Browsing by Author "Payne, K. A."

Now showing 1 - 7 of 7
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    Epidural and intramuscular pethidine - a pharmacokinetic study
    (Health and Medical Publishing Group -- HMPG, 1983-02) Payne, K. A.
    Epidural preservative-free pethidine hydrochloride 0,75 mg/kg is rapidly absorbed into the blood. At 1,5 mg/kg the plasma levels reached are similar to those achieved by intramuscular preservative-free pethidine hydrochloride, as is the time course. Plasma levels fall more rapidly after epidural pethidine. Since the plasma levels lag behind the analgesic effects, they are unlikely to be of importance as regards clinical analgesia.
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    Epidural versus intramuscular pethidine in postoperative pain relief
    (1983) Payne, K. A.
    Twenty-one patients received epidural pethidine 0,75 mg/kg in 10 ml normal saline for postoperative analgesia. A control group of 20 patients received intramuscular pethidine 1,5 mg/kg. Respiratory and cardiovascular parameters in both groups were stable, and in both side-effects were similar and not serious. In the epidural group analgesia was more intense and of longer duration and the level of consciousness was better. Central depression was present in both groups but less so in the epidural group.
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    Intramuscular 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.
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    Midazolam premedication in paediatric anaesthesia
    (Health & Medical Publishing Group, 1986) Payne, K. A.; Heydenrych, J. J.; Kruger, T. C.; Samuels, G.
    To investigate the efficacy of midazolam (Dormicum; Roche) as a paediatric premedication, 150 children, aged 6 months - 5 years, were divided into three groups. All three groups spent time with the anaesthetist to allow rapport to be established. Group A received midazolam premedication, group B received oral trimeprazine, droperidol and methadone (TDM) and group C received no sedative medication. Midazolam gave the best behaviour patterns in the holding room. Behaviour at induction was the same in all three groups. The recovery times were similar in the midazolam and unsedated groups, but in the TDM group recovery was significantly delayed. Temperatures remained stable in the unsedated and midazolam groups, but decreased in the TDM group. It is concluded that midazolam is a satisfactory paediatric premedication agent.
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    Obtunding 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.
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    Oral midazolam in paediatric premedication
    (Health & Medical Publishing Group, 1991) Payne, K. A.; Coetzee, A. R.; Mattheyse, F. J.; Dawes, T.
    In a premedication study involving 135 children, aged 1-10 years, four regimens were investigated: (i) no premedication; (ii) oral trimeprazine tartrate 2 mg/kg, methadone 0.1 mg/kg, droperidol 0.15 mg/kg (TMD); (iii) intramuscular midazolam (Dormicum; Roche) 0.15 mg/kg; and (iv) oral midazolam 0.45 mg/kg. All premedications were given 60 minutes before a standard halothane anaesthetic. No impairment of cardiovascular stability occurred but after premedication the mean oxygen saturation decreased by 1.6% and 1.1%, respectively, in the intramuscular midazolam and TMD groups. Overall, children under 5 years of age behaved less satisfactorily in the holding room and at induction, than those over 5 years (P<0.01). Midazolam, intramuscularly and orally, produced more satisfactory behaviour than the other two regimens (P<0.05) and, combined with a 70% more rapid recovery than the TMD regimen (P<0.05), suggests that oral midazolam is a more effective paediatric premedication agent than placebo or TMD.
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    Rural anaesthetic practices in the Western Cape
    (Health & Medical Publishing Group, 1991) Payne, K. A.; Muller, C. J. B.; Coetzee, A. R.
    The findings of specialist anaesthetists on visits to rural towns in the western Cape over 6 years are reported. The importance of academic units communicating with general practitioners, nursing staff and hospital authorities in their own working environment is emphasised. Hospital anaesthetic facilities and general practice anaesthetic methods are discussed and recommendations made and, in addition, common problems that could improve anaesthesia in general practice are summarised.