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Biomedical subjects

O A Williams

Publications and source records attributed to O A Williams.

8 recordsLinked to original sources

Gastric emptying is delayed at 8-12 weeks' gestation.

Gastric emptying was studied indirectly by paracetamol absorption in 20 patients at 8-12 weeks' gestation and also in 20 non-pregnant controls. Subjects received paracetamol 1.5 g in a tablet with 50 ml of water and remained semi-recumbent for 2 h while venous blood samples were obtained at 15-min intervals. The maximum concentration of paracetamol was significantly lower and the time to maximum concentration significantly greater in pregnant patients. In addition, the areas under the time-concentration curves at 60 and 120 min were significantly smaller in the pregnant group. These changes are indicative of a delay in gastric emptying at 8-12 weeks' gestation.

Acetaminophen↗

Lignocaine spray applicators are a potential source of cross-infection in the anaesthetic room.

Ten percent lignocaine spray is in widespread clinical use as a means of suppressing responses to tracheal intubation. It is sprayed from a multidose container into the glottis and on to the vocal cords through an applicator nozzle, which may be used on successive patients. We have investigated the likelihood of the contamination of these nozzles, with patients' mouth flora. Spray applicators from four of the 20 cases investigated showed contamination with potential bacterial pathogens. We therefore recommend that lignocaine spray should not be applied to successive patients using the same applicator nozzle.

Adolescent↗

Addition of droperidol to patient-controlled analgesia: effect on nausea and vomiting.

A double-blind trial of the effect of droperidol on the incidence of nausea and vomiting in patients using patient-controlled analgesia was carried out in 60 healthy women undergoing abdominal hysterectomy. After a standard anaesthetic including droperidol 2.5 mg as a prophylactic antiemetic, patients were randomly allocated to receive postoperative patient-controlled analgesia with either morphine alone (2 mg.ml-1) or morphine (2 mg.ml-1) with droperidol (0.2 mg.ml-1) added to the syringe. Verbal scores and visual analogue scores for nausea, vomiting, pain and sedation were made at 4, 12 and 24 h postoperatively, and any requirement for intramuscular prochlorperazine noted. There was no difference between the groups at any time in the amount of morphine consumed or in pain scores. At 12 h, patients receiving droperidol experienced significantly less nausea, and over the first 24 h, 31% required prochlorperazine compared with 59.3% of patients not receiving droperidol. The number of patients with sedation at 24 h was significantly greater in the droperidol group. We conclude that the addition of droperidol to morphine both reduces nausea and the need for further antiemetic treatment.

Adult↗

Patient knowledge of operative care.

To investigate knowledge of perioperative events, a questionnaire was administered to 111 elective surgical patients. Six topics were covered: the operation, the anaesthetic, time spent in the operating theatre, amount of post-operative pain, duration of hospital admission and time required to return to normal fitness. Apart from evaluating information-sources for each topic, the questionnaire assessed degree of knowledge and satisfaction with this information, and the relationship of these to anxiety. More than 30% of the patients responded that they had received no information about anaesthesia, time in theatre, return to fitness or pain. For each topic more than 40% desired further information. Nursing staff provided most information, although for the anaesthetic, time in theatre, return to fitness and pain, more than 60% of patients responded that nobody had provided explanation. There was no correlation between knowledge relating to the topics per se and anxiety, but there was a significant correlation between satisfaction with information and anxiety. This survey shows a considerable need for improved information provision, especially for patients in whom anxiety is associated with a desire for further explanation of operative care.

Adolescent↗

Pulmonary collapse during anaesthesia in children with respiratory tract symptoms.

A frequent dilemma facing the anaesthetist is the child with respiratory tract symptoms. The risks of anaesthesia and surgery in these patients have not been clearly established. We present three cases which illustrate a potentially serious complication which may arise. Our patients each had symptoms of cough, but were systemically healthy. Two of the children had absent clinical signs, whilst the third had a normal chest X ray. However, during surgery and anaesthesia each child developed significant pulmonary collapse, associated with desaturation on oximetry.

Anesthesia, General↗