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Biomedical subjects

E Abouleish

Publications and source records attributed to E Abouleish.

66 records · Page 4Linked to original sources
PubMedDate not supplied

Acupuncture in obstetrics.

Electroacupuncture (ACP) during childbirth was used in 12 parturients. On the average, it produced 66 percent analgesia in 7 patients for 139 minutes while patients were in active, progressive labor. When ACP no longer could relieve pain, spinal, epidural, or double-catheter technic produced complete analgesia in all patients. ACP did not adversely affect the fetus or uterine contractions and had no harmful aftereffect on mother or neonate. However, its use as a routine method had disadvantages because analgesia was inconsistent, unpredictable, and incomplete. The technic was time-consuming, limited the patient's movement, added more wires and machinery, and interfered with electronic monitoring of the mother and fetus.

Acupuncture Therapy↗
PubMedDate not supplied

Regional analgesia following epidural blood patch.

During the period November 1972 through October 1974, 118 epidural blood patch procedures were performed for severe postlumbar-puncture cephalgia. Subsequently, in a period varying from 105 to 380 days, three patients, two of whom had twice undergone epidural blood patch, were readmitted for either surgical operation or delivery. Either epidural, caudal, or spinal block was successfully accomplished. During the epidural block, the epidural block the epidural space was easily identified and no resistance was felt either to injection of the local anesthetic or to advancement of the epidural catheter. During the spinal block, ligmentum flavum was distinctly felt from the dura. The extent of the blocks, the onset and duration of action ofpivacaine, mepivacaine, and lidocaine were within normal limits. It is, therefore, concluded that epidural blood patch does not obliterate the epidural space and should not preclude the use of regional block for later surgical or obstetric procedures.

Adult↗
PubMedDate not supplied

Long-term follow-up of epidural blood patch.

Epidural blood patch (EBP) was performed for the treatment of severe postlumbar puncture cephalalgia in 118 young patients. Following the first EBP, 105 patients had relief of headache. Eleven of the 13 in whom it failed had a second EBP, with adequate relief in 10, giving an overall success of 97.5 percent. Lumbar epidural, caudal, and spinal procedures were successful in 3 patients 105 to 380 days after EBP. Soon after EBP, one patient developed facial paralysis and one complained of episodes of vertigo, dizziness, tinnitus, and ataxia without headaches. Residual complications included backache and/or back stiffness in 22 patients and paresthesia in two. Two-year follow-up revealed 95 percent patient acceptance of the procedure. EBP was found to be a safe, effective method for treating severe postlumbar puncture cephalalgia, provided a proper diagnosis is made and there is no contraindication.

Adult↗
PubMedDate not supplied

Caudal analgesia for quadruplet delivery.

During the period January 1969 to November 1974, in a total of 39,800 deliveries, there were two sets of quadruplets. Both parturients had been taking ovulation-inducing drugs. Maternal problems were distended abdomen and heavy uterus, causing supine hypotension and lordosis; toxemia of pregnancy; increased possibility of hemorrhage before, during and/or after delivery; edema of the back; mental depression. The fetal problems were prematurity; intrauterine growth retardation; increased possibility of transfusion syndrome and prolapsed cord; increased obstetric manipulation. An adequate number of obstetricians, pediatricians, anesthesiologists, and nurses, necessary equipment, and blood and blood components should be available. Early hospitalization is necessary. Close observation of the patient before, during, and after delivery is essential. The patient should stay on her side throughout the labor. General anesthesia may add to fetal depression and increase the possibility of uterine atony. Spinal or lumbar epidural anesthesia may be difficult because of the associated lordosis and back edema. Caudal block allowed intrauterine manipulation; provided adequate analgesia, permitted high FIO2 administration, and did not interfere with voluntary bearing down when required.

Adult↗
PubMedDate not supplied

Effect of morphine-diazepam on signs of anesthesia, awareness, and dreams of patients under N2O for cesarean section.

Morphine (0.2 mg/kg) and diazepam (0.1 mg/kg) were injected IV after delivery of the fetus in 68 parturients undergoing cesarean section (CS). General anesthesia was with thiamylal-N2O-O2 (4:2) and muscle relaxant. Twenty-four to 36 hours postoperatively, 1 patient had recall, 1 had unpleasant dreams, and 2 had pleasant dreams. The incidence of recall and unpleasant dreams was 3.8 percent in elective CS and 0 percent in emergency cesareans. Morphine-diazepam combination caused anterograde and retrograde amnesia. During the cesarean, movement of patient, size of pupils, or changes in blood pressure were not indicative of awareness or dreams. During anesthesia, 33 percent O2 produced adequate oxygenation of mother and fetus.

Amnesia↗
PubMedDate not supplied

Postpartum hypertension and convulsion after oxytocic drugs.

An 18-year-old primipara developed acute hypertension leading to cerebral edema and convulsions following the IV injection of a bolus of 10 units of oxytocin with 0.2 mg methylergonovine maleate. Oxytocin in a dose of more than 2 units should not be administered IV in a single injection, as severe hypotension may result. If oxytocin is required, it can be injected either IM, or by IV pump or drip. The use of ergot in obstetrics should be limited to the treatment of life-threatening postpartum hemorrhage and be given only by the IM route. Ergot should not be administered to patients with cardiac, renal, or hypertensive disease, or in association with a vasoconstrictor.

Adolescent↗
PubMedDate not supplied

The addition of 0.2 mg subarachnoid morphine to hyperbaric bupivacaine for cesarean delivery: a prospective study of 856 cases.

In an effort to determine the incidence of respiratory depression and other side effects of subarachnoid morphine, we conducted the following prospective study in a large number (856) of young female patients undergoing cesarean delivery in one hospital. During the period from July 1987 to January 1989, patients receiving subarachnoid hyperbaric bupivacaine combined with 0.2 mg preservative-free morphine were included. They were continuously monitored for 24 hours using a pulse oximeter. For 24 hours, the vital signs, including respiratory rate every hour, and the side effects, including pruritus, nausea, and vomiting, were recorded. The need for analgesia and the total dose of opioids during the first 24 hours were documented. Our results showed that respiratory depression (SaO2 less than or equal to 85% and/or respiratory rate ten breaths per minute or less) occurred in eight patients, all of whom were markedly obese. Fifty-eight percent of the patients did not require analgesics for 24 hours. In those requiring an added opioid, the dose was (9.1 +/- 0.5 mg morphine, mean +/- SEM). Eighty-five percent of the patients were satisfied with the postoperative analgesia. Six percent were dissatisfied due to the side effects, i.e., pruritus, nausea and/or vomiting. Nine percent were dissatisfied with the pulse oximeter because it caused false alarms and limited their mobility.

Anesthesia, Obstetrical↗
PubMedDate not supplied

Comparative flow rates of saline in commonly used spinal needles including pencil-tip needles.

BACKGROUND AND OBJECTIVES: Certain characteristics of spinal needles that can influence their clinical usefulness were examined, namely, flow rates, internal diameters, and size of orifices of pencil-type needles. METHODS: Flow rates of 0.9% sodium chloride solution were measured in spinal needles with an infusion pressure of 10 mmHg at isothermic and steady-state conditions. In 15 different types, a new needle was used for each experiment, and 6 experiments were performed with each needle type for a total of 90 experiments. The Hagen-Poisseuille Law for laminar flow was used to calculate the internal diameters. RESULTS: The flow rates of needles of the same gauge varied considerably depending on the manufacturer. Compared with 26-gauge ultrathin-wall spinal needle produced by the same manufacturer (Braun, Bethlehem, Pennsylvania), the flow rate through 29-gauge spinal needle was 18% that of the former needle. The flow rate through 27-gauge Quincke Whitacre needle (Becton Dickinson, Rutherford, New Jersey) was not statistically different from that through 26-gauge needle by the same manufacturer. By arbitrarily choosing < or = 2 seconds to be the in vitro desirable period for saline to traverse the needle from one end to the other, all needles with the exception of 29-gauge and standard 26-gauge Quincke Braun needles met this criterion. The length and size of the orifices of Whitacre needles were found to be significantly smaller than those of Sprotte needles (Havel, Cincinnati, Ohio). The orifice of Sprotte needle was longer than the known thickness of the dura while that of the Whitacre needle was smaller. CONCLUSIONS: Needles of the same gauge do not necessarily have the same flow rate. Flow rate correlates well with internal, not external, diameter. By considering < or = 2 seconds to be the desirable time for saline to traverse a spinal needle, all, except two, meet this criterion. The orifice of Whitacre needle has more desirable features than that of Sprottle needle. Anesthesiologists are encouraged to use 27-gauge needles since their flow rate is not slower than that of 26-gauge needles.

Needles↗