PubMed Health⌕ Search

Biomedical subjects

K H Simpson

Publications and source records attributed to K H Simpson.

At least 19 recordsLinked to original sources
PubMed1992

Concentration of ondansetron in cerebrospinal fluid following oral dosing in volunteers.

This study measured the concentrations of ondansetron in plasma and cerebrospinal fluid (CSF) in six volunteers after oral dosing to steady state. Ondansetron concentrations ranged from 39.5-147 ng ml-1 in plasma and from 2.6-15.4 ng ml-1 in CSF. There was good correlation between plasma and CSF concentrations (r = 0.89, p = 0.017). CSF concentrations were less than 15% of plasma concentrations in all cases, indicating that the rate of penetration of the blood brain barrier by ondansetron is low.

Aged↗
PubMed1992

Effect of addition of hyaluronidase to bupivacaine during axillary brachial plexus block.

We have studied in 22 patients the effect of adding hyaluronidase to bupivacaine during axillary brachial plexus block (BPB) in a double-blind design. Patients received BPB using bupivacaine 2 mg kg-1 with adrenaline 1 in 200,000, either with or without hyaluronidase 3000 iu, in a volume of 0.5 ml per 2.54 cm of the patient's height. The use of hyaluronidase did not increase the speed of onset of anaesthesia or reduce the incidence of inadequate nerve block. Hyaluronidase produced a significant reduction in the duration of anaesthesia. Changes in grip strength and skin temperature were useful in assessing the onset and progress of BPB.

Adult↗
PubMed1992

ECT anaesthetics.

Explore the source record for details and available documents.

Contraindications↗
PubMed1989

Pain on injection of methohexitone. The use of lignocaine to modify pain on injection of methohexitone during anaesthesia for electroconvulsive therapy.

The present study was designed to assess the incidence of pain when methohexitone was administered to 35 depressed patients who had electroconvulsive therapy, and to determine whether the use of lignocaine could modify this, without affecting seizure duration. The same patients were studied during three separate treatment sessions; they received either methohexitone alone or mixed with, or preceded by, lignocaine 10 mg. Six (17%) patients spontaneously complained of pain during injection of methohexitone alone; the use of lignocaine prior to methohexitone reduced this to zero (p less than 0.05). A total of 49% patients reported pain during injection of methohexitone; the use of lignocaine either mixed with, or given prior to, methohexitone significantly reduced this to 23% and 20% respectively (p less than 0.05). Seizure duration was not significantly different during the three treatments.

Adolescent↗
PubMed1989

An investigation of premedication with morphine given by the buccal or intramuscular route.

1. Premedication with 30 mg buccal morphine or 10 mg intramuscular morphine was evaluated in 40 healthy women undergoing major gynaecological surgery. 2. Buccal administration of morphine produced lower plasma morphine concentrations than intramuscular injection of morphine (P less than 0.01). 3. The mean systemic availability of the buccal tablet, during the first 5 h after administration, was approximately 3% relative to that of the intramuscular preparation. 4. Poor absorption of buccal morphine resulted in inadequate sedation prior to surgery and poor post-operative analgesia. 5. Patients experienced difficulty with the buccal formulation of morphine; tablet bitterness and failure to dissolve were particular problems.

Administration, Buccal↗
PubMed1988

Pregnancy delays paracetamol absorption and gastric emptying in patients undergoing surgery.

Gastric emptying may be delayed during pregnancy by hormonally mediated relaxation of the musculature of the stomach and by mechanical effects. In the present study, the rate of paracetamol absorption was used to measure gastric emptying in 14 non-pregnant women undergoing minor gynaecological surgery, and in 28 women undergoing termination of pregnancy. Of the pregnant patients 16 were of 8-11 weeks gestation and 12 were 12-14 weeks gestation. Paracetamol absorption was delayed in those who were 12-14 weeks pregnant compared with non-pregnant controls. Paracetamol absorption in the 8-11 weeks pregnant group was between the other two groups, but was not significantly different from either.

Acetaminophen↗
PubMed1988

Effect of passive hyperventilation on seizure duration in patients undergoing electroconvulsive therapy.

The influence of end-expired carbon dioxide concentration (E'CO2) on seizure duration was studied in 30 depressed patients undergoing electroconvulsive therapy (ECT) on three separate consecutive occasions. Unpremedicated patients breathed 100% oxygen before the induction of anaesthesia with methohexitone and the provision of partial neuromuscular blockade with suxamethonium. They then received no further ventilation, 10 breaths, or 20 breaths of hyperventilation with 100% oxygen from a non-rebreathing system with a high fresh gas flow. Transcutaneous oxyhaemoglobin saturation (SaO2) was monitored continuously and E'CO2 was measured before and after the seizure. Observation of an isolated forearm was used to time the seizure duration. SaO2 remained greater than 90% in all patients. Passive hyperventilation with 20 breaths significantly reduced E'CO2 and prolonged seizure duration. E'CO2 before the seizure and change in E'CO2 during the seizure did not correlate significantly with seizure duration.

Adult↗
PubMed1988

Comparison of extradural buprenorphine and extradural morphine after caesarean section.

Fifty-seven women received extradural morphine 3 mg, buprenorphine 0.18 mg or buprenorphine 0.09 mg after elective Caesarean section carried out under extradural bupivacaine. Supplementary sublingual buprenorphine was available on demand. Ten-centimetre visual analogue pain scores were completed regularly; emesis, pruritus and urinary retention were recorded for 24 h. Patients who received buprenorphine 0.09 mg had more pain, and required more supplementary analgesia, than those who received morphine 3 mg. Pain scores and analgesic requirements after buprenorphine 0.18 mg were not significantly different from either of the other two groups. Emesis was not significantly different in the three groups. More itching occurred after morphine 3 mg and buprenorphine 0.18 mg than after buprenorphine 0.09 mg; pruritus of the face, legs and perineum was more common after morphine than buprenorphine. Twenty-eight percent of patients without a urinary catheter developed retention of urine. Seventy-five to 84% of patients were satisfied with analgesia during the first day after operation. Analgesia and adverse effects were similar when morphine 3 mg or buprenorphine 0.18 mg was given extradurally after Caesarean section.

Buprenorphine↗
PubMed1988

Premedication with slow release morphine (MST) and adjuvants.

Sixty-one women undergoing major gynaecological surgery received slow release morphine (MST) 60 mg, with placebo, hyoscine 0.6 mg or diazepam 10 mg, by mouth 2 h before surgery. Plasma morphine concentrations reached a steady level usually within 3 h after administration of MST, and did not increase after surgery unless supplementary opioid was given. Hyoscine delayed morphine absorption. Before operation no fewer than 50% of patients were sedated after MST alone, but this increased to 85% after MST and diazepam. Similarly, only the combination MST and diazepam produced anxiolysis. Postoperative mood was unhappier after MST and hyoscine. Emesis occurred in 40-57% of patients, and was not reduced by hyoscine. Therefore premedication with MST alone did not produce reliable sedation or anxiolysis. A combination of hyoscine and MST premedication cannot be recommended, as it did not produce sedation, anxiolysis or antiemesis and hyoscine may have delayed morphine absorption.

Absorption↗
PubMed1988

Propofol reduces seizure duration in patients having anaesthesia for electroconvulsive therapy.

Twenty-five patients received either methohexitone 1.0 mg kg-1 or propofol 1.3 mg kg-1 to induce anaesthesia during two separate electroconvulsive therapy (ECT) treatments. A forearm was isolated before administration of suxamethonium 0.5 mg kg-1, so that unmodified seizure duration could be measured. Bifrontotemporal electrodes were applied to administer a standard 3-s ECT shock. Median (quartile deviation) duration of seizure was reduced significantly after propofol (19.0 (9.0) s), compared with after methohexitone (33.0 (7.8) s). Therefore propofol may not be an appropriate anaesthetic for ECT because of its adverse effect on seizure duration.

Anesthesia, Intravenous↗
PubMed1988

Premedication with piroxicam in patients having dental surgery under general anaesthesia with halothane or isoflurane.

Pain, analgesic requirements, mouth opening and emesis were assessed in 60 patients who received either piroxicam 40 mg or placebo before dental surgery under general anaesthesia which included breathing either halothane or isoflurane. Patients went home on the day after surgery and completed a questionnaire concerning pain and emesis. There were four groups of 15 subjects: piroxicam-halothane, piroxicam-isoflurane, placebo-halothane or placebo-isoflurane. Pain increased at 2 and 4 h and had reduced by 18 h after surgery; there were no significant differences between the groups in pain scores. After operation, fewer patients in the piroxicam-isoflurane group required papaveretum compared with the piroxicam-halothane and placebo-halothane groups. Mouth opening was reduced between 2 and 4 h after surgery, but was less restricted after piroxicam-isoflurane than placebo-halothane. There was no difference between the groups in the incidence of emesis within 18 h of surgery. The postal questionnaire suggested that pain and emesis were reduced significantly during the 3 days after surgery in patients who had received piroxicam before surgery, compared with those who had received placebo.

Adult↗
PubMed1988

Anaphylactoid reaction to vecuronium followed by systemic reaction to skin testing.

An unusual case is presented of a systemic anaphylactoid reaction to tubocurarine and subsequently to vecuronium. Intradermal testing with vecuronium following the latter response was negative at recommended test dose levels but at a higher concentration it initiated a hazardous systemic response. The laboratory investigations and possible mechanisms involved in this unusual case are discussed in detail since they may relate to other patients who experience anaphylactoid responses to anaesthetic drugs and who then undergo intradermal testing.

Adult↗
PubMed1987

Effect of anxiety on gastric emptying in preoperative patients.

On the morning of operation 30 patients awaiting minor gynaecological surgery completed a Spielberger State Trait Anxiety Inventory. Gastric emptying was then measured using paracetamol absorption. Anxiety State scores, which reflected situational anxiety, were unrelated to Anxiety Trait scores, which assessed anxiety proneness. Paracetamol absorption was reduced and delayed in patients with low anxiety trait who developed high anxiety state before surgery, compared with patients whose anxiety state scores were lower than, or similar to, their anxiety trait scores. Therefore, it was concluded that gastric stasis occurred in patients with a low predisposition to anxiety who became apprehensive whilst awaiting surgery.

Acetaminophen↗