Nicholas B Scott

Publications (6)15.79 Total impact

• Article: Spinal analgesia in cardiac surgery.

  Nicholas B Scott
  Journal of cardiothoracic and vascular anesthesia 04/2011; 25(2):388-9; author reply 389-90. · 1.06 Impact Factor
• Article: Femoral nerve block for total knee replacement - a word of caution.

  Mohanasundaram Kandasami, Andrew Wg Kinninmonth, Martin Sarungi, Joseph Baines, Nicholas B Scott
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  ABSTRACT: Femoral nerve block (FNB) is a well documented option for post-operative analgesia following major knee surgery. However, motor blockade may be prolonged preventing early mobilisation thereby increasing the length of stay. In addition, as a consequence of persistent quadriceps weakness, patients have an increased risk of falling. We present a series of five patients who underwent total knee replacement with spinal anaesthesia and FNB who fell, sustaining complete wound disruption - including a patient with peri-prosthetic fracture requiring further surgery and prolonged hospital stay. The literature, which is largely in anaesthetic journals, reflects the high quality of analgesia of FNB but makes little or no mention of the delays or dangers in early mobilization. We believe that the potential risks to orthopaedic patients are underestimated.
  The Knee 12/2008; 16(2):98-100. · 1.74 Impact Factor
• Article: Guillain-Barré syndrome after cardiopulmonary bypass.

  Alison J Campbell, Kenneth McKinlay, Nicholas B Scott
  Journal of cardiothoracic and vascular anesthesia 07/2008; 23(1):82-3. · 1.06 Impact Factor
• Article: Thoracic epidural anesthesia/analgesia for cardiac surgery: don't put down your Tuohy needles yet.

  Nicholas B Scott, Nicholas P Sutcliffe, Stefan Schraag, Kenneth McKinlay, Dominic A A Ray, Adarsh Lal
  Anesthesiology 11/2006; 105(4):853; author reply 854-5. · 5.36 Impact Factor
• Article: Aortic valve repair in a patient with congenital afibrinogenemia.

  Adarsh B Lal, Ram Maruthavanan, Nicholas B Scott
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  ABSTRACT: We describe the management of cardiopulmonary bypass (CPB) in a patient with congenital afibrinogenemia (AF). Although this state is akin to the state after hirudin administration, where CPB has been successfully performed, heparinization is still essential to preserve other clotting factors and prevent excessive bleeding. Aprotinin further helps in preservation of clotting factors. There are case reports of thrombosis associated with AF, but aprotinin can be safely used because it is, by definition, an anticoagulant. Cryoprecipitate effectively restores the fibrinogen and produces normal clotting.
  Anesthesia & Analgesia 01/2006; 101(6):1628-30. · 3.29 Impact Factor
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  Article: The efficacy and safety of three concentrations of levobupivacaine administered as a continuous epidural infusion in patients undergoing orthopedic surgery.

  John A C Murdoch, Ursula K Dickson, Paul A Wilson, Jonathan S Berman, Rita R Gad-Elrab, Nicholas B Scott
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  ABSTRACT: We evaluated the efficacy and safety of three concentrations of levobupivacaine infused epidurally as analgesia for patients undergoing orthopedic procedures. Patients undergoing elective hip or knee joint replacement were enrolled in the study (n = 105). Sensory blockade was established preoperatively with 10-15 mL of 0.75% levobupivacaine. Patients were then randomized to receive 0.0625%, 0.125%, or 0.25% levobupivacaine as a continuous epidural infusion at 6 mL/h for 24 h. IV morphine patient-controlled analgesia was given as rescue analgesia, and time to first request for analgesia and total dose of morphine consumed were recorded. Sensory blockade, motor blockade, visual analog scale pain score, and cardiovascular variables were also recorded at regular intervals postoperatively. Ninety-one patients were included in the primary intent-to-treat analysis. Total normalized dose of morphine, number of patient-controlled analgesia requests, and overall postoperative visual analog scale pain scores were significantly lower for the 0.25% group compared with the other two groups, and the time to first request for rescue analgesia was longer. There was no significant difference between the 0.125% and 0.25% groups in terms of maximum motor blockade achieved and time to minimal motor blockade. Safety data were equivalent among the three groups. We conclude that levobupivacaine as a continuous epidural infusion provided adequate postoperative analgesia and that the 0.25% concentration provided significantly longer analgesia than 0.125% or 0.0625% levobupivacaine without any significant increase in detectable motor blockade relative to the 0.125% group. IMPLICATIONS: Postoperative epidural infusion of levobupivacaine can provide safe and effective analgesia for patients having hip or knee joint replacement. Of the three concentrations we infused at a constant rate, 0.25% provided significantly better pain relief.
  Anesthesia & Analgesia 03/2002; 94(2):438-44, table of contents. · 3.29 Impact Factor