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Biomedical subjects

L Edmondson

Publications and source records attributed to L Edmondson.

10 recordsLinked to original sources
PubMed2003

Intragastric pressure and its relevance to protective cricoid force.

Cricoid pressure is frequently used to protect the anaesthetised and paralysed patient from passive regurgitation. Although intragastric pressure (Pga) drives regurgitation, its relevance in the setting of protective cricoid force has been largely ignored. We sought to define the likely range of Pga encountered in the population at risk. We studied 100 consecutive patients presenting for surgery requiring mechanical ventilation. We measured respiratory swings in Pga during mechanical ventilation in the paralysed state following rapid sequence induction (n = 24) and routine induction of anaesthesia (n = 76). Pga (mmHg) in the whole group recorded at end-inspiration (Pga-In) and end-expiration (Pga-Ex) was [mean (SD)]: Pga-In 6.48 (2.60) mmHg and Pga-Ex 3.23 (2.24) mmHg. We found no correlation between Pga and body mass index (r2 = 0.018). These findings have implications for the level of cricoid force required to protect a patient during the induction of anaesthesia.

Adult↗
PubMed1995

Percutaneous dilational tracheostomy. Malposition leading to delayed weaning.

We report a patient in whom delayed weaning from ventilatory support was caused by the malposition of a percutaneous dilational tracheostomy tube. A fold of mucosa, identified at tracheoscopy, was found to be the limiting factor, and the situation was resolved by removal of the tracheostomy and reintubation. We believe that the case supports the routine use of a bronchoscope to check the position of the tracheostomy tube.

Airway Obstruction↗
PubMed1988

Penetrating tracheal injury in a child.

A case is reported of a 3.5-year-old child with a stab wound in the neck, that penetrated the trachea. A pneumomediastinum was present. The anaesthetic problems are discussed and the child's management outlined.

Anesthesia, General↗
PubMed1988

Intra-ocular pressure changes during rapid sequence induction of anaesthesia. A comparison between thiopentone and suxamethonium and thiopentone and atracurium.

The changes in intra-ocular pressure associated with two different anaesthetic induction and tracheal intubation techniques were compared (n = 30). After pre-oxygenation, Group A received thiopentone (5 mg/kg) followed by suxamethonium (1.5 mg/kg), both within 25 seconds, and Group B atracurium (0.5 mg/kg) followed by thiopentone (5 mg/kg) again both within 25 seconds. Tracheal intubation occurred after one minute in Group A and 2 minutes in Group B to allow for full paralysis. In Group A intra-ocular pressure did not alter significantly from baseline and the maximum increase was only 0.93 mmHg. The statistical type II error risk was consistently below 55% and all 95% confidence limits included negative values. Intra-ocular pressure in Group B was consistently lower than baseline (p less than 0.05) but with a longer induction-intubation interval. These results therefore provide valuable information about the 'balance of risks' when choosing a muscle relaxant for an inadequately starved patient with a penetrating eye injury.

Adolescent↗