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Biomedical subjects

K R Milligan

Publications and source records attributed to K R Milligan.

14 recordsLinked to original sources
PubMed1992

Extradural clonidine and bupivacaine for postoperative analgesia.

We have assessed the use of clonidine and bupivacaine for postoperative analgesia. Both drugs were administered via the extradural route, and were given both alone and in combination. The analgesia produced by clonidine was superior to that of bupivacaine; a combination of the drugs resulted in significantly better and longer duration of analgesia than each drug administered alone. Cardiovascular changes and the incidence of side effects were similar in all three groups. The sedative effects of clonidine were not marked.

Adult↗
PubMed1992

Extradural clonidine infusions for analgesia after total hip replacement.

We have examined the effectiveness of extradural clonidine infusions for postoperative analgesia and the effect of clonidine on extradural morphine. In a double-blind, controlled study, patients, undergoing total hip replacement were allocated randomly to receive one of two doses of extradural clonidine (25 micrograms h-1 or 50 micrograms h-1), low dose extradural morphine or a combination of morphine and clonidine. Pain scores in the morphine group were significantly greater than in the clonidine groups (P less than 0.01) and the combination group (P less than 0.05) during the first 1 h after surgery. The requirements for systemic analgesia were least in the combination and larger dose clonidine group, and the duration of effect of the initial bolus dose was significantly longer compared with the morphine and low dose clonidine groups (P less than 0.05). Arterial pressure was reduced in the clonidine groups, although the incidence of clinical hypotension was low. There were no significant differences between the groups in emetic symptoms or urinary retention.

Adult↗
PubMed1991

Adrenergic modulation of preoperative anxiety: a comparison of temazepam, clonidine, and timolol.

To assess the influence of adrenergic modulation on preoperative anxiety, we used a randomized, double-blind, placebo-controlled trial to compare temazepam, clonidine, and timolol as preanesthetic medications in patients undergoing minor orthopedic surgery. All the active treatments resulted in less preoperative anxiety than the placebo (control) did. Induction of anesthesia was smoother in all the treated patients compared with the control group. Recovery was slowest in the temazepam and clonidine groups, but there were no significant differences between the groups after 90 min. Cardiovascular changes were most marked in the timolol group. Pain scores were lower in the temazepam and clonidine series in the early postoperative period. Neither clonidine nor timolol offers any major advantage over temazepam for premedication in these patients.

Adult↗
PubMed1991

Use of halogenated anesthesia with maternal hemorrhage.

Obstetrical hemorrhage accounts for about 16% of all maternal deaths. The most common cause of hemorrhage is uterine atony. General anesthesia is considered a predisposing cause of uterine atony. This article briefly reviews the hemodynamic changes occurring during pregnancy and uterine atony. Aspects of predisposing factors and management related to the use of drugs and halogenated anesthetics are discussed.

Anesthesia, Obstetrical↗
PubMed1990

Propofol anesthesia for major thoracic surgery.

One hundred patients undergoing elective thoracic surgery were anesthetized with propofol as a continuous intravenous infusion. In 60 patients, nitrous oxide was used for supplementation. The technique proved satisfactory, but induction of anesthesia was associated with significant decreases in blood pressure. The use of nitrous oxide markedly reduced the propofol requirements, and prolonged the time to the first spontaneous breath during recovery. The mean infusion rate of propofol was 7.2 +/- 2.72 mg/kg/h with air-oxygen, and 5.7 +/- 1.97 mg/kg/min with nitrous oxide-oxygen (P less than 0.01). This technique seems to be a satisfactory alternative for patients primarily requiring an intravenous anesthetic during thoracic surgery.

Anesthesia Recovery Period↗
PubMed1989

Use of auditory evoked responses as a measure of recovery from benzodiazepine sedation.

The amplitude of the P300 component of auditory evoked responses was found to be depressed by benzodiazepine sedation and was subsequently used to monitor the recovery of volunteers sedated with midazolam. The amplitude of the evoked responses was found to be highly correlated with blood midazolam levels but to be no more sensitive than standard psychomotor testing in assessing recovery from sedation.

Adult↗
PubMed1988

Postoperative gastric emptying in outpatient anesthesia: the effect of opioid supplementation.

Acetaminophen (paracetamol) 20 mg/kg was administered orally to 45 gynecological outpatients who had received either alfentanil 5 micrograms/kg, fentanyl 1 microgram/kg, or no analgesic supplement immediately prior to the induction of general anesthesia. Postoperative gastric emptying, assessed by acetaminophen absorption, was significantly inhibited in those given alfentanil. This inhibition is unlikely to be of great clinical importance and was much less than that found in previous studies using longer-acting opioids such as morphine.

Absorption↗
PubMed1988

Halothane and isoflurane in outpatient anaesthesia. A comparison of recovery.

The speed and quality of recovery after anaesthesia were studied in 60 outpatients. Anaesthesia was induced using propofol and maintained by nitrous oxide in oxygen supplemented with either halothane or isoflurane. Initial clinical recovery was significantly faster in the halothane group but no differences were found during subsequent psychomotor testing. Minor postoperative side effects were common in both groups.

Adolescent↗
PubMed1988

The antiemetic action of propofol.

Eighty patients who underwent minor gynaecological surgery were anaesthetised with either incremental propofol or incremental methohexitone after an opioid premedication. The group anaesthetised with propofol had significantly fewer emetic sequelae and the results suggest that propofol has a definite antiemetic action.

Adult↗
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

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↗