ABSTRACT
The predicted outcome of anaesthesia and surgery was compared with the immediate outcome in 508 patients by means of two 100 mm linear analogue scales. The results were used to obtain a statistically based rule by which the anaesthetist may consistently select three groups of patients for audit: group 1, patients in whom immediate outcome of anaesthesia and surgery is worse than predicted; group 2, patients whose outcome is better than predicted; and group 3, the remaining patients. The rule, which is simply adapted to departmental audit, does not necessarily need a computer but is suited to the computer as it is numerically based.
Subject(s)
Anesthesia , Medical Audit/methods , Outcome and Process Assessment, Health Care/methods , Adult , Aged , Aged, 80 and over , Computers , Female , Humans , Male , Pilot Projects , Surgical Procedures, OperativeABSTRACT
The absorption of morphine sulphate, given orally as a controlled release preparation, was studied in 10 patients who had undergone peripheral vascular surgery with a standard opioid-based general anaesthetic technique. Serum morphine concentrations were measured (high pressure liquid chromatography) every 2 h for the first 16 h after surgery and the results were strongly suggestive of a decrease in the rate of absorption of morphine in this situation.
Subject(s)
Intestinal Absorption , Morphine/metabolism , Pain, Postoperative/drug therapy , Administration, Oral , Aged , Delayed-Action Preparations , Humans , Middle Aged , Morphine/administration & dosage , Morphine/therapeutic useABSTRACT
Trait anxiety levels (predisposition to anxiety) and personality profiles were recorded in four novice anaesthetists prior to the start of their training in anaesthesia. State anxiety (the extent of anxiety at the moment of testing) was also assessed before and after the transition from accompanied to solo anaesthetic practice. There was no demonstrable difference in anxiety scores as a result of 'going solo' in any subject.
Subject(s)
Anesthesiology/education , Anxiety/diagnosis , Education, Medical, Graduate , Medical Staff, Hospital/psychology , Adult , Humans , Male , Personality Assessment , United KingdomABSTRACT
Nalbuphine 10 mg and morphine 10 mg were compared in a randomised double-blind trial as intramuscular premedication in 50 patients undergoing minor gynaecological surgery. Both nalbuphine and morphine produced significant sedation without anxiolysis as assessed by patient linear analogue scales, but there were no significant differences between the two drugs. Observer ratings demonstrated that nalbuphine produced calm/sleepy patients to a greater extent than morphine. There were no differences in untoward effects produced by each drug.
Subject(s)
Morphinans , Morphine , Nalbuphine , Preanesthetic Medication , Adult , Anti-Anxiety Agents/pharmacology , Clinical Trials as Topic , Dilatation and Curettage , Dizziness/chemically induced , Double-Blind Method , Drug Evaluation , Female , Humans , Middle Aged , Morphinans/pharmacology , Morphine/pharmacology , Nalbuphine/pharmacology , Random Allocation , Sleep/drug effectsABSTRACT
Oral morphine sulphate slow-release (MST) 40 mg and intramuscular morphine sulphate 10 mg, each administered with intramuscular atropine 0.6 mg, were compared in a randomised double-blind trial as premedication agents in 30 patients undergoing abdominal hysterectomy. Both formulations produced sedation but no anxiolysis in the anaesthetic room, as measured by 10 cm, horizontal linear analogue scales. There was no significant difference between the preparations in terms of postoperative pain, recorded either by the linear analogue scales or using a patient questionnaire. The usage of analgesics and anti-emetics postoperatively was comparable in both groups.
Subject(s)
Morphine/administration & dosage , Preanesthetic Medication , Administration, Oral , Adult , Delayed-Action Preparations , Female , Humans , Injections, Intramuscular , Morphine/pharmacology , Pain, Postoperative/prevention & controlABSTRACT
Triazolam 0.25 mg, diazepam 10 mg and placebo were compared in a randomized double-blind trial of oral premedication in 90 patients undergoing minor gynaecological surgery. Both triazolam and diazepam produced a significant sedative effect as measured by patient self assessment linear analogue scales but only diazepam was more anxiolytic than placebo. Psychomotor performance assessed by the letter-search test at 3 and 6 hours after awakening showed a decrement in performance in patients receiving triazolam at 3 hours compared with the two other groups. Triazolam was shown to have a pronounced amnesic effect and whilst it might be used for premedication, its lack of anxiolysis coupled with a significant impairment of psychomotor performance at 3 hours after awakening, render the drug unsuitable for premedication in the short stay patient.
