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L Riishede

Publications and source records attributed to L Riishede.

8 recordsLinked to original sources
PubMed1998

Codeine in post-operative pain. Study of the influence of sparteine phenotype and serum concentrations of morphine and morphine-6-glucuronide.

OBJECTIVE: Within the past decade, human experimental pain studies have supported the 50-year-old hypothesis that codeine is a prodrug, which has to be converted to morphine to exert an analgesic effect. This study aimed at evaluating the impact of sparteine phenotype and serum concentrations of morphine on the efficacy of codeine in post-operative pain. METHODS: Eighty-one patients with a pain rating of 3 or more on a 0-10 numerical rating scale 0.5 h after surgery were included in the study. The patients were given an oral dose of 100 mg codeine and rated pain with the numerical rating scale 0.5 h and 1 h after medication. Blood for determination of serum concentration of codeine and its metabolites was collected 1 h after medication, and a 12-h urine sample after administration of 100 mg sparteine was used to determine the sparteine phenotype. RESULTS: Eight patients were poor metabolizers and 66 were extensive metabolizers of sparteine, while the urine samples for the remaining seven patients were lost. In 22 patients, including the eight poor metabolizers, the serum concentrations of both morphine and morphine-6-glucuronide (M6G) were below the limit of determination of the assay, i.e. 1.5 nmol x l(-1) and 2 nmol x l(-1), respectively. A sum of the concentration of these two substances below 10 nmol x l(-1) was found in an additional eight patients. The sum of differences between pre- and post-operative pain ratings did not differ between the two phenotypes (P = 0.60), whereas the 30 patients with serum concentrations of morphine plus M6G below 10 nmol x l(-1) had a marginally significant lower sum than the 51 patients with higher levels of these substances (median 1.5 vs 2.5, P = 0.058). CONCLUSION: A low serum concentration of morphine and M6G seems to be common in patients treated with codeine for post-operative pain, and low concentrations of these active substances may be related to decreased efficacy of codeine.

Adult↗
PubMed1993

[Stomach rupture after nasal oxygen therapy].

A 69-year-old male developed a spontaneous rupture of the normal stomach during oxygen administration via a nasopharyngeal catheter. The clinical picture and treatment is discussed.

Aged↗
PubMed1991

[Retroperitoneal complications after lumbar disk prolapse surgery].

Injury to retroperitoneal vascular structures secondary to lumbar disc surgery is a rare but serious complication. In some cases early recognition and surgical intervention is of vital importance. Vascular injuries may be classified in in the following manner. 1. Laceration of one artery or a vein only. 2. Laceration of a artery and a vein leading to formation of arteriovenous fistula. 3. False aneurysm. Based on a review of the literature and three case reports, the anatomy is reviewed. The diagnosis, clinical pictures and the vascular reconstruction are discussed.

Adult↗
PubMed1990

Myocardial effects of adrenaline, isoprenaline and dobutamine at hypothermic conditions.

The pharmacodynamic myocardial effects of adrenaline, isoprenaline and dobutamine were studied in isolated, perfused and spontaneously beating rabbit hearts at hypothermic conditions. Cardiac contraction amplitude increased from the control value at 37 degrees set equal to 100% to about 165% at 22 degrees, whereas contraction velocity decreased to 52%, frequency to 30% and oxygen consumption to about 19%. At 22 degrees all drugs produced pronounced positive inotropic and chronotropic effects. Em-values related to contraction velocity, frequency and oxygen consumption were for isoprenaline 152, 98 and 136%, respectively, for adrenaline 127, 100 and 198% and for dobutamine 120, 86 and 165%, respectively. The corresponding EC50-values decreased and a marked left-shift of the log-concentration response curves was observed as an expression of increased myocardial sensitivity to the drugs. Em for contraction velocity for dobutamine was distinctly reduced at 32 and 27 degrees and for adrenaline at 27 degrees in comparison to the increase seen at 22 and 37 degrees. Em for oxygen consumption showed for all drugs an increase at decreasing temperatures. The frequency-corrected QTc-interval decreased slightly to moderately during exposure to the drugs at hypothermic conditions. None of the drugs caused arrhythmias during the experiments. Coronary flow rate decreased only moderately at the higher drug concentrations at decreased temperatures. Dobutamine and adrenaline at 37 degrees and isoprenaline at 37 and 22 degrees caused an increase of Em for oxygen consumption that was slightly less than proportional to the increase of Em for contraction velocity.

Animals↗
PubMed1988

Reversal of flunitrazepam sedation with flumazenil. A randomized clinical trial.

Fifty-nine male patients scheduled for transurethral resection of the prostate under flunitrazepam sedation and spinal analgesia were randomized in a double-blind trial to reversal of sedation with either the benzodiazepine antagonist flumazenil or placebo. Judged by degree of sedation, comprehension and cooperation as well as by estimation of orientation in time and space, flumazenil was superior to placebo (P less than 0.001). The median duration of anterograde amnesia was 16 min after flumazenil and 75 min after placebo (P less than 0.001). Adverse events were more frequent with placebo (P greater than 0.05), while no differences were evident with regard to laboratory data or cardiorespiratory function.

Aged↗