Articles: patients.
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Patients, as the recipients of medical care, have a unique and crucial perspective from which to judge the performance of physicians. In this study, 27 interns (postgraduate year 1 residents) were evaluated by a sample of 212 medical inpatients at two university-affiliated hospitals using a previously validated questionnaire constructed from patients' comments. Patients were generally very satisfied with the performance of their interns and valued traditional clinical skills and interpersonal skills equally. ⋯ Encouraging mutuality by the interns was not often done and was not believed to be particularly important by patients. Older patients and whites were more satisfied with their interns, whereas college-educated, employed, and male patients were less satisfied. Implications of the findings for understanding and teaching about the physician-patient relationship are discussed.
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Subcutaneous self-administration of morphine with a "pain pen", a semiautomatic mechanical injection system about the size of a penholder, was tested in nine patients with severe chronic pain of malignant origin. During a period of treatment of 12-100 days (on an outpatient basis in three patients) side-effects of subcutaneous morphine could only be observed during a short-lasting initial period of adaptation. ⋯ There were no hygienic problems, and the patients learned the technique of self-injection within a few days. This system may be especially suitable for patients with gastrointestinal incompatibility of oral opiate preparations, e.g. patients with multiple drug intake.
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Journal of anesthesia · Sep 1987
Tracheal tube cuff pressure--study on tube size and inflating gases.
The effect of nitrous oxide on the cuff pressure was studied from the following points of view. One was the size of tubes and the type of cuff. The other was the effects of different gas mixture in the cuff. ⋯ In the group of air, the cuff pressure increased as well as experiment I. However in the group of mixtured gas, there were almost no changes in the cuff pressure. This means that if the cuff is inflated with a mixtured gas in which nitrous oxide is under the equivalent condition, the cuff pressure would not change.
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Journal of anesthesia · Sep 1987
Epidural pressure and its relation to spread of epidural analgesia.
The relationships between the epidural pressures following the injection of local anesthetic solution and the spread of epidural analgesia were investigated. In 46 patients, 15 ml of 2% mepivacaine was injected into the lumbar epidural space at a constant rate (1 ml/sec) using an electropowered syringe pump. Injection pressures and residual pressures were recorded and the spread of analgesia to pinprick was assessed. ⋯ The spread of analgesia closely correlated with the epidural pressures during and following the injection of local anesthetic solution. The most close correlation was found between the epidural pressure immediately after the completion of injection and the spread of analgesia (r = -0.5659, P < 0.001). In conclusion, the lower the terminal injection pressure and the residual pressures associated with higher age, the wider the spread of epidural analgesia.