Browsing by Author "Murray, W. B."
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- ItemAnaesthesia for microsurgery(Health and Medical Publishing Group -- HMPG, 1985-04) Jakubowski, M.; Lamont, A.; Murray, W. B.; De Wit, S. L.The data from a retrospective study of 32 anaesthetics administered for free-flap tissue operations are analysed. We suggest balanced analgesic-dominated general anaesthesia, supported wherever possible by continuous regional block. Special attention is paid to full control over the cardiovascular system and the haemodynamics, including the microcirculation and optimal rheological properties of the blood, as well as metabolic ability. Our results suggest that factors such as adequate infusion therapy guided by central venous pressure and urinary output and strict body temperature control, supplementary use of regional blocks and peri-operative use of dextran 40 (Rheomacrodex) can contribute significantly towards the overall success of free-flap surgery.
- ItemIntramuscular buprenorphine compared with morphine for postoperative analgesia(Health & Medical Publishing Group, 1987) Payne, K. A.; Murray, W. B.; Barrett, H.The postoperative analgesic efficacy of buprenorphine (Temgesic; R & C Pharmaceuticals) 0,004 mg/kg and morphine 0,15 mg/kg were compared in 60 patients, both agents given by intramuscular injection. According to patients, buprenorphine gave better analgesia. There was no difference in the number of analgesic injections the two groups received in the 24-hour postoperative period. Cardiovascular and respiratory system were not depressed by either drug. Side-effects were not marked, nausea being the most common in both groups. Morphine had a greater effect on the mood of patients. Buprenorphine proved a satisfactory analgesic for postoperative use by intramuscular injection.
- ItemObtunding the sympathetic response to intubation : experience at 2 minutes after administration of the test agent in patients with cerebral aneurysms(Health & Medical Publishing Group, 1988) Payne, K. A.; Murray, W. B.; Oosthuizen, J. H. C.The sympathetic response to laryngoscopy and intubation was studied in 39 patients who were to undergo surgical clipping of a cerebral aneurysm. Intravascular radial artery pressure and ECG monitoring for ST-segment changes or dysrhythmias were used. Ward blood pressures were controlled on bed rest and labetalol. Induction of anaesthesia was with pentothal 4 mg/kg and suxamethonium 1 mg/kg intravenously. This was followed by one of the following intravenous agents by random choice: alfentanil 30 μg/kg, fentanyl 5 μg/kg, lignocaine 2 mg/kg, and lignocaine 10% spray 2 mg/kg to the larynx. ECG changes at laryngoscopy and intubation were minimal. Intubation produced an immediate increase in blood pressure and pulse rate, maximal at 30-60 seconds, falling rapidly towards normal within 2-3 minutes. Alfentanil was very effective in obtunding this response with stable cardiovascular parameters; fentanyl produced a more variable response; and intravenous lignocaine was less satisfactory. Lignocaine spray was ineffective.
- ItemPrevention of post-tonsillectomy pain with analgesic doses of ketamine(Health & Medical Publishing Group, 1987-12) Murray, W. B.; Yankelowitz, S. M.; Le Roux, M.; Bester, H. F.ENGLISH ABSTRACT: The prevention of postoperative pain in children who had undergone tonsillectomy was investigated in a double-blind trial. Ketamine (Ketalar; Parke-Davis) 0.5 mg/kg was given intravenously before the operation to 20 children and saline to a control group of 20 children. Premedication consisted of oral trimeprazine 4 mg/kg given 2 hours pre-operatively. The anaesthetic technique was standardised. There were no significant differences between the groups pre- or intra-operatively. Postoperatively there were significant differences in the measurement of pain but not in that of sedation. No hallucinations were encountered in those receiving ketamine. It is concluded that analgesic doses of ketamine are safe and effective.
- ItemShould we pre-oxygenate?(Health & Medical Publishing Group, 1981) Erasmus, F. R.; Murray, W. B.The importance of routine pre-oxygenation before induction of anesthesia was demonstrated in animals. The onset of dangerous levels of hypoxia after the administration of suxamethonium can be delayed considerably by the administration of pure oxygen for 5 minutes before induction. This allows time for an atraumatic and panic-free intubation before controlled ventilation. After pre-oxygenation the volume of oxygen in the functional residual capacity of the lungs shows a sixfold increase. This is the principal oxygen stored during apnea.