oximetry was used to measure changes in oxygen saturation in the early post-operative phase in three groups of 50 patients in whom anaesthesia was induced with propofol. One group breathed room air during induction and anaesthesia was maintained with halothane whereas the other two groups both breathed oxygen during induction and anaesthesia was maintained with either halothane inhalation or a propofol infusion. In 59 patients distributed fairly evenly between the three groups the oxygen saturation fell below 90%; the mean minimum oxygen saturation was 91.7 +/- 0.3 and the mean time at which it occurred was 3.9 +/- 0.4 min after the anaesthetic was withdrawn. Neither the inhalation of oxygen during induction nor the anaesthetic technique affected the decrease in postoperative oxygen saturation but the infusion group took significantly longer to recover consciousness.

Adolescent↗
PubMed1987

Recovery of respiration after neuromuscular blockade with alcuronium.

Alcuronium 0.2 mg kg-1 was given to six patients to investigate the simultaneous recovery of breathing and peripheral neuromuscular function. Anaesthesia was maintained with 66% nitrous oxide in oxygen supplemented with 0.5% halothane, and the patients were ventilated to normocarbia. Patients were disconnected from the ventilator after the reappearance of the tetanic response. This response returned at a mean time of 19.2 min after the injection of alcuronium and oxygenation was maintained thereafter by means of apnoeic diffusion. Spontaneous breathing returned at a mean time of 23.6 min after the injection of alcuronium. Sixty minutes after the administration of alcuronium, respiratory exchange was judged adequate, and at that time neuromuscular function was still markedly depressed with a tetanic height less than 25% of control. It was concluded that, because of the slow recovery of neuromuscular function, alcuronium should be reserved for the longer surgical procedure.

Adolescent↗
PubMed1987

Electrical and mechanical responses after neuromuscular blockade with vecuronium, and subsequent antagonism with neostigmine or edrophonium.

Six unpremedicated patients who had given their informed consent were given vecuronium 0.08 mg kg-1 before elective surgery. Recovery from neuromuscular blockade was measured electrically and mechanically. Neuromuscular blockade was antagonized 1 h after the administration of vecuronium with two doses of neostigmine 2.5 mg (three patients) or edrophonium 0.5 mg kg-1 (three patients). Although the onset of initial recovery was similar, subsequent recovery was faster when measured electrically (EMG) than when measured mechanically. Recovery appeared to be faster in younger patients. Reintroduction of neuromuscular blockade occurred after the second dose of neostigmine 2.5 mg, given to antagonize the block. This did not occur after either dose of edrophonium 0.5 mg kg-1.

Adult↗
PubMed1986

Halothane and the liver.

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Chemical and Drug Induced Liver Injury↗
PubMed1986

Recovery of spontaneous breathing following neuromuscular blockade with atracurium.

Atracurium 0.3 mg kg-1 was given to two groups of patients to compare the recovery of spontaneous breathing with that of peripheral neuromuscular function. Anaesthesia was maintained in one group (n = 6) with an infusion of etomidate (mean flow rate 24 micrograms kg-1 min-1) and in the other group (n = 5) with 0.5% halothane. From the time of discontinuing ventilation, about 5 min after the reappearance of the tetanic response, spontaneous breathing returned in an average time of 135 s (range 18-300) in the patients given etomidate and in 68 s (range 0-123) in the patients who received halothane (ns). The duration of action of atracurium was not significantly prolonged by halothane, probably because of the low concentration used. Adequate recovery of respiratory muscle function occurred within 30 min of administration of atracurium at a time when there was less than 25% recovery of the tetanic response of the adductor pollicis muscle. It was concluded that recovery of the muscles of respiration from neuromuscular blockade by atracurium occurred more rapidly than recovery of the muscles of the hand, but an adequate tidal volume in the absence of other clinical signs should not be regarded as a reliable indicator of complete return of neuromuscular function.

Adult↗
PubMed1979

Interaction of halothane with non-depolarizing neuromuscular blocking drugs in man.

1 Tetanic and single twitch contractions of the adductor pollicis muscles, in response to indirect stimulation of each ulnar nerve, were recorded in patients anaesthetized with thiopentone and nitrous oxide in oxygen. 2 Concentrations of 1 and 2% halothane were administered for 10 min during recovery from neuromuscular paralysis by tubocurarine, dimethyl tubocurarine and gallamine. 3 During exposure to halothane, the peak contraction of the tetanic response was reduced and tetanic fade was increased whereas the single twitch was unaffected. 4 The effects of halothane on the tetanic responses were readily antagonized by intravenous neostigmine preceded by atropine. 5 Halothane could act post-synaptically by a non-depolarizing block or by desensitizing the post-synaptic receptors, but a pre-synaptic action seems more likely since neuromuscular block was only evident when tetanic stimulation was applied. Such an effect could be caused by impairment of the release of acetylcholine.

Anesthesia↗
PubMed1978

The uptake and elimination of chloroform in man.

The rate of alveolar uptake of chloroform was studied in 16 patients during general anaesthesia. Eight patients breathed spontaneously and in eight the lungs were ventilated. Elimination was studied after 30 min and 65 min of exposure to the anaesthetic. The arterial and venous blood concentrations of chloroform plotted against time during the early phase of equilibration showed that the initial uptake of chloroform was rapid, approaching a plateau after 40-50 min. In patients breathing spontaneously the arterial concentration of chloroform, which averaged 17.28 +/- 4.1 mg dl-1, did not exceed 25% equilibration with the inspired concentration, whereas under controlled ventilation with 1% chloroform the mean concentration was 10.14 +/- 3.30 mg dl-1, which amounted to an equilibration of approximately 41%. The elimination of chloroform from the body was rapid, so that recovery was not prolonged.

Adult↗