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Biomedical subjects

J P Sale

Publications and source records attributed to J P Sale.

13 recordsLinked to original sources
PubMed1987

The effect of preoperative oral fluid and ranitidine on gastric fluid volume and pH.

One hundred unpremedicated daycare patients were randomly assigned to one of four groups. Between two and three hours preoperatively all patients received either oral ranitidine 150 mg, or placebo, with bromosulphthalein (BSP) 50 mg in 10 ml water, immediately followed by either 150 ml water or no further fluid. The residual gastric volume (RGV) in the two placebo groups was significantly lower in patients given 150 ml water (20.6 +/- 14.1 ml) than in those who continued fasting (29.9 +/- 18.2 ml) (p less than 0.05). The RGV was further significantly decreased in the two ranitidine groups (10.0 +/- 8.8, 9.7 +/- 10.5 ml) compared with the two placebo groups (20.6 +/- 14.1, 29.9 +/- 18.9 ml) (p less than 0.01). Mean pH values were significantly higher in the two ranitidine groups (6.71 +/- 0.99; 6.31 +/- 1.81) than in the two placebo groups (2.05 +/- 1.41; 1.72 +/- 0.33) but were not significantly different in the fluid versus non-fluid groups. In patients who ingested 150 ml water there was no correlation between the premedication interval and either RGV or pH values. The extremely low percentage of the original BSP (less than 0.9 per cent) in the gastric fluid of these patients demonstrated that gastric emptying of the ingested water was virtually complete prior to surgery. The combination of RGV of 25 ml or more with pH less than 2.5 was present in 56 per cent of patients who had only a sip of water with placebo, in 28 per cent of those who received 150 ml water with placebo, and in only two per cent of those patients who received ranitidine.

Adult↗
PubMed1987

The pharmacokinetics of alfentanil in children.

The pharmacokinetics of alfentanil were studied in 18 children (3 months to 14 yr of age) undergoing surgery. Alfentanil was administered as a 30-s infusion of either 50 or 120 micrograms.kg-1. Pharmacokinetic values were independent of dose. There was no correlation between Vdss (Volume of distribution at a steady state, measured as l.kg-1) and age or weight, and there was a weak correlation between clearance and age (r = 0.51, P less than 0.05). Vdss and elimination t1/2 were not different in infants less than 1 yr of age when compared to older children. The mean value of Vdss was 0.419 (SE .028) l.kg-1) for the whole group, and elimination t1/2 was 76.3 (SE 6.5) min. The clearance rate [TBC = 7.9 (SE 0.41) ml.kg-1.min-1] was within the range of values previously determined in adult studies. From these data, it would appear that, although there may be differences in the disposition kinetics between children aged 3 months to 14 yr and those measured in adults in some studies by other investigators, age-related differences within this group were not demonstrable.

Adolescent↗
PubMed1987

Anaesthesia for combined heart and lung transplantation.

In December 1983, Harefield Hospital started a programme for combined heart and lung transplantation. Fifty-two transplants have been successfully performed, with 36 survivors (April 1986). Patient selection and anaesthetic management of both donor and recipient are discussed. Two case histories are presented which illustrate the principles of anaesthetic management and postoperative care.

Adolescent↗
PubMed1986

Preoperative oral fluids: is a five-hour fast justified prior to elective surgery?

The effects of preoperative oral administration of 150 ml fluid were studied prospectively in 140 unpremedicated, ambulatory outpatients presenting for first trimester therapeutic abortion. Intraoperative gastric fluid volume, pH, and rate of gastric emptying were measured in the four groups to which patients were randomly assigned. At an average time of 2 1/2 hr preoperatively all patients received either oral ranitidine, 150 mg, or a placebo tablet, with the nonabsorbable marker dye bromosulphthalein (BSP, 50 mg in 10 ml water, followed by either 150 ml water or no further fluid. The effect of volume ingested was assessed by comparing the volume of gastric contents obtained by gastric tube suctioning at the completion of surgery in the two groups given placebos. The gastric volume was significantly less in patients given 150 ml water (17.6 +/- 14.5) than in those given only BSP (26.7 +/- 18.9) (P less than 0.02), and was further significantly decreased in the two groups given ranitidine (8.3 +/- 7.3, 9.5 +/- 7.7 ml) (P less than 0.001). Mean pH values were significantly higher in the two ranitidine groups (5.52 +/- 1.79, 5.03 +/- 1.79) than in the two placebo groups (1.75 +/- 0.94, 1.92 +/- 1.27). The combination of a residual volume of 25 ml and pH less than 2.5 was found in 46% of patients given only BSP with placebo, in 23% of those given 150 ml water with placebo, and in no patient given ranitidine. There was no correlation between the gastric volume or pH values with the ingestion-surgery interval in patients given 150 ml water.

Adult↗
PubMed1985

Controlled ventilation in dental outpatients. Controlled ventilation with atracurium and alfentanil analgesia compared with halothane.

This study compares anaesthesia with controlled ventilation of the lungs with atracurium and alfentanil analgesia with halothane anaesthesia. Recovery time, the incidence of dysrhythmias and postoperative morbidity were evaluated. Anaesthesia with controlled ventilation was found to reduce significantly the incidence of cardiac dysrhythmias during dental surgery, and to produce a significantly more rapid recovery than halothane anaesthesia. The incidence of subjective postoperative complications is similar. It is concluded that controlled ventilation with atracurium and alfentanil is a suitable outpatient dental technique.

Adjuvants, Anesthesia↗
PubMed1984

Prevention of air embolism during sitting neurosurgery. The use of an inflatable venous neck tourniquet.

An inflatable neck tourniquet has been developed for compression of the jugular veins during neurosurgery in the sitting position. Neck compression abolishes the subatmospheric pressure within the neck veins and therefore minimises the risk of air embolism. Compression can be applied throughout the initial part of the operation, a major period of risk during these surgical procedures, and released once full surgical exposure has been achieved. Venous congestion is then released and normal operating conditions are restored.

Embolism, Air↗