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Biomedical subjects

J Vogelsang

Publications and source records attributed to J Vogelsang.

At least 19 recordsLinked to original sources
PubMed1995

[Transcranial color-coded real time ultrasound. An improvement in patient monitoring in the neurosurgical intensive care unit?].

It is still not always possible to detect in time early intracranial complications in neurosurgical critical care patients. In addition, the exact definition of the lesion requires an often life-threatening transport to the CCT. Hence, there is still a need for improved bedside monitoring. New developments in ultrasound technique enable us not only to get a two-dimensional image of intracranial parenchymatous structures through the intact bone but also to visualise, by means of colour-coding, the blood flow the intracranial vessels. In 70 mostly neurotraumatised patients we found that this method is helpful in solving diagnostic or therapeutic problems without the patient having to leave the intensive care unit.

Adolescent↗
PubMed1995

An integrative review of postanesthesia care unit phase I patient outcome research: 1982 to 1993.

Specialty nursing practice tends to define itself by a set of competencies believed to be essential by the practitioner. A specialty practice rarely is the result of patient outcome research. Although nurses have been caring for postoperative patients since the early 1900s, a review of published PACU phase I patient outcome nursing research has not been reported. As part of a larger study, an integrative review of phase I postanesthesia research was conducted to investigate compliance with the scientific method and to examine whether reported research findings link the nursing process with patient outcome. Data were collected from identified PACU phase I research studies published between 1982 and 1993. The table of contents from 16 nursing journals were examined to identify published studies. The sample for the integrative review consisted of 43 studies meeting inclusion criteria. Data from the 43 studies were collected independently by two researchers on Post Anesthesia Research Literature Instrument coding sheets developed for the review. Findings indicated that the scientific method was used with varied levels of sophistication. The linkage of nursing process with patient outcome did not appear explicit in the studies reviewed.

Clinical Nursing Research↗
PubMed1994

Patients talk about their postanesthesia shaking experiences.

Postanesthesia shaking is a frequent complication developing for unknown reasons during emergence from general anesthesia. The sources of primary knowledge concerning how patients describe their postanesthesia shaking experiences are sparse. This study presents data to expand the body of PACU nursing knowledge through patients offering information about the shaking phenomenon. In an attempt to categorize ways patients talk about their shaking experience, the research question guiding this study was this: How do patients talk about the postanesthesia shaking phenomenon? This descriptive research used an interview design. Telephone interviews were conducted with 103 subjects. Tape recorded interviews with the 43 subjects who remembered their shaking experience are included in the presentation of data. These data show that when patients were asked to talk about their shaking experience, they not only had memory of the postanesthesia shaking phenomenon, but they talked about their shaking experience in various ways. Further research is needed to promote a greater understanding of patient responses to this postanesthesia complication.

Clinical Nursing Research↗
PubMed1992

Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine.

The cause of postanesthesia shaking (PS) is unknown. PS develops spontaneously and unpredictably in up to 67% of patients emerging from general anesthesia, and it continues for minutes to hours when not treated with medications or radiant heat lamps. The purposes of this study were to (1) examine whether butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN), meperidine (Demerol; Winthrop, NY, NY), and morphine are differentially effective in suppressing PS, (2) compare PS suppression by sex, and (3) determine time to PS development. PS, measured on a 0 to 3 visual scale, developed in 120 of 533 patients (23%). Medication treatment was initiated for 66 of 120 patients by PACU nurses following standard policies and procedures for intravenous doses of 1 mg butorphanol (n = 12), 15 to 30 mg meperidine (n = 18; n = 23), or 2 to 4 mg morphine (n = 13). Treatment effect was measured in units on a 0 to 2 visual scale. By t test, butorphanol is more effective within 2 minutes than meperidine for suppressing shaking alone (P less than .02) or shaking among patients also complaining of pain (P less than .02). Morphine does not relieve shaking. The chi 2 test indicates women suppress PS more rapidly than men (P less than .01), and PS develops within 5 minutes of PACU arrival (P less than .001). Findings suggest that butorphanol is an alternative PS treatment to meperidine, since it relieves shaking within 2 to 5 minutes without producing nausea, vomiting, or recurrence of shaking.

Adolescent↗
PubMed1991

Opiate receptors and analgesia: an update.

Opiates remain the choice of analgesia for severe pain despite numerous side effects. They possess the unique ability to alter the interpretation of noxious sensations normally sensed as pain, while leaving the sensations of touch, temperature, and proprioception essentially unchanged. Opiates act by mimicking naturally occurring endogenous peptides at a variety of receptors in the central nervous system (CNS). Disruption of pain sensation occurs because of the action of different opiate receptor types located along pain pathways in the CNS. Analgesic activity and adverse side effects of all narcotic analogs are directly related to the activity of the drugs at a combination of opiate receptors. The currently known opiate receptors (mu 1, mu 2, kappa, sigma, and delta) are described with respect to function and location along pain pathways. A brief description of nociceptive (pain) pathway anatomy is also presented. Application of knowledge has allowed the development of mixed agonist-antagonist drugs such as butorphanol (Stadol; Anaquest, Madison, WI/Bristol Meyers Squibb, Evansville, IN) that capitalize on specific opiate receptor activation or antagonism to decrease adverse side effects and abuse-dependence potential. Future research areas are discussed.

Classification↗
PubMed1991

Butorphanol tartrate (stadol): a review.

Butorphanol tartrate (Stadol; Anaquest, Madison, WI/Bristol-Meyers Squibb, Evansville, IN) is an analgesic possessing mixed agonist-antagonist activity at opiate receptors. Receptor specificity has been used to limit respiratory depression, gastrointestinal side effects, and reduce the risk of dependency. Theoretically it offers an advantage over traditional opiates such as morphine and meperidine in the treatment of moderate pain. Butorphanol has been used as a preoperative sedative and analgesic, as a supplement to balanced anesthesia, and for suppression of postanesthesia shaking. Other recognized uses include obstetric analgesia during labor and relief of moderate postpartum pain. In addition, butorphanol has been used effectively for conscious sedation. Its lack of euphoric effects may be useful in emergency medicine for clinical populations prone to drug-seeking behavior. Butorphanol has been used more recently for epidural analgesia or for intravenous patient-controlled analgesia when allergies to opiates exist. Since butorphanol is not a controlled substance, its use can reduce administrative liability for abuse and can lower the number of distribution records associated with Schedule II narcotics.

Butorphanol↗
PubMed1991

Patients who develop postanesthesia shaking show no difference in postoperative temperature from those who do not develop shaking.

While the cause of postanesthesia shaking (PS) remains unknown, nurses traditionally believe that the etiology of PS is hypothermia. Two theoretical constructs have been proposed to describe the development of PS. The first is based on classic thermoregulation theory. The second is based on spinal reflex hyperactivity. The purpose of this comparison study was to determine if significant differences in postoperative temperature, as well as change in preoperative to postoperative temperature, exists between patients who develop and who do not develop PS. The study also examined the difference in postoperative temperature between women and men. Postoperative axillary temperature was measured on admission to the PACU. The nonprobability convenience sample consisted of patients between the ages of 18 and 89 years who were extubated and breathing spontaneously following general anesthesia. PS developed in 120 of 533 patients. By t-test analysis, there was no statistical significant difference between groups in postoperative mean temperature (P greater than .10) or in preoperative to postoperative mean temperature change (P greater than .40). The group that developed PS had a narrower and higher range of postoperative temperature and a smaller preoperative to postoperative temperature change than those who did not develop PS. In both groups, 52% of the patients were hypothermic (less than 35 degrees C[less than 95 degrees F]) on PACU admission. Women had lower postoperative mean temperature than men (P less than .05). Findings indicate that temperature on PACU admission is not a variable of difference between groups of patients who develop or who do not develop PS. As postoperative temperature decreases, the incidence of PS does not increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Continued contact with a familiar nurse affects women's perceptions of the ambulatory surgical experience: a qualitative-quantitative design.

Ambulatory surgery patients tend to have different nurses providing care during each phase of the surgical stay. The purpose of this study was to investigate the impact continued contact with a familiar nurse, from preadmission procedures through postoperative awakening to consciousness in the PACU, had on women's postdischarge evaluations of their ambulatory surgical experience. The study consisted of a convenience sample of 40 women between the ages of 19 and 68 years scheduled to receive general anesthesia. Women in the continued contact group (n = 20) reestablished contact with the familiar nurse when arriving at the ambulatory surgery unit (ASU) 1 hour before surgery and they maintained continued contact with that nurse while awakening to consciousness in the PACU. A postdischarge telephone interview was conducted with women in both groups 3 to 5 days following surgery. chi 2 Analysis found that women who had continued contact with a familiar nurse reported being ready to go home when discharged from the ASU significantly more often than women in the control group (P less than .05). By t test analysis, women in the continued contact group reported greater satisfaction with the nursing care received (P less than .01). Women in both groups also talked about their ambulatory surgical experience. The data are presented descriptively. Findings indicated that receiving continued contact with a familiar nurse significantly affected women's postdischarge evaluations of their ambulatory surgical experience compared with receiving standard nursing care in the study hospital.

Adult↗
PubMed1986

Role of atrial natriuretic factor in renin release.

Atrial natriuretic factor (ANF) was studied for its effect on renin release by rat renal cortical slices. ANF (rat) alone (10(-9)-10(-6) M) had no effect on basal renin release, but significantly (P less than 0.001) potentiated angiotensin II (AII) inhibition of renin secretion in doses as low as 10(-9) M. ANF also potentiated the inhibitory effect of AII on 8-(N,N-diethylamino)octyl 3,4,5-trimethoxybenzoate hydrochloride (which alters intracellular calcium) and calmidazolium (a calmodulin blocker) effects on renin release. ANF did not inhibit the action of isoproterenol, which probably acts through cAMP, at doses below micromolar concentrations. Large, probably pharmacological amounts (greater than 10(-6) M) produce some inhibition. Since AII action on renin is associated with increases in intracellular calcium, our studies suggest that ANF acts by altering the intracellular calcium-calmodulin-mediated steps of AII action on this tissue and not via cAMP.

Angiotensin II↗