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Biomedical subjects

T M Savege

Publications and source records attributed to T M Savege.

At least 19 recordsLinked to original sources
PubMed1991

Intramuscular injections through indwelling cannulae.

A study was performed to establish the feasibility of an indwelling intramuscular cannula for the administration of post-operative analgesic and anti-emetic medication. One-hundred cannulae were inserted for periods up to 7 days (mean = 2.4). A mean of five and maximum of 15 injections were made through each cannula with a maximum volume in any patient of 29 ml. On 18 occasions cannulae were removed for minor complications; no serious complications were seen. This technique may be useful for administration of intramuscular analgesic and anti-emetic medications in the post-operative period.

Adolescent↗
PubMed1985

Endocrinological effects of intrathecal morphine.

This study was designed to evaluate the metabolic effects of intrathecal morphine in patients undergoing coronary artery surgery. Ten patients received 4 mg preservative-free morphine in 6 ml saline intrathecally before surgery and were compared with 10 patients anaesthetised in a similar manner, though without intrathecal morphine. Catecholamines, cortisol and glucose measurements were made during surgery and for 24 h post-operatively. The control group had a higher post-operative requirement for papaveretum, indicating that intrathecal morphine provided some post-operative analgesia. In the period from end of surgery to 5 h after surgery, cortisol secretion was suppressed in the intrathecal morphine group.

Adult↗
PubMed1985

Intrathecal morphine in cardiac surgery.

The effects of intrathecal morphine in 60 patients undergoing open-heart surgery were studied in an observer-blind control trial. The patients were randomly allocated into three groups of 20 each: (A) Control, (B) 2 mg and (C) 4 mg of intrathecal morphine. This study confirms that intrathecal morphine provides useful post-operative analgesia. Patients given intrathecal morphine required less postoperative analgesia and sedation and their respiratory function tests were less depressed than the control group. Since the completion of this study, reports have suggested that 1 mg of morphine intrathecally avoids the serious complications of respiratory depression. In the study described, the patients were electively ventilated post-operatively and respiratory depression was therefore not a problem. Of the other associated side-effects of intrathecal morphine, vomiting (20%) and pruritus (20%) proved the most troublesome.

Adolescent↗
PubMed1983

Influence of sample site on blood concentrations of ICI 35868.

Simultaneous blood samples from an artery, a peripheral vein and a central vein were analysed for ICI 35868 concentrations following an induction dose of 2.0 mg kg-1 administered i.v. over 60 s, to five patients before cardiac surgery. Up to 60 s after the end of the administration of the drug there were wide differences in drug concentration between the sampling sites. Thus, any attempt to correlate effect with blood concentration over this early period would be problematic. From 60 s there were no significant differences in drug concentration between the three sites. Thus, as long as the mixing period is allowed for, peripheral venous sampling provides an acceptable alternative to arterial puncture in studies to correlate drug effect and concentration and for pharmacokinetic investigations.

Adult↗
PubMed1982

Comparison of the cerebral function monitor and plasma concentrations of thiopentone and alphaxalone during total i.v. anaesthesia with repeated bolus doses of thiopentone and althesin.

Repeated bolus doses of thiopentone or Althesin were administered to 10 patients every 240 s while cerebral electrical activity was recorded with the Cerebral Function Monitor (CFM). Peripheral venous blood samples were collected at 60 and 225 s after each bolus dose for the measurement of plasma concentrations of the drugs. Significant correlations in the range r = 0.56-0.96 (P = 0.02-0.00001) between plasma thiopentone or alphaxalone concentrations and the upper and lower edges of the CFM trace were found. For the patients with relatively poor correlations, better correlations were obtained when 60- and 225-s sample were analysed separately.

Alfaxalone Alfadolone Mixture↗
PubMed1981

A study of three doses of ici 35 868 for induction and maintenance of anaesthesia.

Three doses (1.5, 2.0 and 2.5 mg kg-1) of diisopropyl phenol (ICI 35 868) were compared for induction and maintenance of anaesthesia in healthy females undergoing short gynaecological procedures. Induction of anaesthesia was smooth and rapid. Cardiovascular changes (which were dose-dependent) included a decrease in arterial pressure and an increase in heart rate. These changes were magnitudes comparable to those reported for other induction agents. Recovery from the effects of the drug was rapid and uneventful.

Adult↗
PubMed1979

Cardiorespiratory changes following induction of anaesthesia with etomidate in patients with cardiac disease.

The cardiorespiratory effects of etomidate were measured in two groups of six patients with aortic or mitral valve disease. The induction of anaesthesia with etomidate 0.3 mg kg-1 was followed by a second dose 10 min later. After the first dose, a 19% decrease in systemic arterial pressure was associated with a decrease in systemic vascular resistance and left ventricular heart work. Cardiac index, pulmonary artery pressure and wedge pressure all decreased slightly. Central venous pressure and heart rate did not change. A slight increase in respiratory frequency failed to prevent an increase in PACO2. Changes after the second dose were similar. The two groups of patients did not differ significantly in their response to etomidate. No patient complained of pain during injection, nor did myoclonic movements occur.

Aged↗
PubMed1978

Preliminary investigation into a new method of assessing the quality of anaesthesia: the cardiovascular response to a measured noxious stimulus.

It is suggested that the autonomic response to noxious stimulation may be measured during anaesthesia. The response may be marked despite considerable depression of cortical activity as measured by the cerebral function monitor. Preliminary results suggest that large doses of narcotic analgesics reduce the autonomic response to noxious stimulation and this may be used as a test to compare the potency and duration of action of narcotic drugs during anaesthesia. It is possible that the measurement of beat-to-beat variation in heart rate may be used to monitor autonomic nervous system activity and, indirectly, the degree of stress during surgery, provided that the efferent limb of the reflex arc remains intact. With the aid of the cerebral function monitor and with an index of reflex response to noxious stimulation it should be possible to monitor the effect of anaesthesia on the central nervous system more precisely.

Alfaxalone Alfadolone Mixture↗
PubMed1978

Assessment of recovery from short anaesthesia using the cerebral function monitor.

In 18 females undergoing minor gynaecological surgery, recovery from anaesthesia, which included methohexitone, has been assessed using: clinical examination, six different psychomotor tasks and, in six patients, e.e.g. The cerebral function monitor (CFM) was used also to determine its value in such patients. Clinical signs and the results of performance tests returned to the pre-anaesthetic values 2 h following anaesthesia, but CFM tracings were still significantly different at 8 h (P less than 0.05). Similar changes in e.e.g. were significant only in the first 2 h; this may be a result of the visual analysis of the traces. The results suggest that CFM is a sensitive indicator of persistent effects of anaesthesia.

Adult↗
PubMed1977

Etomidate in electroconvulsive therapy. A within-patient comparison with alphaxalone/alphadalone.

In a group of 31 patients undergoing electroconvulsive therapy, there was no significant difference between the times of return of eyelash reflex, swallowing and respiration following a single induction dose of 0.2 mg/kg of etomidate as compared with an induction dose of 0.036 ml/kg of alphaxalone/alphadalone. The incidence of involuntary movements and increased muscle tone was significantly greater after etomidate than following alphaxalone/alphadalone; but the involuntary movements were never marked. The overall incidence of pain on injection was 15% after etomidate. There was a low incidence of venous sequelae following either drug.

Adolescent↗
PubMed1976

A comparison of some cardiorespiratory effects of althesin and ketamine when used for induction of anaesthesia in patients with cardiac disease.

Cardiorespiratory effects of ketamine and Althesin were measured in two groups of premedicated patients with cardiac disease. The drugs were given in clinically equivalent doses with a second dose administered about 10 min after induction. The first dose of ketamine caused a marked increase in systemic and pulmonary arterial pressure, heart rate, and central venous and wedge pressures and cardiac index. The first dose of Althesin caused a decrease in systemic arterial pressure, central venous pressure, cardiac index and heart work, but little change in heart rate. The second dose of induction agent was administered before the cardiorespiratory effects of the initial dose had resolved. The second dose of Althesin caused changes similar to those following the first dose, but less marked. The changes following the second dose of ketamine were opposite to those following the first dose.

Alfaxalone Alfadolone Mixture↗
PubMed1976

A comparison of oesophageal and central venous pressures in the measurement of transpulmonary pressure change.

Oesophageal (oes) and central venous pressure (CVP) were compared as indices of transpulmonary pressure change (deltap). The mean increase of deltaPoes over deltapCVP was 2.8 cm H2O. The size and variability of the increase were similar to the expected difference between oesophageal and pleural pressure fluctuations occurring in the supine patient. Central venous pressure may be more accurate and reliable than oesophageal pressure for estimations of transpulmonary pressure change in the supine position.

Aged↗