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Biomedical subjects

N D Edwards

Publications and source records attributed to N D Edwards.

10 recordsLinked to original sources
PubMed1995

Perioperative myocardial ischaemia in patients undergoing transurethral surgery: a pilot study comparing general with spinal anaesthesia.

We have studied the incidence and duration of perioperative myocardial ischaemia using ambulatory ECG monitoring in 100 patients undergoing transurethral surgery, who were allocated randomly to receive either general or spinal anaesthesia. The overall incidence of myocardial ischaemia increased from 18% to 26% between the preoperative and postoperative periods. Patients with ischaemic heart disease had a significantly greater incidence of myocardial ischaemia after operation than patients without known ischaemic heart disease (P < 0.05). There was an increase in both the incidence and duration of myocardial ischaemia after operation with both anaesthetic techniques, but no significant difference between the two.

Aged↗
PubMed1995

Early detection and treatment of myocardial ischaemia after operation using continual ambulatory arterial pressure monitoring and ECG ST segment analysis.

We report a case in which the use of continual ambulatory arterial pressure monitoring and ECG ST-segment analysis allowed early detection and treatment of myocardial ischaemia in the postoperative period. We believe that this case illustrates the potential value of ambulatory monitoring in the early postoperative period in high-risk patients.

Blood Pressure Monitoring, Ambulatory↗
PubMed1995

Utilisation of the pre-operative ECG.

The utilisation of the pre-operative ECG in patients undergoing routine surgery was investigated in 354 adult patients over a 2-week period. Sixty-four percent of patients had an ECG pre-operatively. An ECG was not performed in 17% of patients who, current hospital policy suggests, should have had one. In contrast, an ECG was performed in 33% of patients who, hospital policy suggests, have no need of one (all of which were normal), which represented 18% of the total number of pre-operative ECGs performed. In 62% of patients with known cardiac disease, and 44% of patients with strong risk factors for ischaemic heart disease (in the absence of known disease) the ECG was abnormal. This compares with only 7% of patients aged over 50 with no risk factors in whom the ECG was abnormal. These findings suggest that there is room for improvement in the utilisation of the pre-operative ECG, which may have cost implications.

Adolescent↗
PubMed1992

Epidural pethidine and bupivacaine in labour.

A double-blind randomised study was performed to assess the value of the addition of pethidine 50 mg to the initial dose of bupivacaine given for epidural analgesia in labour. Forty-nine patients received either 1 ml of saline (n = 24), or 50 mg of pethidine (n = 25), added to 9 ml of 0.25% bupivacaine as an initial injection for intrapartum epidural analgesia. There was a significant increase in the mean duration of analgesia in the pethidine group. However, pethidine did not increase the speed of onset of analgesia, or improve the quality of analgesia.

Adult↗
PubMed1992

Continuous low-dose 3-in-1 nerve blockade for postoperative pain relief after total knee replacement.

We have investigated the value of a 3-in-1 nerve block, followed by a continuous low-dose infusion of bupivacaine into the femoral nerve sheath for postoperative analgesia after total knee replacement. Thirty-seven patients were randomly allocated to either a control group or a study group. The study group had a catheter placed in the ipsilateral femoral nerve sheath. A 3-in-1 nerve block was then performed in the study group with injection of 30 mL of 0.25% bupivacaine through the catheter. This was followed by a continuous infusion of 0.125% bupivacaine at 6 mL/h. The study group had significantly lower pain scores 4 and 24 h postoperatively (P less than 0.01) and required less postoperative opioid analgesic medication (P less than 0.01) than the control group. The authors conclude that a continuous low-dose infusion into the femoral nerve sheath results in better pain relief than conventional intramuscularly administered narcotics after total knee arthroplasty.

Aged↗
PubMed1991

Day case laparoscopy: a survey of postoperative pain and an assessment of the value of diclofenac.

A randomised, controlled study was undertaken to assess the postoperative pain and side effects experienced by patients undergoing day case diagnostic laparoscopy and laparoscopic sterilisation, and to evaluate the effectiveness in these patients of peroperative diclofenac. Patients undergoing laparoscopic sterilisation had significantly higher pain scores at one hour postoperatively, and at discharge, than patients undergoing diagnostic laparoscopy (p less than 0.01) but there were no significant differences in pain scores 24 hours after discharge. The incidence of postoperative side effects following discharge from hospital was high, but there were no significant differences between the groups. Diclofenac had no significant effect in either group on the severity of postoperative pain, or the incidence of postoperative side effects.

Acetaminophen↗
PubMed1990

Survival in adults after cardiac arrest due to drowning.

Some remarkable cases of full neurological recovery after cardiac arrest following immersion incidents have been intermittently reported in the journals over the years. These have largely been in children or teenagers who have fallen into extremely cold water. We report here two older adults who recovered completely after a period of cardiac arrest in cold water. Certainly, death should not be pronounced in cold water drowning, without a thermometer reading and ECG.

Aged↗