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Biomedical subjects

P J McKenzie

Publications and source records attributed to P J McKenzie.

15 recordsLinked to original sources
PubMed1992

Postoperative hypoxaemia after major abdominal vascular surgery.

We have studied the severity and duration of nocturnal hypoxaemia before operation and for the first five nights after operation after elective major abdominal vascular surgery. Oxygen supplementation was almost 100% effective in keeping oxygen saturation greater than 90% during the early postoperative period; however, 50% of patients spent prolonged periods with an SpO2 less than 85% during at least one night after operation. The risk of severe hypoxaemia persists well beyond the current prescription of supplementary oxygen in these high risk patients. A significant association exists between the mean preoperative overnight saturation value and the nocturnal saturation observed subsequently in the later postoperative period.

Adult↗
PubMed1988

Outcome after general anaesthesia for repair of fractured neck of femur. A randomized trial of spontaneous v. controlled ventilation.

One hundred and fifty-two patients undergoing surgery for fractured neck of femur were randomly allocated to receive either general anesthesia with spontaneous ventilation with nitrous oxide and halothane in oxygen or general anaesthesia with controlled ventilation with fentanyl, nitrous oxide and halothane in oxygen. Atracurium was used to provide muscle paralysis in 65% of the latter group, the remainder receiving no neuromuscular blocking agent other than suxamethonium for intubation. Patients were followed up for 6 months. Mortality and outcome were not significantly different between the groups. Overall mortality at 4 weeks was 5.2%, and at 6 months was 15.1%--figures which are considerably lower than in some other comparable studies. This study does not support the suggestion that general anaesthesia with controlled ventilation is associated with increased postoperative mortality.

Aged↗
PubMed1986

Effects of diazepam and midazolam on recovery from anaesthesia in outpatients.

Sixty patients were randomly allocated in an open study to receive either midazolam or diazepam (Diazemuls) with fentanyl and etomidate for induction and maintenance of anaesthesia during day-stay gynaecological surgery. The excitatory effects of etomidate were controlled by the benzodiazepine-fentanyl combination in both groups. No significant difference in the quality of recovery (as judged by Trieger test analysis), amnesia, incidence of recall of pain on injection of etomidate or nausea and vomiting could be demonstrated between the groups. There was a high degree (97%) of patient acceptance.

Adult↗
PubMed1985

Effects of anaesthetic technique on deep vein thrombosis. A comparison of subarachnoid and general anaesthesia.

Forty patients with fractured neck of femur were allocated randomly to undergo surgery under general anaesthesia (GA) or subarachnoid anaesthesia (SAB). After operation, the incidence of deep vein thrombosis (DVT), assessed by venography, was found to be 40% in the SAB group, which was significantly lower than the incidence (76.2%) in the GA group. These observations may account for the previously reported effect of SAB, in comparison with GA, in reducing early postoperative mortality in this category of patient.

Adult↗
PubMed1985

Assessment of bleeding in eye surgery.

A new method for assessing microhaemorrhage in eye surgery was used in 16 patients for cataract extraction. It was shown that bleeding was greatest in the first five minutes and that it correlated with the surgeon's clinical estimate of blood loss. The method was used to assess the effect of two different general anaesthetic induction regimens on intraoperative bleeding.

Aged↗
PubMed1984

Long-term outcome after repair of fractured neck of femur. Comparison of subarachnoid and general anaesthesia.

One hundred and forty-eight patients undergoing "pin-and-plate" repair of fractured neck of femur received either subarachnoid blockade or general anaesthesia. The patients were followed up for 1 year after surgery. At the end of the year, 34% had died and 50% had returned home. Twelve per cent were either in hospital or in institutional care; 4% were lost to follow up. The mean duration of acute plus convalescent hospital bed occupancy was 84.4 days. There was a significantly lower mortality in the subarachnoid anaesthetic group by 14 days after surgery. The majority of the deaths in the general anaesthetic group were clustered between 6 and 16 days. However, at the end of 2 months the mortality rates were similar in both groups. It is conceivable that the difference in the distribution of deaths between the groups was a result of thrombo-embolism.

Aged↗
PubMed1980

Comparison of the effects of spinal anaesthesia and general anaesthesia on postoperative oxygenation and perioperative mortality.

One hundred patients presenting for surgical treatment of fractured neck of femur were allocated to receive either spinal (SAB) or general (GA) anaesthesia. Before operation, the mean PaO2 was 9.04 kPa. There was a significant decrease in PaO2 of 0.68 kPa in GA group at 1 h after operation, while blood-gas values were unchanged in SAB group. Eight patients (15.7%) in GA group and five patients (10.2%) in SAB group died within 4 weeks of surgery. The difference was not statistically significant.

Acid-Base Equilibrium↗
PubMed1965

Haemorrhagic smallpox. 2. Specific bleeding and coagulation studies.

A total of 60 patients in Madras with haemorrhagic and non-haemorrhagic clinical forms of smallpox were investigated by a variety of bleeding and coagulation studies in an attempt to reveal specific haematological defects that might account for the haemorrhagic diathesis in certain cases of smallpox.The non-haemorrhagic smallpox patients had no coagulation abnormalities, although some had thrombocytopenia.The early haemorrhagic patients showed a deficiency of platelets, prothrombin and accelerator globulin, and increased circulating antithrombin. Patients with the late form of haemorrhagic smallpox showed significant thrombocytopenia and less severe deficiencies of the same coagulation factors; a few also had increased antithrombin.The authors suggest that therapy with fresh, frozen or lyophilized plasma should be tried; fresh, platelet-rich plasma should offer the greatest benefit.

Blood Coagulation↗