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Biomedical subjects

J S Crawford

Publications and source records attributed to J S Crawford.

At least 19 recordsLinked to original sources
PubMed1979

Experience with spinal analgesia in a British obstetric unit.

A series of 443 spinal anaesthetics is described. The procedures included operative vaginal delivery, removal of retained placenta and a miscellaneous group common to most obstetric units. Failure to provide effective relief of pain occurred in 5.2% of patients. There was one potentially serious complication, but with this exception hypotension was not a feature. Headache following spinal analgesia was experienced by 16.3% of patients, the frequency being greater among those who received spinal analgesia at or shortly after delivery, but was unrelated to the size of the needle (23-gauge of 25-gauge) used. Extradural blood patch promptly and permanently cured the headache. The duration of sensory and motor loss after operation varied considerably with the local anesthetic agent used. The re-introduction of spinal analgesia into British obstetric anaesthetic practice is advocated.

Anesthesia, Obstetrical↗
PubMed1979

Premedication for elective Caesarean section.

Four coded, but otherwise unidentified, premedicants were prescribed in randomised order for 219 patients who were to undergo elective Caesarean section. Seventy-six (35%) of these patients affirmed at the pre-operative visit that they were not anxious. Diazepam 5 mg and lorazepam 1 mg appeared to be superior to the placebo and to 10-6 ml of 90% alcohol in inducing calmness and/or drowsiness, although the differences were not statistically significant. The incidence of awareness or unpleasant dreams was considerably higher in the placebo and alcohol series (6.2% and 7.5%) than in the diazepam and lorazepam series (nil and 2.1%). There was no remarkable difference in the condition of the immediate newly-born related to the premedicant received by the mother, any small differences being much less impressive than that related to the duration of the U-D interval. No notable differences were observed in the long term conditions between the infants in the placebo, alcohol and diazepam series but the incidence of "reluctance to feed". If relief from preoperative anxiety-and possibly a reduction in the likelihood of awareness-without undue effect upon the infant is considered desirable, diazepam 5 mg is the preferred choice from the four drugs investigated.

Anesthesia, Epidural↗
PubMed1978

Ophthalmic sequelae of infantile hemangiomas of the eyelids and orbit.

The major findings in a study of 51 infants and children with infantile hemangioma of the eyelid were as follows: Visual complications occurred in 27 patients. The most common complications were amblyopia (in 22) and strabismus (in 17). Amblyopia of 6/60 (20/200) or less was probably caused by stimulus-deprivation, but amblyopia in the range of 6/30 (20/100) to 6/12 (20/40) was likely caused by anisometropia or strabismus. Eyelid occlusion of six months or more invariably resulted in amblyopia of 6/60 (20/200) or less. Occlusion for even one month carried a risk of amblyopia. Each child must be considered individually for therapy, which must be started as early as possible. Patients should receive careful follow-up from the beginning to prevent severe amblyopia. For difficult cases, we need more efficacious, safe methods to induce regression of these tumors.

Adolescent↗
PubMed1978

Visual acuity after iridectomy or aspiration for congenital cataract: Experimental and clinical studies.

Studies with a camera and a model eye showed that the image produced by peripheral light rays is inferior to the image produced by paraxial rays. In a retrospective clinical study, we determined the best corrected visual acuity in 33 patients (52 eyes) who had had iridectomy (group I) or aspiration (group II) or both for central cataracts. Vision was significantly better (p less than 0.01) in group II than in group I, and postoperative complications of aspiration were minimal. Some patients had unilateral amblyopia or pendular nystagmus. We conclude that if vision is to be improved with a single procedure, aspiration - not optical iridectomy - is indicated. We could not identify any factors in early infancy that would have predicted which patients with congenital central cataracts required early surgery.

Cataract↗
PubMed1978

Congenital fibrosis of the extraocular muscles.

Congential fibrosis of the extraocular muscles is characterized by the replacement of normal contractile muscle tissue by fibrous tissue or fibrous bands in varying degrees. The clinical entities which result from the fibrous replacement can be classified under the following headings: general fibrosis syndrome, congenital fibrosis of the inferior rectus muscle with blepharoptosis, strabismus fixus, vertical retraction syndrome and congential unilateral fibrosis, enophthalmos and blepharoptosis. Genetic factors may or may not be apparent. One pedigree with general fibrosis syndrome was traced through five generations. Light and electron microscopy demonstrated replacement of normal muscle by collagen and dense fibrous tissue with occasional areas of degenerated skeletal muscle. The surgical mangement attempts to achieve some functional readjustment of the ocular and lid position as well as the abnormal head posture. The surgical results were considered satisfactory when compared with the original position of the eyes and the backward head tilt.

Adolescent↗
PubMed1977

An epidural service.

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Anesthesia, Epidural↗
PubMed1977

Lumbar epidural analgesia for labor and delivery of twins.

In this study we examined the effects on mother and infants of epidural analgesia for labor and delivery of twins. Fourteen women with twins received lumbar epidural analgesia. Maternal radial artery and umbilical vessel blood-gas and acid-base measurements together with Apgar scores were determined. Resulting values were compared to those of women receiving epidural analgesia for labor and delivery of one infant. Apgar scores and blood-gas values for first twins were virtually the same as for singleton controls. Our small series confirms the problem of second-twin compromise, but this was minimal and was more pronounced in nonvertex presentations, as would be expected. We believe there is much to recommend lumber epidural analgesia for labor and delivery of twins, and that it is a safe form of analgesia in this situation.

Acid-Base Equilibrium↗
PubMed1977

Obstetrics, analgesia and anaesthesia.

A brief review of recent advances in the understanding and practive of obstetric anaesthesia and analgesia is presented. The failure to reduce maternal mortality associated with anaesthesia is related to laxity in the provision of anaesthetic services to obstetric units. The outstanding importance for the quality of life of infants and mothers, of a well-conducted obstetric anaesthetic and analgesic service is emphasized. Relating this to the needs of the community, it is claimed that the demands of obstetrics should have priority in the anaesthetic service, and that this requirement can and should be met by a redeployment of anaesthetic personnel, especially at consultant level.

Anesthesia, Obstetrical↗