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Biomedical subjects

J W Dundee

Publications and source records attributed to J W Dundee.

At least 55 records · Page 3Linked to original sources
PubMed1988

Comparison of propofol and methohexitone as anaesthetic agents for electroconvulsive therapy.

Propofol was compared to methohexitone for induction of anaesthesia for electroconvulsive therapy. Seizures were significantly shorter after the use of propofol, in respect of both visible seizures and duration of cerebral electrical seizure activity. This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent. Propofol was more effective than methohexitone at obtunding the hypertensive response to electroconvulsive therapy without causing significant hypotension.

Adult↗
PubMed1988

P6 acupressure reduces morning sickness.

A prospective study was designed to test the efficacy of pressure at the P6 (Neiguan) acupuncture point, in preventing morning sickness. Three groups of patients in early pregnancy recorded the severity and frequency of sickness over a period of 4 consecutive days following daily pressure at P6 point, pressure at a point near the right elbow and with no treatment. Troublesome sickness was significantly less in both the genuine (23/119) and dummy (41/112) pressure groups as compared with the control series (67/119). When the data are adversely 'weighted' to compensate for the lower incidence of fully completed returns in the active treatment groups, only the P6 group show a significant reduction in sickness. No side effects occurred in either group and while anticipation of benefit may offer a partial explanation for the findings, pressure at the Neiguan point appears to have a specific therapeutic effect.

Acupuncture Therapy↗
PubMed1988

Midazolam sedation for outpatient fibreoptic endoscopy: evaluation of alfentanil supplementation.

Alfentanil, a short-acting opioid, was used as an adjuvant to midazolam for sedation of 30 outpatients undergoing upper gastrointestinal endoscopy. The operating conditions and recovery times were compared with those of a similar group of 30 patients sedated with midazolam only. The use of alfentanil resulted in improved operating conditions and a more rapid recovery. Patient acceptance was high.

Adult↗
PubMed1987

Cimetidine and ranitidine increase midazolam bioavailability.

Cimetidine has been shown to inhibit the oxidative metabolism of a variety of low- and high-extraction drugs. Despite the findings of initial investigators, there is evidence that ranitidine may exert similar effects. Eight healthy volunteer subjects took part in a within-subject crossover study. They received midazolam, 15 mg, by mouth after pretreatment with cimetidine, ranitidine, or nothing and midazolam, 10 mg, intravenously on separate occasions. Mean absolute bioavailability of midazolam was increased by more than 30% after cimetidine (P less than 0.01) and 26% after ranitidine (P less than 0.05). The data, which agree with a concurrent clinical study indicating greater hypnotic action of midazolam after ranitidine, indicate that this is not a result of enhanced midazolam absorption and that reduced hepatic clearance is the most likely explanation.

Absorption↗
PubMed1987

I.v. temazepam: theoretical and clinical considerations.

Two injectable forms of temazepam, in 90% propylene glycol or 40% salicylic acid, were studied in volunteers, and before surgery in healthy patients. The volunteers also received two forms (capsule and elixir) by mouth. The salicylate preparation was painful on injection and both i.v. formulations caused an unacceptably high incidence of venous thrombosis. Temazepam was detected in plasma earlier following the elixir preparation than the capsule. Plasma concentrations were similar following both injectable preparations. The potency of i.v. temazepam in inducing drowsiness in patients was much less than expected and doses greater than 0.6 mg kg-1 were required to produce adequate sedation. There was a significant reduction in thiopentone induction dose in patients receiving temazepam i.v.

Administration, Oral↗
PubMed1987

Midazolam sedation following open heart surgery.

Midazolam given as hourly intermittent injections was compared with the same dose given by infusion for postoperative sedation in patients after cardiopulmonary bypass. A stable concentration was rapidly attained with the infusion whereas 6-8 h was required to attain stable plasma (trough) concentrations in the intermittent injection group. Plasma concentrations decreased rapidly to low values within 6 h of discontinuation of therapy. High plasma concentrations and a long (16 h) half-life were noted in one patient who may be a slow metabolizer of the drug.

Adult↗
PubMed1987

Comparison of nalbuphine, pethidine and placebo as premedication for minor gynaecological surgery.

In a randomized double-blind placebo-controlled trial involving 80 patients nalbuphine 10 mg and 20 mg were compared with pethidine 100 mg and a placebo given i.m. at least 90 min before minor gynaecological surgery. Nalbuphine proved a suitable alternative to pethidine, producing beneficial sedation which was maximum at 60 min after injection. Both nalbuphine and pethidine reduced the excitatory sequelae of methohexitone induction. Increasing the dose of nalbuphine from 10 mg to 20 mg produced no significant additional sedation or intraoperative benefit. Short-lived pain at the injection site was a feature of the use of nalbuphine in either dose. The main disadvantage of nalbuphine was nausea and vomiting of delayed onset, the frequency of which was similar after either dose.

Adult↗
PubMed1987

Recovery from outpatient anaesthesia: a comparison of incremental propofol and propofol-isoflurane.

Propofol was used to induce anaesthesia in 60 patients undergoing minor outpatient gynaecological procedures. Maintenance was with 66% nitrous oxide in oxygen, plus either isoflurane or 10-mg increments of propofol. Recovery was assessed using both clinical and psychomotor criteria and the results compared with those obtained in a non-anaesthetized control group. As far as the two test groups were concerned, initial recovery was more rapid in the incremental propofol group but, by 1 h after surgery, there were no differences between all three groups.

Adolescent↗
PubMed1987

A comparison of the early pharmacokinetics of midazolam in pregnant and nonpregnant women.

The early pharmacokinetics of midazolam were compared in pregnant (active labour, awaiting and during elective Caesarean section) and matched gynaecological patients scheduled to undergo elective hysterectomy, half of whom were given an oxytocin infusion. A standard dose of 5 mg was given intravenously. For the first 15 minutes patients in labour had significantly higher plasma midazolam levels compared to all other groups. This was associated with the largest area under the curve (2 hours), the smallest volume of distribution and lowest clearance. Midazolam when given immediately before Caesarean section, can result in depression of the infant.

Apgar Score↗
PubMed1987

Antiemetic studies with traditional Chinese acupuncture. A comparison of manual needling with electrical stimulation and commonly used antiemetics.

The application of low frequency (10 Hz) electrical current for 5 minutes to an acupuncture needle placed at the P6 (Neiguan) point is as effective as manual needling in the reduction of emetic sequelae in women premedicated with nalbuphine 10 mg for a minor gynaecological operation carried out under a standard anaesthetic. Both were slightly, but not significantly, better than the antiemetic properties of cyclizine 50 mg.

Acupuncture Therapy↗
PubMed1987

Low dose sufentanil pretreatment. Effect on the induction of anaesthesia with thiopentone, methohexitone or midazolam.

The effects of pretreatment with varying doses of sufentanil on the subsequent induction of anaesthesia with thiopentone, methohexitone or midazolam were studied in 240 healthy patients. The induction dose requirements for the barbiturates were significantly reduced by sufentanil 5.0 micrograms (methohexitone p less than 0.05, thiopentone p less than 0.01). Excitatory effects following methohexitone were decreased (p less than 0.01) but brief respiratory depression was increased in both cases. Midazolam onset time was reduced, as was the frequency of failed induction, after sufentanil 5.0 micrograms (p less than 0.01).

Adult↗