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Biomedical subjects

W M Woodward

Publications and source records attributed to W M Woodward.

8 recordsLinked to original sources

Propofol infusion vs thiopentone/isoflurane anaesthesia for prominent ear correction in children.

Postoperative nausea and vomiting (PONV) frequently follows prominent ear correction under general anaesthesia in children. In a prospective, single-blind study, we compared the incidence of PONV after propofol infusion anaesthesia with that following thiopentone induction and isoflurane maintenance in 30 children aged from four to 14 years randomly allocated to one of two groups. All the children were mechanically ventilated. Anaesthesia was supplemented in both groups with nitrous oxide and infiltration of the ears using a mixture of bupivacaine, adrenaline, and hyaluronidase. One child receiving propofol (group P) complained of nausea, compared with eight receiving thiopentone/ isoflurane, (group T) (P = 0.005), while three children in group P and ten in group T vomited before hospital discharge, (P = 0.01). Eight children in group P were considered to be fit for discharge on the day of surgery as against four in group T, (not significant). Only four out of twelve children receiving opioid analgesia vomited.

Adolescent↗

Hypoxia and myocardial ischaemia during peripheral angioplasty.

We have used continuous ambulatory electrocardiography and concurrent monitoring of arterial oxygen saturation (SpO2) and non-invasive arterial pressure in a pilot study of 29 unsedated patients undergoing percutaneous peripheral vascular angioplasty. Twelve patients (Group 1) received oxygen 41 min-1 by Hudson mask during the procedure, the remaining 17 patients (Group 2) breathing air. Fourteen patients in Group 2 had an SpO2 of 94% or below during the procedure, compared with two patients in Group 1. Episodes of silent ischaemia were recorded during the procedure in one patient in Group 1 and five patients in Group 2. Administration of oxygen significantly reduced the incidence and severity of hypoxaemia, and may be responsible for the reduction in silent ischaemia.

Adult↗

Exacerbation of post-dural puncture headache after epidural blood patch.

The purpose of this report is to describe a new complication of epidural blood patch for inadvertent dural puncture. A dural tap in an obstetric patient was managed initially with a prophylactic blood patch via the epidural catheter. Despite this, 48 hr later, she developed post-dural puncture headache, neck, and shoulder pain, and was given a second epidural blood patch. This was followed by an immediate and severe exacerbation of her symptoms, which later resolved after the administration of diclofenac. There were no further sequelae. Although severe complications of epidural blood patch are rare, they are alarming. Exacerbation of the original symptoms of post-dural puncture headache caused by, or following, epidural blood patching has not previously been reported.

Adult↗