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Biomedical subjects

W D Owens

Publications and source records attributed to W D Owens.

16 recordsLinked to original sources
PubMed1994

The American Board of Anesthesiology.

The American Board of Anesthesiology (ABA) has been in existence since 1937 for the purpose of advancing the practice of anaesthesiology in the United States. It is a credentialling organization which requires anaesthesiology residency training, medical licensure, and successful completion of written and oral examinations in order for an individual physician to be granted a diploma. Residency training requires four years and must culminate with a satisfactory certificate of clinical competence. The written and oral examinations follow residency training. The ABA also issues subspecialty certificates in critical care medicine and pain management. There is a voluntary mechanism for diplomates to demonstrate continuing qualifications. This is accomplished by peer review and a written examination.

Anesthesiology↗
PubMed1982

Plasma epinephrine and norepinephrine levels during anesthesia: enflurane-N2O-O2 compared with fentanyl-N2O-O2.

During intra-abdominal surgery, plasma levels of norepinephrine in peripheral venous blood were higher in 11 patients who received fentanyl-nitrous oxide-oxygen than in 10 patients who received enflurane-nitrous oxide-oxygen [703 +/- 95 vs 463 +/- 38 (SEM) pg/ml]. At the same time, systolic blood pressure (143 +/- 6 vs 121 +/- 4 torr), mean blood pressure (108 +/- 4 vs 98 +/- 3 torr), and pulse rate (87 +/- 3 vs 98 +/- 4 beats per minute) also differed significantly (p less than 0.05); plasma levels of epinephrine (235 +/- 61 vs 113 +/- 21) did not. These values did not differ significantly between the two groups before induction of anesthesia, after induction but before skin incision, or in the recovery room. These data support the concept that enflurane anesthesia blocks the sympathetic response to surgical stress more effectively than low dose fentanyl anesthesia.

Adult↗
PubMed1979

Glycopyrrolate and cardiac dysrhythmias in geriatric patients after reversal of neuromuscular blockade.

The increase in cardiac muscarinic activity following injection of anticholinesterases can be minimized by the long-acting anticholinergic drug glycopyrrolate. In a series of 50 patients 65 years of age or older who had received glycopyrrolate (0.88 +/- 0.15 mg) mixed with neostigmine (4.40 +/- 0.66 mg) or pyridostigmine (17.46 +/- 2.92 mg) to antagonize neuromuscular blockade, the incidence of new postoperative cardiac dysrhythmias was 16 per cent. All dysrhythmias occurred in patients with pre-existing cardiovascular disease. There was no statistically significant relationship between the incidence of cardiac dysrhythmias and the choice of anaesthetic technique or anticholinesterase drug.

Aged↗
PubMed1978

ASA physical status classifications: a study of consistency of ratings.

The American Society of Anesthesiologists' (ASA) Physical Status Classification was tested for consistency of use by a questionnaire sent to 304 anesthesiologists. They were requested to classify ten hypothetical patients. Two hundred fifty-five (77.3 percent) responded to two mailings. The mean number of patients rated consistently was 5.9. Four patients elicited wide ranges of responses. Age, obesity, previous myocardial infarction, and anemia provoked controversy. There was no significant difference in responses from different regions of the country. Academic anesthesiologists rated a greater number identical than did those in private practice (P less than 0.01). There was no difference in ratings between those who used the classification for billing purposes and those who did not. The ASA Physical Status Classification is useful but suffers from a lack of scientific precision.

Adult↗
PubMed1975

Development of two indices of postoperative morbidity.

Two indices of postoperative morbidity, Nursing Assessment Index and Observed Treatment Index, are described and evaluated in this study of 4,182 consecutive anesthetics. The use of these indices in studies of the quality and effectiveness of surgical and anesthetic care should increase the economy and precision with which the causes of unsatisfactory outcome are identified. Specific illustrations of the relationship of the preanesthetic status of patients to their postoperative morbidity as measured by these indices and mortality rates are given. In addition these two indices of morbidity measured on the seventh postoperative day are shown to be strongly co-related with subsequent in-hospital deaths. Thus, of the 100 patients with a Nursing Assessment Index worse than 3, 19 percent died; only 0.4 percent of the 550 patients who had no morbidity as measured by this index died. Although they ultimately survive, about an equal number of patients become seriously ill as die follow operations.

Anesthesia↗
PubMedDate not supplied

An unusual complication of lumbosacral plexus block: a case report.

Lumbosacral plexus block is a valuable anesthetic technic in the hands of an experineced anesthesiologist. However, as illustrated by this case report, anesthetic dosage must be selected with great care, and patients unable to describe paresthesias should be excluded from use of this procedure.

Aged↗
PubMedDate not supplied

Cardiac dysrhythmia following reversal of neuromuscular blocking agents in geriatric patients.

Ninety-three patients 65 years of age or older were studied to determine the incidence of dysrhymia following administration of 1 of 2 cholinesterase inhibitors, neostigmine or pyridostigmine. The ECG was then continuously monitored for 90 minutes. Neostigmine was associated with a higher incidence of dysrhythmia than was pyridostigmine. Neostigmine administered to patients with pre-existing coronary artery disease and/or conduction defects and to patients with hypertension was associated with a significantly higher incidence of dysrhythmia than was pyridostigmine when administered to patients with the same conditions. The incidence of dysrhythmia in patients who received a halogenated anesthetic was 5 times greater after neostigmine than after pyridostigmine.

Aged↗