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Biomedical subjects

P Toft

Publications and source records attributed to P Toft.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Sickle-cell anemia and anesthesia].

On account of immigration there are now groups in the Danish population, which should be tested for sickle-cell disorders before anaesthesia. In certain other countries patients of negro or arabian anchestry are sickle tested. Specific diagnosis of sickle-cell disorders is made only by haemoglobin electrophoresis. Sickle-cell crises are commonly precipitated by infection, dehydration, cold, hypoxia and acidosis. Before anaesthesia the patient must be free from intercurrent infection and well hydrated. During anaesthesia it is important to avoid hypoxia, hypotension, cold and venous stasis. Either general or regional anaesthesia may be used. Controlled oxygen therapy must be continued well into the postoperative period.

Anemia, Sickle Cell↗
PubMed1990

[Poisoning with nightshade, Atropa belladonna].

Serious poisoning with atropine-like substances may produce symptoms which can be confused with acute psychosis. The diagnosis in a case of acute poisoning may be difficult and diagnostic treatment with physostigmine may be considered. A case of serious atropine poisoning caused by consumption of the fruits of deadly nightshade (Atropa belladonna) which commenced with psychosis in a boy of nine years is described. It was known that the child had eaten 20-25 of the berries. He survived after treatment with intravenous administration of physostigmine.

Atropa belladonna↗
PubMed1990

A comparison of glucose-free 2% lidocaine and hyperbaric 5% lidocaine for spinal anaesthesia.

Fifty patients scheduled to undergo transurethral surgery of the bladder were allocated to receive spinal anaesthesia with either glucose-free 2% lidocaine (80 mg) or hyperbaric 5% lidocaine (80 mg). Onset time, cephalad spread of analgesia, duration of analgesia, duration and intensity of motor block, quality of analgesia, and the patients' ability to walk 5 m and to micturate postoperatively were assessed. Onset and spread of analgesia were fast and comparable in the two groups. At 60 min, the median segmental level of analgesia was T9 and T10 for the 2% and the 5% group, respectively, allowing transurethral surgery to be performed for at least 1 h. In the 2% group the motor block was more pronounced and longer lasting than in the 5% group. Two patients in the 5% group needed general anaesthesia because of pain. The time from injection of the spinal anaesthetic until the patients were able to walk 5 m and to micturate was equal in the two groups, and 89% of all the patients were able to walk and micturate within 4 h. It is concluded that spinal anaesthesia with 80 mg and 2% or 5% lidocaine provides analgesia for transurethral surgery and is characterized by fast recovery of motor and detrusor function.

Analgesia↗
PubMed1990

Effect of epidurally administered bupivacaine on atracurium-induced neuromuscular blockade.

The effect of epidurally administered bupivacaine on duration, intensity and reversal characteristics of atracurium-induced neuromuscular blockade was studied in 30 healthy patients anaesthetized with thiopentone, fentanyl, midazolam and nitrous oxide. Fifteen patients received, in addition, epidural anaesthesia with bupivacaine. The remaining patients served as controls. The ulnar nerve was stimulated at the wrist and the evoked twitch response from the adductor pollicis was measured with a force displacement transducer. Neuromuscular blockade was induced with atracurium 0.5 mg i.v. and maintained with repeated doses of atracurium 0.15 mg/kg whenever the twitch height had recovered to 15% of the initial twitch height. After operation, the neuromuscular blockade was reversed with neostigmine when the twitch height had recovered to 15%. In the epidural group the clinical duration of neuromuscular blockade, time until first response to train-of-four (TOF) and reversal time were all significantly prolonged (P less than 0.05). Post-tetanic count (PTC) after 20 min was also significantly lower in the epidural group (P less than 0.05). It is therefore concluded that epidurally administered bupivacaine prolongs atracurium-induced neuromuscular blockade. The clinical implication of the modest prolongation is, however, limited.

Adult↗
PubMed1990

Serum aminoterminal type III procollagen peptide reflects repair after acute myocardial infarction.

In 16 patients with acute myocardial infarction and in 15 controls, procollagen type III aminoterminal peptide in serum (PIIINP) was measured consecutively. Serum PIIINP was increased on the second to third postinfarction day (p less than 0.01) and remained elevated for more than 4 months. Peak values were observed on the third to seventh postinfarction day. The individual peak changes were correlated to infarction size calculated from serum CK-MB and serum lactate dehydrogenase (p = 0.60, p = 0.02). The changes in distribution of PIIINP-related antigens in serum after gel chromatography were similar to changes observed during wound healing in humans. PIIINP is cleaved off procollagen type III during the biosynthesis of type III collagen, which characterizes the early stages of repair and inflammation. Our findings suggest that serum PIIINP reflects the repair processes and scar formation following acute myocardial infarction. The serum PIIINP alterations in acute myocardial infarction differ essentially from the changes in myocardial enzymes reflecting myocardial injury. Serum PIIINP may therefore provide new and clinically relevant information on the healing of myocardial infarction.

Adult↗
PubMed1989

Interaction of ketamine with atracurium.

The effect of ketamine on the duration of atracurium-induced neuromuscular blockade was studied in 40 healthy patients anaesthetized with midazolam, fentanyl and nitrous oxide. Twenty received, in addition, i.v. ketamine 2 mg kg-1 followed by an infusion of 2 mg kg-1 h-1. Atracurium 0.5 mg kg-1 was injected i.v. and the time to 25% recovery of the twitch height was measured. It was 8.0 min longer in the ketamine group (P less than 0.005), with a 95% confidence interval of from 2.3 to 11.8 min.

Atracurium↗
PubMed1989

Spinal anaesthesia with glucose-free 2% lignocaine. Effect of different volumes.

Spinal anaesthesia with 2, 3 or 4 ml of glucose-free 2% lignocaine was studied in 64 patients undergoing transurethral surgery of the bladder. Cephalad spread of analgesia, onset time, duration of analgesia, duration of motor block, quality of analgesia, and the cardiovascular effects were assessed. Two ml of 2% lignocaine was insufficient to produce reliable analgesia. Three ml provided sufficient analgesia in most of the patients, but 4 ml was needed to guarantee sufficient analgesia in all patients. Onset times for analgesia and motor block were 10-20 min. After 4 ml the median and interquartile values were: maximum cephalad spread: T8, (T10-T5); time from injection to regression of analgesia to T11: 84 min, (60-103 min); duration of complete motor block: 90 min, (60-120 min). All patients in the 3-ml and 4-ml groups developed complete motor block. There was a positive correlation between the dose and the duration of analgesia and motor block. A positive correlation, although weaker, was also seen between the dose and the maximum cephalad spread of analgesia. There was an inverse relationship between the cephalad spread of analgesia and the duration of motor block. Falls in systolic blood pressure greater than 30% were noted in seven patients in whom the cephalad spread of analgesia was higher than in the rest of the patients. Spinal anaesthesia with glucose-free 2% lignocaine in doses of 3-4 ml provides reliable analgesia for transurethral surgery of the bladder.

Aged↗
PubMed1989

The cardiovascular effects of vecuronium during halothane anaesthesia.

In a double-blind, placebo-controlled, prospective randomized trial in 70 otherwise healthy patients undergoing elective surgery of the thyroid gland, the breast, the inguinal canal or the lower limbs, we studied the cardiovascular effects of vecuronium during halothane-nitrous oxide anaesthesia. Vecuronium was found to have no clinically significant influence on heart rate or mean arterial pressure, before or during surgery. Bradycardia was a rare event under the special conditions of the study design.

Adult↗
PubMed1989

Ketamine does not affect suxamethonium-induced neuromuscular blockade in man.

The effect of ketamine on the onset time, the duration of action and the recovery characteristics of suxamethonium-induced neuromuscular blockade was examined in a double-blind randomized study comprising 30 patients anaesthetized with thiopentone, fentanyl, midazolam and nitrous oxide. The ulnar nerve was stimulated at the wrist using train-of-four stimulation (TOF; 0.2-ms duration, 2-Hz frequency every 10s), and the evoked twitch response was measured with a force-displacement transducer. After stabilization of the twitch recording, the patients in the ketamine group received ketamine 2 mg kg-1 i.v., followed by a ketamine infusion of 2 mg kg-1 h-1. The remaining patients served as controls and received equivalent volumes of isotonic saline. Suxamethonium I mg kg-1 was injected 2 min after the ketamine/placebo bolus dose. The onset time, recovery index, time to 90% recovery of the twitch height and the TOF ratio during recovery were similar in the two groups. Therefore, it is concluded that ketamine does not affect suxamethonium-induced neuromuscular blockade in man.

Adult↗
PubMed1988

An electronic timer for closed circuit anaesthesia.

During the first period of a total closed-circuit anaesthesia the unit dose must be injected relatively often and the gas flows have to be adjusted. To help the anaesthetist, especially during this period, an electronic timer was constructed where an acoustic signal indicated the square of time when the unit dose had to be given. The construction of the electronic timer is described here.

Anesthesia, Closed-Circuit↗
PubMed1988

Congestive heart failure in thyrotoxicosis.

Congestive heart failure due to thyrotoxicosis without preexisting heart disease is rare. Indeed, the very existence of a thyrotoxic heart disease has been much discussed. We describe a 44-year-old woman in whom thyrotoxicosis was found to be the sole cause of congestive heart failure.

Adult↗
PubMed1987

Continuous thoracic epidural analgesia for the control of pain in myocardial infarction.

Continuous thoracic epidural infusion of bupivacaine 0.25% for the relief of pain in acute myocardial infarction (AMI) was studied. The method was only employed for patients, who could not obtain adequate pain relief by parenteral opioid analgesics without unacceptable respiratory depression and/or emesis. The method was effective in controlling pain. The systolic blood pressure was reduced significantly, while the diastolic blood pressure and the heart rate did not change.

Adult↗