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Biomedical subjects

D Soroker

Publications and source records attributed to D Soroker.

36 records · Page 2Linked to original sources
PubMed1991

Symptomatic hyponatraemia due to inappropriate antidiuretic hormone secretion following minor surgery.

A rare case of the syndrome of inappropriate antidiuretic hormone secretion occurring after minor surgery is presented. A ten-year-old, previously healthy boy underwent general anaesthesia for detorsion and right orchiopexy. Throughout the operations, which lasted for one hour, he received 120 ml Ringer's lactate solution. The immediate postoperative period was uneventful. Twenty-two hours postoperatively he was found unconscious with generalized tonic-clonic seizures. Simultaneously obtained serum sodium concentration (121 mEq.L-1) serum osmolarity (265 mEq.L-1), urine sodium concentration (87 mEq.L-1) and urine osmolarity (525 mEq.L-1) suggested inappropriate antidiuretic hormone secretion which was confirmed by an elevated serum arginine-vasopressin (AVP) level of 14.5 pcg.ml-1 (normal 1-5 pcg.ml-1) measured by radioimmune assay. He was treated with a single iv dose of 30 mg furosemide and fluid restriction, which produced a gradual increase of his serum sodium concentration to normal within two days. He was well during the remainder of his hospitalization.

Child↗
PubMed1991

Influence of epidural anaesthesia on the course of labour in patients with antepartum fetal death.

The course of labour in 22 patients with antepartum fetal death who received epidural anaesthesia was evaluated as compared to 22 controls matched for parity and gestational age, who received narcotic pain relief. Both groups had similar preinduction cervical dilatation and the induction was performed by amniotomy and oxytocin infusion. The mean first stage of labour was 5.4 hours in the epidural group, and 8.7 hours in the controls (p = 0.0192). The mean cervical dilatation rate was 3.3 cm/hour and 1.0 cm/hour respectively (p = 0.0142). The second stage was similar in both groups. We conclude, that parturients receiving epidural anaesthesia may benefit both emotionally and physically from excellent pain relief and a shorter delivery process when going through the distressing experience of delivering a dead fetus.

Amnion↗
PubMed1990

[Inflammatory cells in bronchial lavage fluid after general anesthesia and artificial respiration].

Bronchial lavage was performed immediately after intubation and artificial respiration (sample A) and one hour later (sample B) in 26 patients who underwent general anesthesia for elective surgery, but were otherwise normal. The number of cells recovered in sample B was significantly greater than that in sample A (5.64 +/- 4.62 x 10(6) vs 1.42 +/- 0.99 x 10(6). This difference was greater in smokers than in nonsmokers. There was also a significantly greater proportion of granulocytes in sample B compared to sample A. The results were similar after inhalation or after intravenous anesthesia. There were dynamic changes in quality as well as quantity of inflammatory cells in the lower respiratory tract following intubation and artificial respiration.

Anesthesia, General↗
PubMed1988

Carotid surgery under local anesthesia in the elderly.

Carotid endarterectomy in 39 elderly patients was carried out under local anesthesia and neuroleptic analgesia. There were no deaths within 30 days. Two patients required an intraoperative shunt because of signs of ischemic changes (aphasia, motor changes) during two-minute test cross-clamping. In two patients, transient vocal cord paresis was observed, and seven patients (18%) experienced immediate postoperative hypertension. Our results support the contention that in awake elderly patients the need for an intraoperative shunt can be accurately assessed by simple neurological monitoring. Carotid surgery under local anesthesia and neuroleptic analgesia appears to be a safe procedure, and is especially recommended for elderly patients with hypertension, diabetes mellitus or ischemic heart disease.

Aged↗
PubMed1983

Cell-mediated immune suppression due to alfathesin in short-term anaesthesia.

The immunosuppressive effects on cell-mediated immunity of alfathesin, when used as the sole agent for short-term anaesthesia, were investigated in ten women undergoing pregnancy termination. Cell-mediated immunity was evaluated by E rosette formation in peripheral blood (reflecting the percentage of T lymphocytes) and by proliferative responses to the mitogens concanavalin A and phyto-haemagglutinin in various concentrations. Measurements were made before alfathesin was administered, and again after 60 minutes, two days and seven days. Significant reductions in the percentage of E rosettes in peripheral blood and in mitogenic responses to concanavalin A were observed 60 minutes after administration of alfathesin. A model is proposed in which alfathesin binds to lymphocytic membrane receptors, thus affecting in vitro cell-mediated immune reactions.

Abortion, Induced↗
PubMed1983

Tracheal puncture. A complication of percutaneous internal jugular vein cannulation.

We report two cases in which tracheal puncture (diagnosed by puncture of the orotracheal tube cuff) followed internal jugular vein cannulation by the posterior approach. This complication is only likely to occur when using posterior approach and it may be followed by potentially dangerous subcutaneous emphysema, pneumomediastinum or air trapping between the chest wall and the pleura. This has led us to believe that the posterior approach should be substituted by the alternative central or anterior approach whenever it is possible.

Adult↗
PubMedDate not supplied

Pulse oximetry from the nasal septum.

STUDY OBJECTIVE: To evaluate the accuracy of the nasal septum site for pulse oximetry measurement of arterial oxyhemoglobin saturation (SpO2) in hypothermic patients. DESIGN: Prospective study. SETTING: Operating theater of a public hospital. PATIENTS: Fourteen hypothermic (temperature 34.6 degrees C to 36 degrees C) patients (eight males and six females) undergoing a major surgical abdominal procedure. INTERVENTIONS: Fifty estimations of SpO2 were simultaneously made by a flex sensor probe applied at the nasal septum site and by a finger sensor probe using a pulse oximeter. The results were compared with arterial oxygen saturation (SaO2) as measured by arterial blood gas sampling. MEASUREMENTS AND MAIN RESULTS: In 18% of the estimations, the finger probe produced unmeasurable results. The nasal septum probe did not produce any unmeasurable results (p = 0.0055). In the remaining 41 estimations, a comparison of the measurements from the nasal septum versus the controls showed a mean difference of 0.15 and a limit of agreement of -0.106 to +0.398. A comparison difference of 2.27 and a limit of agreement of 1.986 to 2.551. CONCLUSION: Monitoring SpO2 at the nasal septum site is more reliable than monitoring it at the finger site in hypothermic patients.

Adult↗
PubMedDate not supplied

Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation.

STUDY OBJECTIVE: To evaluate the effect of lidocaine inhalation on the circulatory response to direct laryngoscopy and endotracheal intubation. DESIGN: Prospective, randomized study. SETTING: Operating theater at a public hospital. PATIENTS: Eighty patients (ASA physical status I and II ages 25 to 45 years) scheduled for major abdominal surgery. INTERVENTIONS: In the first stage, 40 patients were randomly assigned to receive inhalation of either lidocaine 40 mg or a 0.9% solution of sodium chloride (placebo). In the second stage, the next 20 consecutive patients received inhalation of lidocaine 120 mg, and another 20 consecutive patients received intravenous (IV) lidocaine 1 mg/kg. MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure rose significantly in the i.v. lidocaine group (21.2 mmHg; p < 0.05), the saline inhalation group (29.2 mmHg; p < 0.05), and the lidocaine 40 mg inhalation group (22.9 mmHg; p < 0.05), but not in the lidocaine 120 mg inhalation group (10.1 mmHg). The heart rate (HR) response to intubation with lidocaine inhalation was dose dependent. In the saline inhalation group, HR increased by 15.6 beats per minute (bpm) (p < 0.05); in the lidocaine 40 mg inhalation group, HR increased by 9.1 bpm (p < 0.05); and in the lidocaine 120 mg inhalation group, HR increased by only 3.1 bpm. CONCLUSION: Inhalation of lidocaine 120 mg prior to induction of anesthesia is an effective, safe, and convenient method to attenuate the circulatory response to laryngoscopy and endotracheal intubation.

Adult↗
PubMedDate not supplied

Laser treatment of eye disorders in children.

The increasing range of indications for laser treatment and the development of new modalities of lasering have led to a growing tendency to extend this type of treatment to the pediatric population. Problems of compliance in this age group often necessitate the use of general anesthesia. This report describes the operative technique used in 11 children (13 eyes) under the age of 13 years, all of whom underwent laser treatment under general anesthesia for a variety of ocular conditions. Argon or krypton laser photocoagulation was performed in eight children (10 eyes), seven of whom were treated for various retinal pathologies and one for an iris cyst. The other three children underwent Nd:YAG posterior capsulotomy for secondary cataract.

Anesthesia, General↗
PubMedDate not supplied

Respiratory function following premedication with droperidol or diazepam.

Respiratory function was measured before and 1 hour after premedication with diazepam (10 mg IM) or droperidol (5 mg IM) in 2 groups of 14 normal patients scheduled for elective surgery. Diazepam had no significant effects on respiratory rate, tidal volume, minute ventilation, dead space, VD/VT %, alveolar ventilation, expired Po2, or Pco2, end-tidal Pco2, arterial Po2 or Pco2, or alveolar-arterial Po2 or Pco2 gradients. Droperidol was associated with statistically significant but modest reductions in tidal volume (-13.3%) and minute ventilation (-8.4%) while other respiratory functions remained unaffected.

Adult↗