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Biomedical subjects

W R MacRae

Publications and source records attributed to W R MacRae.

At least 19 recordsLinked to original sources
PubMed1996

Anaesthesiological manpower in Europe.

Information about physician anaesthesiologist manpower in the countries of the European Union was collected from questionnaires sent to the delegates representing their respective countries on the European Board of Anaesthesiology. In the countries of the European Union and Switzerland and Norway 40,259 specialist anaesthesiologists are recorded. The number of anaesthesiologists in relation to population varies between as little as 4.4 and 4.6 (Ireland and UK) and as many as 15.6 (Italy), with a mean of 10.8/100,000 inhabitants. There are 11,610 physicians recorded in training in anaesthesiology. The ratio of trainees to specialists in the European Union countries was 28.8/100, varying from as low as 6.5 in France, to as high as 96.7 and 98/100 in Ireland and the UK respectively. These figures indicate a wide difference in the numbers of specialists and trainees between the European countries studied. However, the overall mean figure is close to that reported in the USA (9.2/100,000).

Adult↗
PubMed1987

Acute beta-adrenoreceptor blockade and induced hypotension.

Thirty patients scheduled for major middle ear surgery and induced hypotension, with a trimetaphan/sodium nitroprusside infusion, were randomly allocated to receive a single oral dose of beta-adrenoreceptor antagonist 2 hours before surgery. In group 1 ten patients received metoprolol 50 mg, in group 2 ten patients received metoprolol 25 mg and in group 3 ten patients received oxprenolol 20 mg. There were ten controls for each group. The nitroprusside infusion rate was significantly reduced in groups 1 and 3. However, there was an unacceptably high incidence of profound bradycardia after induction of anaesthesia in those patients who had received beta-adrenoreceptor antagonists pre-operatively and this technique is not recommended for routine use.

Adolescent↗
PubMed1985

Induced hypotension.

The use of induced hypotension in the hands of a competent anaesthetist combined with the careful technique of a surgeon skilled in operating under these conditions can aid surgical access, improve delineation of pathology, and reduce levels of blood loss, all of which are to the advantage of the patient. These advantages should encourage surgical and anaesthetic teams to become accomplished exponents of the art.

Anesthesia, General↗
PubMed1983

Haemodynamic effects of induced hypotension with a nitroprusside-trimetaphan mixture.

The haemodynamic effects of a 10:1 mixture of trimetaphan and nitroprusside have been studied before and during the course of surgery, in 12 patients placed in 5 degrees reverse Trendelenburg position. Six patients breathed spontaneously and in six the lungs were ventilated artificially. The mixture had a potent hypotensive action that was almost as rapid in onset and recovery as that produced by nitroprusside alone, but the required dose of each drug was decreased considerably. In patients breathing spontaneously, cardiac output remained unchanged on the induction of hypotension, but it decreased significantly in the IPPV group. Heart rate increased, and stroke volume, peripheral resistance and central venous pressure decreased in both groups. The start of surgery was associated with a need to increase the dose of the hypotensive mixture, and with a further increase in heart rate and decrease in stroke volume. Levelling the operating table produced an increase in cardiac output and discontinuation of the mixture resulted in a rapid return of all measurements towards control values.

Adult↗
PubMed1981

Induced hypotension with a mixture of sodium nitroprusside and trimetaphan camsylate.

Thirty patients undergoing induced hypotension were given a 10:1 mixture of trimetaphan camsylate and sodium nitroprusside by intravenous infusion. A readily controllable hypotension was produced with considerable reduction in the dosage of these drugs compared to their used individually. There were no cases of prolonged hypotension.

Adolescent↗
PubMed1980

Clinical applications of sodium nitroprusside.

Sodium nitroprusside has its place in two main spheres of medical practice. It is used for the production of deliberate hypotension during anaesthesia to reduce surgical bleeding, and in the management of the acute phase of certain cardiac conditions. This paper considers the value of the drug separately in these two clinical situations.

Blood Pressure↗
PubMed1979

Metabolic effects of induced hypotension with trimetaphan and sodium nitroprusside.

In two groups of patients undergoing induced hypotension with sodium nitroprusside or trimetaphan blood concentrations of lactate, pyruvate and standard bicarbonate did not differ significantly between the groups. In the nine patients who received trimetaphan there was a progressive, but statistically non-significant, decrease in mean lactate. Nitroprusside (15 patients) was associated with a small increase in mean lactate, but at low dosage there was a small decrease. No relationship to dose rate of nitroprusside was found with these short-term infusions. It is concluded that sodium nitroprusside can be used safely for induced hypotension at doses less than 1.5 mg kg-1 and that simple blood-gas analysis is adequate for the assessment of toxic effects when greater doses are given.

Adolescent↗
PubMed1975

Blood-gas changes during induced hypotension with sodium nitroprusside.

A blood-gas study of the respiratory effects of sodium nitroprusside during anaesthesia has shown a marked reduction in PaO2 when the drug was administered. After nitroprusside PaO2 returned to the previous values. It is suggested that the reduction in PaO2 is a result of an increased scatter of ventilation/perfusion relationships in the lung. The reduction in PaO2 was evident during both spontaneous and artificial ventilation. Nitroprusside was associated with a small decrease in actual bicarbonate.

Adolescent↗