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Biomedical subjects

K Bjerre-Jepsen

Publications and source records attributed to K Bjerre-Jepsen.

At least 19 recordsLinked to original sources
PubMed1994

Subcutaneously versus subfascially administered lidocaine in pain treatment after inguinal herniotomy.

We conducted a randomized, prospective, double-blind trial to compare the efficacy of subfascial (SF) versus subcutaneous (SC) lidocaine (10 mL 1%) given in the wound postoperatively through a catheter placed in the respective layer intraoperatively. The initial pain scores were similar in the two groups before injection of lidocaine. In the SC group, there was a reduction in pain scores during rest from 4 to 3 (P > 0.05), during cough from 6 to 5 (P > 0.05), and during mobilization from 7 to 5.5 (P > 0.05) at 15 min. In the SF group, the reductions in pain scores were from 4 to 2 (P < 0.05), from 6 to 3 (P < 0.05), and from 7 to 3 (P < 0.05), respectively. Supplemental analgesics after the lidocaine administration were needed earlier in the SC group than in the SF group (P < 0.01). We conclude that postoperative pain treatment with local lidocaine application after herniotomy has a better effect when applied in the SF, rather than the SC, layer.

Adult↗
PubMed1992

Catecholamine response to laryngoscopy and intubation. The influence of three different drug combinations commonly used for induction of anaesthesia.

The haemodynamic response and changes in plasma catecholamine concentrations associated with laryngoscopy and tracheal intubation were compared during anaesthesia employing three strictly standardised techniques with commonly used drug combinations. Thirty-six patients were investigated consecutively resulting in 12 patients in each of three study groups. Anaesthesia was induced with thiopentone 5 mg.kg-1 (group 1), fentanyl 6 micrograms.kg-1 with thiopentone 5 mg.kg-1 (group 2), or midazolam 0.2 mg.kg-1 with fentanyl 6 micrograms.kg-1 (group 3). Undesirable changes in haemodynamic effects and an elevation of plasma catecholamine concentrations during laryngoscopy and intubation occurred in group 1. Heart rate and mean arterial pressure increased significantly (34% and 23% respectively). Noradrenaline concentration increased by a maximum of 147%. The addition of fentanyl (groups 2 and 3) attenuated the adverse haemodynamic response and elevation of plasma catecholamine concentrations; heart rate and mean arterial pressure did not differ from pre-intubation values and plasma catecholamine concentrations decreased steadily. Substitution of thiopentone by midazolam in combination with fentanyl abolished the adverse haemodynamic response and modified the increase in plasma catecholamine concentrations. 'High-dose' opioid anaesthesia is not necessary to produce optimal conditions during laryngoscopy and intubation.

Adolescent↗
PubMed1992

Does alfentanil preserve left ventricular pump function during rapid sequence induction of anaesthesia?

A double-blind, randomised trial was conducted in 24 patients without cardiopulmonary disorders (20-43 years), to assess the effect of an intravenous bolus of alfentanil on the circulatory and catecholamine responses to rapid sequence induction of general anaesthesia. Induction included injection of thiopentone 5 mg/kg and suxamethonium 1.5 mg/kg in rapid succession, followed by laryngoscopy and intubation. Half of the patients received alfentanil 100 micrograms/kg immediately before thiopentone. The other half received saline. Blood pressure, heart rate, and plasma catecholamine concentrations were measured repeatedly, together with left ventricular ejection fraction assessed by radionuclide angiocardiography. The responses following laryngoscopy and intubation were completely different in the saline vs. the alfentanil group: rate pressure product +76% vs. -32%, mean arterial blood pressure +46% vs. -25%, heart +46% vs. no change, noradrenaline +117% vs. -25%, adrenaline +50% vs. -53%, and left ventricular ejection fraction -32% vs. no change. In conclusion, during rapid sequence induction of anaesthesia with thiopentone and suxamethonium, an intravenous bolus of alfentanil 100 micrograms/kg 1 min before laryngoscopy and intubation completely prevents hypertension, tachycardia, decrease in left ventricular ejection fraction, and activation of plasma catecholamines, though at the expense of moderate hypotension.

Adult↗
PubMed1986

The infective dose of aerobic and anaerobic bacteria in postoperative wound sepsis.

Surgery for perforated appendicitis was used to estimate the infective dose of aerobic and anaerobic bacteria in postoperative wound sepsis. The wound sepsis rates were 22.6% (7/31) after treatment with intravenous ampicillin sodium and metronidazole and 23.5% (8/34) after penicillin G sodium, streptomycin, and metronidazole, a nonsignificant difference. Intraoperative sampling by velvet pads demonstrated that the density of aerobes did not differ significantly from that of anaerobes, either on the surface of the appendix, in peritoneal exudate (aspirated), or in the wound before closure. The predominant pathogens were Escherichia coli and Bacteroides fragilis. In 15 patients who developed wound sepsis, the density of aerobes and anaerobes was significantly higher at all sampling sites than in 50 noninfected patients. The median infective dose of aerobes and anaerobes together was 4.6 X 10(5) colony forming units.cm-2 in the operative wound. There was a significantly high correlation between the densities of bacteria during operation and subsequent wound sepsis.

Adolescent↗
PubMed1984

Effect of therapy on 24-h subcutaneous blood flow in the leg in patients with severe ischemia.

The effect of vascular surgical reconstruction or Buerger's exercises upon average subcutaneous blood flow for a 24-h period was studied in 14 patients with severe leg ischemia due to occlusive arterial disease. Blood flow was estimated proximally in the calf and in the foot by a 133Xe washout technique. Seven patients underwent vascular surgery. Postoperatively subcutaneous blood flow increased in the calf and the foot in all patients except one in whom a decrease in blood flow in the foot was seen. In this case a decrease in systolic blood pressure occurred following the operation. Buerger's exercises did not alter subcutaneous blood flow either in the calf or in the foot in the seven patients studied. Buerger's exercises seem to be of no value for these patients. The measurement of blood flow in subcutaneous tissue over a period of 24 h seems to be a useful test of the effect of different treatments.

Aged↗
PubMed1983

Vibration sense and sympathetic vasoconstrictor activity in patients with occlusive arterial disease.

The function of sympathetic vasoconstrictor fibres was studied in 18 patients with occlusive arterial disease of the legs and somatic neuropathy, as evidenced as an increased vibration perception threshold. Nine patients suffered from long-term diabetes mellitus. Sympathetic vasoconstrictor function was studied by the capability of the local sympathetic venoarteriolar reflex (Henriksen 1977) elicited by lowering the leg to induce an arteriolar constriction in subcutaneous tissue at the ankle level. Blood flow was measured by the local isotope washout technique. In only five patients with loss of vibration sense, abnormal vasoconstrictor function was found. In three of these patients, the abnormal response most likely could be ascribed to impaired function of the vascular smooth muscle cells. Neither in diabetics nor in non-diabetics could an abnormal vibration sense be taken as evidence for loss of sympathetic vasoconstrictor function. It is suggested that this is studied by a simple postural test as used in the present study.

Aged↗
PubMed1983

A vascular band to Meckel's diverticulum.

In a Meckel's diverticulum, heterotopic tissue, inflammation and a vascular band co-existed. The band originating from the superior mesenteric artery, was separated from the mesentery and represented a remnant of the vitelline artery.

Diverticulitis↗
PubMed1982

Subcutaneous blood flow over 24-hour periods in patients with severe leg ischaemia.

This paper describes a method for studying the clearance of 133Xenon from the subcutaneous tissue of the calf and foot over 24-h periods. The average blood flow over this period can be estimated from the clearance constant obtained. Two series of measurement of the radioactivity are made, the first 2 h after the injection of 1-2 mCi 133Xenon in saline and the second 18-24 h later. The distance between the detector and the depot is reproduced using a cylinder 20 cm long. The median washout rate of the isotope (k) in 25 patients was 2.57 X 10(-3) min-1 for the calf and 2.39 X 10(-9) min-1 for the foot. The median difference between repeated measurements in the same patient ws 0.24 X 10(-3) min-1 in the calf and 0.43 X 10(-3) min-1 in the foot. This method, which can be used to estimate the average blood flow over 24 h while the patient undertakes his normal activities, should be useful in assessing the effect of therapy on the blood flow to the limb.

Adult↗
PubMed1982

Determination of the subcutaneous tissue to blood partition coefficient in patients with severe leg ischaemia by a double isotope washout technique.

Knowledge of the tissue to blood partition coefficient (lambda) is essential for calculation of the perfusion coefficient in a single tissue based on measurements of the washout of locally injected isotopes. No measurements of lambda for Xenon in subcutaneous tissue in the leg have been done in patients with occlusive arterial disease. In 12 patients with occlusive arterial disease in the legs lambda for Xenon was determined in subcutaneous tissue in the calf region and foot as the ratio between the washout rate constant of 131I-Antipyrine and 133Xe. A mixture of the two indicators was injected subcutaneously laterally on the calf and in the first interosseous space on the foot. The time until the curves followed a monoexponential course varied between 15 and 45 min in the calf and 5 and 45 min in the foot. The calculated lambda for Xe showed a great variance between individuals in calf as well as foot. Mean value was 3.7 ml X g-1 (range: 1 X 7-10 X 7) in the calf and 2 X 7 ml X g-1 (range: 1 X 2-4 X 9) in the foot. It is concluded that lambda measurements are necessary for determination of subcutaneous blood flow from 133Xe washout curves in these patients. Determination of lambda is especially important when comparisons are made between individuals.

Aged↗
PubMed1982

Intraoperative autotransfusion.

Intraoperative autotransfusion (IAT) was proposed in 1818 by Blundell. In 1968 Klebanoff introduced the modern IAT system (Bently ATS-200) which can suck blood from the operative field and infuse up to 900 ml/min into the patient again. Ten patients in this series were autotransfused a median of 2275 ml blood during aortoiliac surgery for occlusive arterial disease. Blood samples taken before, during and after surgery showed no significant changes attributable to IAT, except for a minor decrease in the platelets. Total heparinization for elective vascular surgery and citrate (ACD or CPD) for emergencies is recommended. IAT was found safe, easy to operate, efficient in handling large quantities of blood and relatively inexpensive. Furthermore autotransfused blood--in contrast to bank blood--has a normal content of platelets and labile clotting factors.

Adult↗
PubMed1981

Inspiratory resistance training in severe chronic obstructive pulmonary disease.

Twenty-eight patients with stable chronic obstructive pulmonary disease (COPD) undertook a training program with a simple respiratory apparatus for 15 min three times daily for 6 weeks. Fourteen patients were allocated to an inspiratory resistance training program and 14 to a control group. In all subjects the median FEV1 was 0.72 and the median FEV1/FVC was 39%. There was no difference in FEV1 or FEV1/FVC between the control and the test groups. In both groups of patients FEV1 FVC and the corresponding values during inspiration, FIV1 and FIVC, as well as MVV, were found unchanged following the training period. Inspiratory resistance tolerance increased in both groups but no significant difference in the improvement could be observed between the two groups. Both groups also showed a similar increase, 23 (76-10) %, in stair-climbing ability. There was no correlation between increases in inspiratory load tolerance and stair-climbing ability. It is suggested that both inspiratory load tolerance and work ability can be improved in COPD patients, but that inspiratory resistance training does not contribute to these improvements.

Adult↗