Biomedical subjects
Publications and source records attributed to K M Leighton.
This article describes an inexpensive device for delivering patient-controlled analgesia. Details of the necessary modifications of a standard IVAC 530 infusion pump are included. The total cost of the modified pump was $2200.
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A case note review of referrals to psychiatrists in Glasgow for 1979-1983 yielded 122 patients. Demographic and clinical data are described and compared to findings in earlier British series. Social class distribution for the Glasgow patients was no different from that of the local general population. This finding contrasted with the upper social class bias found in earlier studies and possible reasons for this difference are discussed.
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Hypotension produced by sodium nitroprusside during halothane anaesthesia in a series of experiments in dogs was accompanied by the maintenance of renal blood flow. Renal blood flow was maintained at levels of systemic pressure at which flow is customarily reduced in man and experimental animals. The significance of this observation is the possibility that sodium nitroprusside has a protective effect on the kidney, not only in states of deliberate hypotension, but in other low flow states where renal perfusion and function may be compromised.
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Nephrotoxicity due to methoxyflurane may be due in part to alterations in intra-renal perfusion. Furosemide is believed to alter the intra-renal distribution of blood flow. Studies have been carried out to observe the effects of systemic furosemide administration during methoxyflurane and halothane anaesthesia in normotensive animals and in animals made hypotensive by increasing inspired concentrations of the anaesthetics. During halothane anaesthesia normotensive dogs showed a rise in total renal blood flow during the infusion of furosemide. Hypotensive dogs showed no increase in flow. During methoxyflurane anaesthesia no change in total renal blood flow followed furosemide administration to normotensive animals. Some diminution in total blood flow followed the administration of furosemide in hypotensive dogs during methoxyflurane anaesthesia. In normotensive dogs during halothane anaesthesia there was a significant increase in deep cortical perfusion after furosemide. Furosemide, therefore, is unlikely to mitigate the potential for nephrotoxicity which methoxyflurane possesses. Furthermore, this diuretic may adversely influence renal function when administered during halothane anaesthesia.
The effects of dobutamine, a new catecholamine, have been studied during anaesthesia with halothane, halothane and nitrous oxide and alphaprodine. Renal blood flow is increased by dobutamine as are mean arterial pressure and heart rate. The increase in rate is less marked during alphaprodine anaesthesia than when halothane is administered. Dobutamine may prove a useful agent in the management of acute circulatory failure but it is capable of inducing dysrhythmias under the conditions of these experiments.
Two hundred and forty-four surgical patients who received no anticholinergic premedication were compared with 160 patients who had received atropine or scopolamine before the induction of anaesthesia. Infants and patients undergoing heart surgery were excluded. Eleven anaesthetists participated in the study. They were asked to report problems with oropharyngeal and tracheobronchial secretions. Two per cent of unpremedicated patients experienced problems with secretions of a degree sufficient to require treatment. This small percentage appears insufficient to warrant routine preoperative anticholinergic medication.
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