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Biomedical subjects

R P Husemeyer

Publications and source records attributed to R P Husemeyer.

18 recordsLinked to original sources
PubMed1999

Migration of sterilisation clips: case report and review.

A case is reported of a sterilisation clip which was discovered, three years after operation, to have migrated to the subcutaneous tissue. A review of current techniques of female sterilisation is given together with a discussion of other relevant accounts of clip migration. It is shown to be a rare event with no reported serious sequelae. There is no conclusive evidence to suggest that one type of clip is more likely to migrate than another.

Adult↗
PubMed1982

A study of pethidine kinetics and analgesia in women in labour following intravenous, intramuscular and epidural administration.

1 Epidural administration of opiates for analgesia has recently generated widespread interest and would theoretically be advantageous as a method for relief of pain in labour. 2 Plasma pethidine concentrations were measured after intravenous, intramuscular and epidural administration of pethidine to women in labour and after epidural administration to non-pregnant female surgical patients. 3 Kinetic parameters were derived from the plasma concentration data in each group of subjects and the relationship between plasma kinetics and analgesia in labour were examined. 4 Absorption of pethidine from the epidural space in pregnant women in rapid and excepting the lower initial values, the average plasma concentration and area under the plasma concentration v time curve did not differ significantly (P less than 0.01) from those obtained with intravenous dosage, but were significantly higher (P less than 0.01) during the first 2 h after dosage than the results after intramuscular administration. The analgesia provided by the epidural route of administration was greater than with intravenous or intramuscular administration. 5 It is postulated that the analgesic efficacy of epidural pethidine in women in labour is due to a combination of systemic and local effects and that the local effect is attributable to the local anaesthetic properties of pethidine rather than a selective anti-nociceptive action on the spinal cord.

Anesthesia, Epidural↗
PubMed1981

Comparison of epidural and intramuscular pethidine for analgesia in labour.

Analgesia mediated by a direct spinal action of narcotic drugs administered via the epidural route may have considerable advantages over conventional(conduction block) epidural analgesia in labour. The efficacy, mode of action and placental transfer of epidurally administered narcotics in labour has not yet been established. We have compared the systemic absorption, analgesia and other effects on the mothers and transfer of drug to the fetus in primigravidae who received epidural or intramuscular pethidine 100 mg in labour. The superior analgesia following epidural pethidine did not appear to be attributable to a selective spinal action but rather to higher plasma concentrations of pethidine together with a possible weak regional conduction block due to local anaesthetic action of 1% pethidine solution. Epidural pethidine is not an advantageous method for providing analgesia in labour.

Adult↗
PubMed1980

Lumbar extradural injection pressures in pregnant women. An investigation of relationships between rate of infection, injection pressures and extent of analgesia.

Before the induction of labour in 34 pregnant women 1.5% lignocaine 10 ml was injected into the lumbar extradural space at constant rates between 0.143 and 0.333 ml s-1. Injection pressures and residual pressures were recorded and the extent of analgesia to pinprick was assessed. No significant correlation was found between the rate of injection and injection pressures or residual pressures over the range investigated. Analgesia was significantly more extensive on the side dependent during injections, but there was no significant correlation between the overall extent of analgesia and the rate of injection, injection pressures or residual pressures in the extradural space. It is concluded that there is no advantage from rapid extradural injections.

Adolescent↗
PubMed1980

Topography of the lumbar epidural space. A study in cadavers using injected polyester resin.

Polyester resin was injected into the epidural space of fresh-adult cadavers to study the shape of the lumbar epidural space and the spatial relationship between the dura mater and vertebral canal. In most of the anatomical preparations the shape of the lumbar dural sac was distinctly triangular and in some cases a dorso-median fold of the dura was apparent. These observations support the explanation suggested by others to account for the midline translucency seen in contrast radiological examination of the lumbar epidural space. Factors which may influence the shape and dimensions of the lumbar epidural space are discussed. It is suggested that these anatomical observations may have clinical significance in the practice of lumbar epidural analgesia.

Adult↗
PubMed1980

Failure of epidural morphine to relieve pain in labour.

Lumbar epidural injections of 2 mg preservative-free morphine were given to 10 subjects in established labour. Assessment of pain using a visual analogue scoring system revealed no appreciable relief of pain 30 min after morphine infection. Analgesia was subsequently provided by epidural injection of 8 ml bupivacaine 0.375%. Failure of epidural 2 mg in the treatment of severe pain other than labour. Possible explanations for this discrepancy are discussed.

Anesthesia, Epidural↗
PubMed1980

Prophylaxis for Mendelson's syndrome before elective caesarean section. A comparison of cimetidine and magnesium trisilicate mixture regimens.

A clinical trial was conducted in which patients undergoing elective Caesarean section received eitherrr oral cimetidine 400 mg or magnesium trisilicate mixture BPC 20 ml before anaesthesia. The pH values of gastric fluid were significantly higher and the incidence of pH less than 2.5 was significantly lower in patients who received magnesium trisilicate mixture BPC. No adverse effects were observed in newborn infants whose mothers had received cimetidine and there was no significant difference in pH values of gastric fluid from the newborn in the two groups. The findings suggest that as a means of prophylaxis for Mendelson's syndrome in patients undergoing elective Caesarean section, magnesium trisilicate mixture BPC 20 ml is more effective than a single oral dose of cimetidine 400 mg, administered in the manner described.

Anesthesia, General↗
PubMed1979

Placental intervillous blood flow measured by inhaled 133Xe clearance in relation to induction of epidural analgesia.

A method of determining placental intervillous blood flow (IBF) using an inhaled 133Xe technique is described. The method was used to investigate the effect on IBF of epidural analgesia with an initial dose of 37.5 mg bupivacaine. There was no statistically significant reduction in IBF following the initial dose of bupivacaine in spite of a small but statistically significant reduction in mean blood pressure. There was no significant correlation between the change in mean blood pressure and the percentage change in IBF following epidural block although the single largest percentage reduction in IBF was associated with the largest fall in mean blood pressure.

Adult↗
PubMed1978

Cimetidine as a single oral dose for prophylaxis against Mendelson's syndrome.

Cimetidine, a histamine H2-receptor antagonist which inhibits gastric acid secretion, was administered as a single 400 mg oral dose before anaesthesia to forty-six patients undergoing elective gynaecological surgery. The incidence of gastric residue pH above 2.5 was significantly greater (P less than 0.001) in cimetidine treated patients than in thirty-seven control patients. No patient who received cimetidine between 4 and 6 h prior to anaesthesia had a gastric residue pH less than 2.5. These findings suggest that cimetidine may be effective as a prophylaxis against acid pulmonary aspiration (Mendelson's) syndrome.

Administration, Oral↗
PubMed1977

Intracranial birth trauma in vaginal breech delivery: the continued importance of injury to the occipital bone.

Between 1966 and 1976, postmortem examinations revealed significant intracranial birth trauma in 17 infants delivered breech first and in ten infants delivered head first; separation of the squamous and lateral parts of the occipital bone (occipital osteodiastasis) was found in five of the infants who died after breech delivery. The finding of the lesions in these infants is attributed to the adoption, since 1971, of a postmortem technique involving dissection of the suboccipital region before opening the skull. Review of earlier necropsy reports suggests that the lesion was sometimes missed. Analysis of the fresh stillbirths and neonatal deaths occurring in the 477 vaginal breech deliveries at the Hammersmith Hospital (1966 to 1976) showed that all neonatal deaths in infants weighing more than 3000 g at birth associated with intracranial birth trauma: 2 out of 3 had occipital osteodiastasis which seems to be more common than is generally recognized and is only found with careful autopsy technique.

Adult↗