Biomedical subjects

P T Cook

Publications and source records attributed to P T Cook.

4 recordsLinked to original sources

PubMed1989

Bed rest and postlumbar puncture headache. The effectiveness of 24 hours' recumbency in reducing the incidence of postlumbar puncture headache.

A prospective, blind, randomised trial was undertaken to determine if the incidence of postlumbar puncture headache is significantly altered by 24 hours' recumbency. One hundred and two patients were allocated randomly to rest supine in bed for either 4 or 24 hours after spinal anaesthesia for urological or gynaecological surgery. A standardised spinal anaesthetic technique was applied that incorporated the use of a 22-gauge needle. All patients were followed-up prospectively to determine if there was a difference in the incidence of postlumbar puncture headache between the two groups. Five patients (11.6%) who were recumbent for 4 hours developed postlumbar puncture headache, a result which was not statistically significantly different from the seven patients (11.9%) in the other group who complained of postlumbar puncture headache.

Aged↗

PubMed1986

An investigation of the effectiveness of bupivacaine applied to the abdominal wall and fallopian tubes in reducing pain after laparoscopic tubal ligation.

Sixty women having laparoscopic sterilisation performed under general anaesthesia were randomly allocated to one of two groups. Intraoperatively, one group had bupivacaine applied topically to the fallopian tubes and injected into the skin wounds, while the other group received no local anaesthetic. A double-blind investigation utilising a visual analogue scale failed to demonstrate a statistically significant difference in postoperative pain between the two groups. In both groups there was a significant reduction in mean pain scores between 1/2 and 7 hours, but there was no further reduction between 7 hours and 17 hours. At 7 hours, only 10% of patients scored their pain as 3 or greater (out of a possible 10). It is concluded that the use of bupivacaine as described is not a useful adjuvant to general anaesthesia and that the low incidence of even moderate pain at 7 hours confirms the view that these patients are suitable for management in the day-stay unit.

Bupivacaine↗

PubMed1986

A prospective randomised trial comparing spinal anaesthesia using hyperbaric cinchocaine with general anaesthesia for lower limb vascular surgery.

One hundred and one patients were randomly allocated to have their peripheral vascular surgery performed under general anaesthesia (51 patients) or spinal anaesthesia (50 patients). Intraoperative haemodynamic changes were markedly different between the two groups with a higher incidence of hypotension in the spinal group (72% vs 31%) and a higher incidence of hypertension in the general anaesthesia group (22% vs 0%). Blood loss was significantly less in the spinal group (560, SD 340, ml vs 792, SD 440, ml). Postoperatively three patients from the general anaesthesia group died from causes unrelated to the anaesthesia, and one had a myocardial infarct. Two patients in the spinal group had myocardial infarcts, both had been treated for bradycardia and hypotension intraoperatively, and one died. There was a significantly higher incidence of postoperative chest infection in the general anaesthesia group (33% vs 16%). There was no significant difference between the groups in the incidence of postoperative confusion, or lower limb amputation rate or need for further surgery prior to hospital discharge.

Aged↗

PubMed1984

The influence on foetal outcome of maternal carbon dioxide tension at caesarean section under general anaesthesia.

The influence on foetal outcome of maternal PCO2 at caesarean section under general anaesthesia was assessed in 27 "clinically acceptable ideal patients" as defined by Crawford. A standard anaesthetic technique was employed which utilised left lateral tilt and an F1O2 of 0.5. A highly significant relationship (p less than 0.001) was found between umbilical vein PO2 and maternal end-tidal PCO2 in the range 20-40 mmHg, such that hypocarbia was associated with a lowering of umbilical vein PO2. In spite of this relationship, only three values of PO2 were less than normal (28 mmHg). No relationship was found between clinically measured parameters of foetal outcome and maternal end-tidal PCO2. The relevant literature is reviewed.

Adult↗