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Biomedical subjects

R F Barrett

Publications and source records attributed to R F Barrett.

10 recordsLinked to original sources

Patient-controlled analgesia and postoperative nausea and vomiting: efficacy of a continuous infusion of ondansetron.

A continuous infusion of ondansetron was compared with a placebo infusion in 80 patients undergoing major breast reconstructive surgery. All patients received a standard anaesthetic and a bolus dose of ondansetron after induction. They were then randomly allocated to receive an intravenous infusion of ondansetron or a placebo infusion for 24 h in a double-blind fashion. Postoperative analgesia was provided by patient-controlled subcutaneous diamorphine. In the ondansetron group, the severity of nausea, measured by a 10-point verbal rating scale, was reduced (p = 0.01) and fewer patients stated at postoperative interview that nausea and vomiting was a problem (p = 0.01).

Adolescent↗

Improving patients' postoperative sleep: a randomized control study comparing subcutaneous with intravenous patient-controlled analgesia.

One hundred female patients undergoing major reconstructive plastic or gynaecological surgery were randomized to either receive subcutaneous patient-controlled analgesia (PCA) (bolus dose 2.5 mg diamorphine in 1 ml with a 20-minute lockout) or intravenous PCA (bolus dose 0.5 mg diamorphine in 1 ml with a 5-minute lockout). Data were collected by questionnaire and interview to evaluate the intervention on pain scores, quality of sleep on the first postoperative night, postoperative nausea and vomiting (PONV) and overall patient acceptability. The subcutaneous PCA group experienced less 'worse pain' (P < 0.01) and less sleep disturbance due to pain (P < 0.001). Subcutaneous PCA would appear to offer patients a safe and effective means of analgesia and may offer significant advantages over the intravenous route of administration.

Adult↗

Extradural diamorphine for postoperative analgesia: audit of a nurse-administered service to 800 patients in a district general hospital.

We report the use of extradural diamorphine for postoperative analgesia as a nurse-based service on selected surgical wards in a district general hospital. Eight hundred patients received lumbar or thoracic extradural diamorphine analgesia for postoperative or traumatic pain. Diamorphine was administered in bolus form by suitably trained nursing staff. Satisfactory analgesia, recorded on a verbal rating scale at the conclusion of the service, was achieved in 94.6% of patients. The technique was considered by medical and nursing staff to be a safe and acceptable method of analgesia. Respiratory depression, defined as a ventilatory frequency of less than 10 b.p.m., occurred in seven patients (incidence of 0.9%). All occurred in the theatre recovery area or in the intensive care unit. Retrospectively, each was predictable and all responded to naloxone 0.4 mg.

Adolescent↗

Viability and distribution of bacteria after passage through a circle anaesthetic system.

We have assessed in vitro the viability of eight species of micro-organism suspended as aerosols and passed through a soda-lime absorber rebreathing system. As had been predicted, the soda-lime exerted a potent cidal effect on non-sporing organisms, all of which were rendered non-viable. One percent of the spore bearing organism, Bacillus subtilis, was still viable after 30 min contact. Although Bacillus subtilis is an organism of low pathogenicity, spores may be more resistant to the alkaline medium of the soda-lime. The micro-organisms were observed to lodge in all components of the breathing system, with the greatest concentration being recovered from the corrugated tubing. We recommend that disposable components of the circle breathing system should be changed, and the non-disposable parts sterilized or disinfected, daily. Soda-lime cannisters should be sterilized or disinfected when changing the soda-lime.

Anesthesia, Closed-Circuit↗

Comparison of two regional techniques for postoperative analgesia in children following herniotomy and orchidopexy.

This study compares the quality and duration of analgesia in two groups of patients aged between 1 and 13 years who received either caudal anaesthesia with plain bupivacaine 0.25% or an iliohypogastric and inguinal nerve block combined with skin infiltration using bupivacaine 0.25% with adrenaline 1:200,000. The results indicate no significant difference in the duration or quality of the analgesia provided by the two techniques. There was no difference in the incidence of vomiting or the time of first micturition between the two groups.

Adolescent↗

Oxazepam premedication in neurosurgical patients. The use of a fast-dissolving oral preparation of oxazepam as a pre-operative anxiolytic drug in neurosurgical patients.

In a double-blind study, a new fast-dissolving formulation of oxazepam used as sole premedicant in patients undergoing neurosurgery, was assessed with particular reference to its effect on the levels of anxiety, consciousness and orientation of the patients pre- and postoperatively. The results show that when given at least one hour pre-operatively the new preparation is a highly effective anxiolytic with minimal sedative or other side-effects, is convenient to administer and has high patient acceptability.

Adolescent↗