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Biomedical subjects

N E Drenck

Publications and source records attributed to N E Drenck.

At least 19 recordsLinked to original sources
PubMed1998

Forced-air surface warming versus oesophageal heat exchanger in the prevention of peroperative hypothermia.

BACKGROUND: In a prospective, randomized, placebo-controlled study we investigated the efficacy of 2 different heating methods in 24 patients undergoing abdominal surgery of at least 2 h expected duration. METHODS: Group I: control, no active warming. Group II: forced-air surface warming on upper extremities and upper thorax. Group III: warming with oesophageal heat exchanger. All patients had a standardized, combined general and epidural anaesthesia. Core and skin temperatures were measured at induction of general anaesthesia, and subsequently every 30 min, and changes in total body temperature were calculated. RESULTS: There were no statistically significant differences between the 3 groups regarding demographic data. Patients in groups I and III developed hypothermia, while this was not the case with patients in group II. When using analysis of variance with repeated measurements, there was no significant difference in core temperature, comparing group I and group III (P = 0.299) or the interaction between time and treatment of these groups (P = 0.373). As a consequence, data from groups I and III were pooled and regarded as an internal group on the one hand, and group II as an external group on the other hand. Core temperature, the mean skin temperature and total body temperature were significantly different comparing the internal group and the external group. The interaction between time and treatment was likewise found to be significantly different. CONCLUSION: We conclude that in major abdominal procedures lasting 2 h or more, serious hypothermia develops unless effective measures to prevent hypothermia are used. Forced-air warming of the upper part of the body is effective in maintaining normothermia in these patients, while central heating with an oesophageal heat exchanger, at least in its present form, does not suffice to prevent hypothermia.

Abdomen↗
PubMed1997

Comparison of psychomotor performance after intravenous and rectal diazepam.

Twenty-four healthy subjects participated in a triple crossover study in which some of the widely used psychomotor tests were applied as indicators of psychomotor ability. Diazepam was administered in doses of 10 mg intravenously, 10 mg rectally, and 35 mg rectally. Plasma levels of diazepam and performance decrement in the Trieger dot test (DOT), the perceptual speed test (PST), the digit symbol substitution test (DSST), and continuous reaction time were measured up to 12 hr after administration. The psychomotor effects were quite similar after administration of 10 mg diazepam intravenously and rectally. When the 35-mg rectal administration was compared to the 10-mg administrations, performance was still affected at 12 hr.

Administration, Rectal↗
PubMed1996

Stereoselective pharmacokinetics of methadone in chronic pain patients.

Ten patients with chronic pain were randomized to an open, balanced, crossover study. Each patients received two different preparations of racemic methadone, i.e., tablets and intravenous infusion. The pharmacokinetic parameters of the R- and S-enantiomers of the racemate are reported. The analgesically active R-methadone has a significantly longer mean elimination half-life than the optical antipode S-methadone (t1/2 = 37.5 and 28.6 h, respectively). The mean total volume of distribution is 496.6 L for R-methadone and 289.1 L for S-methadone. Significant differences in the mean clearance between R- and S-methadone are seen (0.158 and 0.129 L/min, respectively). However, the lagtime after oral administration and the bioavailability did not show differences between the isomers. The data suggest that both enantiomers of methadone should be measured if correlations between pharmacodynamics and kinetics are made due to the stereoselective differences in half-life, total volume of distribution, and clearance.

Aged↗
PubMed1989

[Bruising after venepuncture].

A randomized cross-over investigation was carried out on 24 healthy volunteers to investigate the occurrence of bruising following compression on the extended or flexed elbow respectively, following venepuncture in the cubital fossa. Following 48 uncomplicated venepunctures (24 x 2) a total of 8 (17%) were found to have bruising, four of these after compression on the extended elbow and four after compression on the flexed elbow. It is concluded that there are no differences in the frequencies of bruising following closed venepuncture in the cubital fossa regardless of whether the subsequent compression is undertaken on the extended or flexed elbow.

Adult↗
PubMed1989

Local irritation after administration of diazepam in a rectal solution.

The extent of local irritation after rectal administration of diazepam in solution was studied in 24 adults (mean weight of 70 kg). The trial was randomized using a triple cross-over design. A burning sensation was reported in 60%, 12% and 0% of subjects up to 15 min after administration of diazepam 35 mg, diazepam 10 mg and placebo, respectively. Endoscopic assessment 24 h after medication showed mechanical irritation in three subjects and local irritation probably caused by diazepam, the vehicle, or both, in four. No correlation was found between subjective complaints and objective findings. Control endoscopy 7 days after medication revealed no pathology. It is suggested that a rectal solution of diazepam in doses up to 0.5 mg kg-1 is a safe form of medication in respect of irritation of the rectal mucosa.

Administration, Rectal↗
PubMed1989

Manual evaluation of residual curarization using double burst stimulation: a comparison with train-of-four.

Double burst stimulation (DBS) is a new mode of stimulation developed to reveal residual neuromuscular blockade under clinical conditions. The stimulus consists of two short bursts of 50 Hz tetanic stimulation, separated by 750 ms, and the response to the stimulation is two short muscle contractions. Fade in the response results from neuromuscular blockade as with train-of-four stimulation (TOF). The authors compared the sensitivity of DBS and TOF in the detection of residual neuromuscular blockade during clinical anaesthesia. Fifty-two healthy patients undergoing surgery were studied. For both stimulation patterns the frequencies of manually detectable fade in the response to stimulation were determined and compared at various electromechanically measured TOF ratios. A total of 369 fade evaluations for DBS and TOF were performed. Fade frequencies were statistically significantly higher with DBS than with TOF, regardless of the TOF ratio level. Absence of fade with TOF implied a 48% chance of considerable residual relaxation as compared with 9% when fade was absent with DBS. The results demonstrate that DBS is more sensitive than TOF in the manual detection of residual neuromuscular blockade.

Anesthesia↗
PubMed1986

Repeated deep accidental hypothermia. A comparison of active or passive treatment in one patient.

Deep accidental hypothermia after self-poisoning with drugs occurred twice in the same patient within 25 days. Initial rectal temperatures were 22.0 degrees C and 23.3 degrees C, respectively; the clinical conditions were otherwise identical. In the first instance, active rewarming by means of peritoneal irrigation was performed, while spontaneous rewarming was allowed on the second occasion. Normothermia was attained within 24 hours in both cases, and the patient was discharged in her habitual state of well-being. The course of these nearly identical cases illustrates the possibility of a passive treatment for deep hypothermia.

Aged↗