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  • 1
    Electronic Resource
    Electronic Resource
    The effect of fentanyl administered epidurally by patient-controlled analgesia, continuous infusion, or a combined technique of oxyhaemoglobin saturation after abdominal surgery (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aims of this study were to determine the effect of three different modes of epidural administration of fentanyl on oxyhaemoglobin saturation and pain control. Forty-three patients undergoing elective abdominal surgery were randomly allocated to the following groups: (1) continuous infusion of fentanyl at a rate of 50 μg.h−1 with additional epidural boluses (25 μg.Ug) as required; (2) patient-controlled analgesia using a 25 fig epidural bolus of fentanyl with a 15 min lockout period; (3) a combination of patient-controlled analgesia and continuous infusion. Oxyhaemoglobin saturation was measured by continuous computerised pulse oximetry for 48 h after operation together with pain and sedation scores. In the first 24 h after surgery patients in the continuous infusion group spent a significantly greater proportion of time below oxygen saturations of 94% and 85% than those in the other two groups. On day 2 all oxygen saturation measurements were worse than during day 1, but differences between groups were not significant. Those patients receding patient-controlled analgesia required significantly less fentanyl than patients in either of the other groups (p 〈 0.05). However, the mean pain and sedation scores did not differ significantly between the three treatment groups. There was no association between total fentanyl dose and oxygen saturation values. Overall, self-administered fentanyl appeared to cause less oxyhaemoglobin desaturation than nurse-administered analgesia without any loss of analgesic effect.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb06784.x
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  • 2
    Electronic Resource
    Electronic Resource
    An automated system for testing the accuracy of patient-controlled analgesia devices (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A system was developed to test the accuracy of patient-controlled analgesia devices in situations simulating clinical use. Bolus requests are made automatically at predetermined intervals, and the infusate delivered is measured and recorded without the need for operator presence. To ensure clinical relevance, the bolus request times used in this study corresponded to a pattern typical of those requested by patients on the ward. Graseby, Abbott Provider 5500 and IVAC patient-controlled analgesia devices were tested and found to deliver reasonably accurately over a 24 h period. However, when an infusion was started in an unprimed system or after a period of no bolus requests in a bolus-only mode the Graseby and IVAC machines under-delivered. This system provides a means of testing patient-controlled analgesia devices operating in any delivery mode.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1992.tb02394.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Evaluation of the influence of movement on saturation readings from pulse oximeters (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This study aimed to develop a protocol for assessing the influence of movement on oxyhaemoglobin saturation readings from pulse oximeters. Thirty-six volunteers took part in the study. In each volunteer, each hand was monitored by both a Nellcor N200 oximeter using a disposable probe and by a Datex Satlite DS103 oximeter using a clip-on finger probe. Volunteers made five standardised movements during which output was recorded from all four oximeters. All movements were associated with apparent decreases in oxyhaemoglobin saturation which were statistically significant for two movements with the Nellcor equipment and for four movements with the Datex equipment. Movement was associated with increases in the magnitude of pulse amplitude, but this was not quantitatively associated with magnitude of artefactual changes in saturation. Use of this standardised movement protocol allows quantification of movement artefact from pulse oximeters and should facilitate the development of equipment less affected by movement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb05998.x
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  • 4
    Electronic Resource
    Electronic Resource
    Oxyhaemoglobin saturation following elective abdominal surgery in patients receiving continuous intravenous infusion or intramuscular morphine analgesia (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Oxygen saturation was continuously measured using computerised pulse oximetry for 8 h overnight pre-operatively and for the first 24 h postoperatively in 40 patients receiving intermittent intramuscular morphine or continuous infusion of morphine following elective upper abdominal surgery. The proportion of time with an oxygen saturation less than 94% was used as an index of de'saturation. Patients receiving continuous infusion analgesia received a larger morphine dose and achieved better analgesia than the intramuscular group. Postoperatively, the duration of desaturation increased 10-fold over pre-operative values, ‘intramuscular’ patients spending 39.0% (SD, 37.0%) and ‘continuous infusion’ patients 40.0% (SD, 37.5%) of the time below 94% saturation. Although newer therapies (e.g. epidural analgesia and patient-controlled analgesia) are currently receiving greater attention, the sequelae of these more traditional analgesic techniques warrant further study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1992.tb02131.x
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  • 5
    Electronic Resource
    Electronic Resource
    Dynamic calibration of mechanically, air- and electromagnetically braked cycle ergometers (1998)
    Springer
    European journal of applied physiology 78 (1998), S. 346-352 
    Details
    ISSN: 1439-6327
    Keywords: Key words Torque balance ; Dynamic calibration rig ; Power output calibration ; Cycle ergometers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study we measured the accuracy of the following types of cycle ergometer against the criterion of a dynamic calibration rig (DCR): 35 friction-braked (Monark), 5 research-grade air-braked (Repco) and 5 electromagnetically braked (2 Siemens, 1 Elema-Schonander, 1 Ergoline, l Warren E. Collins). Monark ergometer power outputs over the range 58.9–353.2 W significantly (P 〈 0.001) underestimated those registered by the DCR with mean accuracies of 91.7–97.8%. The least accurate individual reading for each of the six up-scale (0–353.2 W) power outputs ranged from 81.6␣to␣91.6%; corresponding down-scale (353.2–0 W) accuracies were 85.1–92.5%. A hysteresis effect was furthermore evident for this ergometer in that up-scale measurements were significantly (P 〈 0.05) greater than down-scale ones. In addition, when the oldest [mean (SD): 11.3 (2.3) years old] and newest [1.4 (0.8) years old] eight ergometers were compared, the latter were significantly (P 〈 0.05) more accurate over the range 117.7–294.3 W. Apart from the two lowest power outputs of 47␣W (62.2–96.0% accuracy) and 127 W (88.0–97.7% accuracy), the individual up-scale and down-scale accuracies of the Repco ergometers ranged from 98.0 to 104.2% for power outputs of 272.7–1137.8 W and the means were not significantly different from those of the DCR. There was also no evidence of hysteresis. Except for the initial power output of 50 W (40 rev/min: 83.8–99.2% accuracy; 60 rev/min: 93.2–122.6% accuracy), the␣individual accuracies of the electromagnetically braked ergometers ranged from 89.3 to 101.4% over the up-scale range of 100–400 W, and none of the means were significantly different from those of the DCR. The variability of individual errors for the preceding data emphasises that all cycle ergometers should be validated against the criterion of a DCR if accurate power outputs are required.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004210050430
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  • 6
    Electronic Resource
    Electronic Resource
    The uptake and elution of lignocaine and procainamide in the hindquarters of the sheep described using mass balance principles (1988)
    Springer
    Journal of pharmacokinetics and pharmacodynamics 16 (1988), S. 31-40 
    Details
    ISSN: 1573-8744
    Keywords: lignocaine ; procainamide ; pharmacokinetics ; mass balance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Mass balance principles were used to describe the uptake and elution of lignocaine (lidocaine) and procainamide in the hindquarters of the sheep. Each of four sheep received a right atrial infusion of either lignocaine · HCl (2.7 mg/min) or procainamide · HCl (5.5mg/min) for 180 min. Paired arterial and inferior vena cava (draining the hindquarters) blood samples were taken at 20-min intervals during the infusion and for 180 min after the infusion. Lignocaine and procainamide mean total body clearances were 2.9 L/min (SD 1.1) and 1.3 L/min (SD 0.2), respectively. An index of the uptake and elution of these drugs in the hindquarters was estimated from the net drug mass per unit hindquarter blood flow;indirect evidence suggested that hindquarter blood flow was constant. All the net mass/flow of procainamide that was taken into the hindquarters during the infusion also eluted after the infusion, demonstrating reversible distribution into the tissues. However, uptake of procainamide was still occurring when blood concentrations were constant, indicating that the concentrations of procainamide in the hindquarters were not in equilibrium with the inferior vena cava concentrations. Lignocaine did not reach constant blood concentrations during the infusion and showed no tendency to reach arteriovenous equilibration; an arteriovenous difference of 22%(SD5%) across the hindquarters was measured during the last 60 min of the infusion. By 180 min after the lignocaine infusions, 79% (SD 8%) of the lignocaine net mass/flow had not eluted from the hindquarters when arterial and venous lignocaine concentrations were not significantly different. This drug could remain uneluted due to metabolism and/or avid tissue binding, and presents difficulties in the interpretation of pharmacokinetic data whether based on arterial or venous blood sampling.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01061861
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    Paper (German National Licenses)
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