The use of opioids in neonates. A retrospective study of 933 cases

This is a retrospective study on the use of postoperative opioids in neonates admitted to the surgical intensive care unit at Great Ormond Street over a 5-year period (1980-84). A total of 131 (14%) babies received opioids out of 933 neonates admitted to the unit. The use of opioids increased from 9.7% to 27.2% of admitted cases during the survey period. Postoperative ventilation of the lungs was necessary in 240 (25.7%) cases and 88 (36.6%) of these were given opioids. Four babies initially failed to wean from controlled ventilation as a result of opioid induced respiratory depression. A total of 51 (7.35%) spontaneously breathing neonates received opioids and seven (13.7%) of these developed apnoea or respiratory failure thought to be induced by opioids. The administration of opioids by nurses occurred most frequently in the late evening and early hours of the morning, when medical cover is at its lowest level.     

A Brief, Intensive, Clinically Focused Geriatrics Course During the Third Year of Medical School

During the next several decades, the aging of the "baby boom" generation in the United States will result in a dramatic increase in the number of patients aged 65 and older seeking medical care, but current projections suggest that the shortage of geriatrics-trained specialists will only worsen during this time period. As a result, the care of elderly patients will largely fall to other types of physicians. Consequently, it is imperative that medical school training include exposure to the basic skills needed to care safely for older adults. This goal is challenging, because the number of geriatric medicine faculty in most academic medical centers is small, and multiple other medical specialties are also vying for time in a busy medical school curriculum. Whether a 3-day course conducted during the third year of medical school could teach basic principles of geriatric medicine in a time- and manpower-effective manner was explored. It was found that even this brief exposure to geriatrics could have meaningful effects on student knowledge of and comfort with geriatrics.     

盐酸放线瑞香宁的紫外二阶导数光谱法测定及在兔体内的药代动力学

盐酸放线瑞香宁(actinodaphine-HCl)系从莲叶桐科青藤属植物黑吹风(Illigera khasiana C.B Clarke)中分离提取而得的有效成分,结构式如图1。药理试验证明有解热、镇痛、解痉等作用。本文报告用紫外二阶导数光谱法研究盐酸放线瑞香宁在兔体内的药代动力学结果。家兔4只,体重2.8±0.6kg。盐酸放线瑞香宁由本所植化室提供。氯仿、乙醇均为A.R。Perkin-Elmer型紫外—可见光分光光度计系美国产品。     

Papaveretum infusions in infants under 6 months of age

The effectiveness of a continuous low dose papaveretum infusion for the relief of postoperative pain was assessed in 29 infants aged 1-6 months nursed on the infant surgical ward following major abdominal surgery. Trained nursing staff were able to adjust the dosage within prescribed guidelines and satisfactory analgesia was obtained with a regimen which delivered up to 0.0375 mg/kg/hour, approximately half the dose recommended in children older than 12 months. There was one case of clinically significant respiratory depression.