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Biomedical subjects

A Baraka

Publications and source records attributed to A Baraka.

At least 325 records · Page 18Linked to original sources
PubMedDate not supplied

Oxygen-jet ventilation during tracheal reconstruction in patients with tracheal stenosis.

Intermittent jets of O2 at 60 psi via a small bore (5 mm), cuffed tracheal tube have been used relaxants to ventilate adult patients with tracheal stenosis undergoing surgical resection and reconstruction. Before resection, the tube was maintained proximal to the stenosis. During resection and reconstruction, the tube bypassed the resected gap into the distal tracheal segment. The technic allows the surgeon to mobilize, resect, and reconstruct the trachea around the small tube in an unhurried manner, and provides adequate ventilation and oxygenation throughout the procedure.

Adult↗
PubMedDate not supplied

Control of gastric acidity by glycopyrrolate premedication in the parturient.

The effect of premedication with the anticholinergic quaternary ammonium compound, glycopyrrolate (0.4 mg), on gastric juice pH was investigated in 23 parturients scheduled for elective cesarean section under general anesthesia, and the results were compared to a control group of 15 nonpremedicated obstetric patients and 25 parturients premedicated with atropine (0.6 mg). In the nonpremedicated control group, the mean gastric juice pH was 2.36 (SE +/- 0.23), 66% having a pH less than the critical level of 2.5. Premedication with atropine did not significantly increase the gastric pH, while in those premedicated with glycopyrrolate, the mean pH increased to 3.7 (+/- 0.35), and the incidence of pH less than the critical level dropped to 34%. The effect of glycopyrrolate on gastric juice pH was significantly increased when the premedication-induction time was prolonged to 60 to 120 minutes. It was concluded that glycopyrrolate premedication can be used in the parturient as an additional measure to safeguard against acid-aspiration syndrome.

Anesthesia, Obstetrical↗
PubMedDate not supplied

Laparoscopic splenectomy in a patient with acquired angioneurotic edema.

BACKGROUND: We report the case of a 77-year-old female with acquired angioneurotic edema, C1 esterase inhibitor level = 4mg/dL, who was scheduled to undergo laparoscopic splenectomy. METHODS: In the operating room, we administered on call 500 units (UI) of C1 esterase inhibitor concentrate intravenously. Intraoperative hemodynamic instability and generalized blood oozing improved following the administration of aprotinin 250000 UI intravenous (IV) drip. CONCLUSION: We recommend the administration of an antifibrinolytic agent in addition to C1 esterase inhibitor concentrate in patients with acquired angioneurotic edema.

Aged↗
PubMedDate not supplied

Gall-bladder interposition: a rare anomaly of the extrahepatic ducts.

Abnormalities in bile ducts pattern occur frequently enough to merit importance during cholecystectomy. A patient with anomalous insertion of both hepatic ducts into the gall-bladder with the cystic duct replacing the common bile duct is described. This case, and related anomalies of the bile ducts, are sufficiently important for us to ascertain their location and pattern prior to removal of the gall-bladder. Inadvertent injury to a normal or aberrant bile duct can result in morbidity and even mortality. Knowledge of the embryogenesis of these anomalies helps in the understanding of the location and pattern of these malformations. Almost all of these unusual bile duct arrangements can be recognised by following the rules of meticulous dissection and accurate knowledge of these anatomical aberrations.

Adult↗
PubMedDate not supplied

Correlation of the end-tidal PCO2 during laparoscopic surgery with the pH of the gastric juice.

BACKGROUND AND OBJECTIVES: During laparoscopy, the increase of the carbon dioxide tension may increase the synthesis of hydrochloric acid in the parietal cells of the stomach; the source of the secreted hydrogen ions is carbonic acid derived from the hydration of carbon dioxide. The present report tests this hypothesis by correlating the changes of end-tidal PCO2 (ETCO2) with the pH of the gastric juice in patients undergoing laparoscopic cholecystectomy. METHODS: 40 adult patients were investigated: 20 controls, and 20 patients receiving 100 mg nizatidine intravenously, prior to surgery. In both groups, the ETCO2 was measured by capnography and the pH of the gastric juice was monitored before carbon dioxide insufflation and at the end of laparoscopy prior to carbon dioxide deflation. RESULTS: In the control group, the ETCO2 increased following carbon dioxide insufflation from a mean basal value of 30.2 (standard deviation [SD] 4.6) mm Hg to 41.1 (SD 9.5) mm Hg, while the mean pH of the gastric juice decreased significantly from 1.9 (SD 0.4) to 1.27 (SD 0.43). There was a significant negative correlation between the ETCO2 and pH of the gastric juice (r = -0.4). In the Nizatidine group, the ETCO2 also increased following carbon dioxide insufflation from a mean basal value of 30.9 (SD 3.0) mm Hg to 39.4 (SD 5.3) mm Hg. However, in contrast with the control group, the mean pH of the gastric juice did not decrease, but paradoxically increased from 1.68 (SD 0.36) to 3.6 (SD 1.02). CONCLUSIONS: During laparoscopy, the pH of the gastric juice is significantly decreased. This decrease is inversely related to the increase of ETCO2. The preoperative administration of the selective H2-blocker nizatidine can prevent the increase in gastric acidity and can result in a paradoxical increase of pH of the gastric juice.

Capnography↗