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Biomedical subjects

A Baraka

Publications and source records attributed to A Baraka.

At least 55 records · Page 3Linked to original sources
PubMed1998

Supplementation of general anaesthesia with tramadol or fentanyl in parturients undergoing elective caesarean section.

PURPOSE: Tramadol has been recommended for analgesia in parturients undergoing vaginal delivery. The present report investigated the effect of tramadol versus fentanyl on umbilical vein (UV) blood gases and Apgar scores of neonates delivered via elective Caesarean section under general anaesthesia. METHODS: Forty ASA I or II parturients undergoing elective Caesarean section were included in a randomized double-blinded study. The patients were divided into a tramadol (n = 20) and fentanyl groups (n = 20). During preoxygenation, one group received 100 mg tramadol i.v., while the second received 100 micrograms fentanyl. Anaesthesia was induced in both groups by 3 mg.kg-1 thiopentone and 1.5 mg.kg-1 succinylcholine was given to facilitate tracheal intubation. Anaesthesia was maintained during the induction-delivery period with nitrous oxide 50% in oxygen. RESULTS: The umbilical vein PO2 was higher in the fentanyl (34 +/- 5 mmHg) than in the tramadol group (24 +/- 6 mmHg) (P < 0.01), while the UV PCO2 was higher in the tramadol group (50 +/- 5 vs 45 +/- 4 mmHg) (P < 0.01). The Apgar scores at one and five minutes were not different between the two groups. Post operatively, two patients in the tramadol group recalled the crying of their newborn at delivery. CONCLUSION: Tramadol is associated with a high incidence of intraoperative maternal recall and can result in lower umbilical vein PO2 and higher PCO2 than in the fentanyl group.

Adjuvants, Anesthesia↗
PubMed1998

Anaphylactic shock complicating laparoscopic treatment of hydatid cysts of the liver.

Hydatid cysts of the liver have been treated surgically for many years by several surgical techniques including evacuation, marsupialization, and filling the cyst with saline after evacuation of the endocyst. We have previously reported laparoscopic treatment of hydatid cysts using the same hydatid asepsis and surgical techniques as in open surgery, with comparable results. Spillage of hydatid fluid during open surgery has been shown to result in serious anaphylactic reaction. The present report describes the first case report of such a reaction during laparoscopic treatment of hydatid cyst of the liver.

Adolescent↗
PubMed1997

Efficacy of the self-inflating bulb in differentiating esophageal from tracheal intubation in the parturient undergoing cesarean section.

We studied the efficacy of the self-inflating bulb (SIB) in differentiating tracheal from esophageal intubation in 40 parturients undergoing elective cesarean section under general anesthesia. After induction and muscle relaxation, the trachea was intubated under direct vision with cuffed tube. In 20 parturients, the esophagus was also intubated with an identical tube. Before ventilation was initiated, an independent anesthesiologist checked tube positions with the SIB using two techniques. In one technique (T1), the SIB was compressed before connection to the tube; in the other technique (T2), the SIB was first connected to the tube and then compressed. The speed of reinflation was graded as rapid, delayed, and none. Tracheal tube position was reassessed immediately before and after delivery. Before initiation of controlled ventilation, the incidence of false negative results was 47.5% with T1 and 27.5% with T2 but significantly decreased to 17.5% with T1 and 7.5% with T2 when retested before delivery. After delivery, no false negative results occurred. The incidence of false positive results immediately after induction was 30% with T1 and 35% with T2. The mechanism of false negative responses may be attributed to decreased functional residual capacity leading to reduced caliber of intrathoracic airways and terminal airway closure; whereas false positive responses may be related to an incompetent gastroesophageal junction. We conclude that the SIB is unreliable for differentiating tracheal from esophageal intubation in the parturient undergoing cesarean section.

Adult↗
PubMed1996

Oxygen enrichment of entrained room air during Venturi jet ventilation of children undergoing bronchoscopy.

Intermittent oxygen jet ventilation at an inspiratory:expiratory ratio of 1:3 was used to ventilate 15 children undergoing rigid Storz bronchoscopy for removal of inhaled foreign body. Oxygenation of the patient was continuously monitored by pulse oximetry. In all children SpO2 was above 95% when the bronchoscope was above the carina. When the bronchoscope was introduced into one of the bronchi, SpO2 decreased to 70-85% in five children. Delivery of a continuous flow of oxygen via a T-piece attached to the side-arm of the bronchoscope increased the SpO2 > 95% in the five children. Oxygen jet ventilation during bronchoscopy is based on the Venturi principle; the oxygen jet will entrain room air from the side arm of the bronchoscope which functions as an entrainment orifice. This will decrease the FIO2. The FIO2 can be increased by flowing oxygen continuously via the T-piece attached to the side arm of the bronchoscope.

Adolescent↗
PubMed1996

Right bevelled tube for selective left bronchial intubation in a child undergoing right thoracotomy.

Left bronchial intubation was used to achieve selective left lung ventilation in a five-year-old child, undergoing thoracotomy for excision of a hydatid cyst of the right lung. Intubation of the left main stem bronchus was easily achieved from the first attempt by a right bevelled tracheal tube. Using a right bevelled tube facilitates left bronchial intubation, since the bevel of the tube faces the right side while its tip lies left to the axis of the trachea. Chest auscultation confirmed selective left lung ventilation. One lung ventilation using 1-2% halothane in 100% oxygen was associated with Spo2 that ranged between 95-97%, and endtidal PETCO2 ranging between 3.9-4.5 kPa (30-35 mmHg). Following excision of the hydatid cyst, the tube was withdrawn above the carina into the trachea, and two lung ventilation was continued until the end of surgery.

Bronchi↗