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Biomedical subjects

G B Racz

Publications and source records attributed to G B Racz.

At least 37 records · Page 2Linked to original sources
PubMed1976

Changes in plasma potassium and calcium levels and in the electrocardiogram after a single dose of succinylcholine preceded by d-tubocurarine.

One hundred and eighteen patients undergoing surgical procedures not requiring immediate tracheal intubation, nor producing visceral reflexes, were pretreated with d-tubocurarine 6 mg, three minutes before the administration of a bolus of succinylcholine (2 mg/kg). Electrocardiographic changes, venous and arterial plasma potassium and calcium levels, CPK changes (12 patients) and appearance of myoglobinuria (35 patients) were followed. Pretreatment with a small dose of d-tubocurarine did not change the overall incidence and pattern of arrhythmias; it did, however, prevent increases in plasma potassium in 90.4 per cent of the patients, mean plasma potassium values remaining below pre-induction levels. The CPK level changed in only one of 12 patients (from 10 to 21 I.U., the normal range being 0 to 34 I.U.). No myoglobinuria was detected in any of the patients tested. A rapid but short-lasting change in the K+/Ca++ ratio did not seem to influence the occurrence of arrhythmias. Pretreatment with a small dose of d-tubocurarine is effective in preventing or decreasing fasciculations, plasma potassium and CPK changes and myoglobinuria described after the intravenous administration of succinylcholine. The already useful role of succinylcholine in our armamentarium can be made safer by pretreatment with a small dose of d-tubocurarine.

Adolescent↗
PubMedDate not supplied

General anesthesia for cesarean section in a parturient with a single ventricle and pulmonary atresia.

The successful management of a cesarean section in a parturient with a single ventricle and pulmonary atresia using general anesthesia is discussed. After cyanosis at birth, the patient underwent cardiac catheterization, which showed an apparent severe tetralogy of Fallot, atresia of the main pulmonary artery (PA), and a large patent ductus arteriosus. When she was 7 months of age, a Blalock-Taussig shunt (right subclavian artery to right PA) was done. She remained stable until age 11, when cyanosis increased and exercise tolerance decreased. Recatheterization more clearly defined the lesion: closed shunt, pulmonary valvular atresia, severe ductal stenosis, reduced pulmonary flow, double-outlet right ventricle, and severe hypoplasia of the left atrium, mitral valve, and left ventricle. A Potts shunt (left descending aorta to left PA) was done. Compliance with therapy was poor and follow-up difficult. Exercise tolerance was poor, but the patient remained otherwise stable. At 28 weeks' gestation, this 23-year-old parturient presented with severe congestive heart failure (CHF). After initial therapy with oxygen, bed rest, digoxin, and diuretics, she improved and remained stable for a month. At that time (32 weeks' gestation), CHF worsened. Because the cervix was unfavorable for a vaginal delivery, a cesarean section was planned. The patient was then taken to the operating room electively, and an opioid-based general anesthetic was administered. Both mother and infant did well. This case is presented because the physiology of the patient's lesion and her unusual social history presented challenges for her anesthetic management.

Abnormalities, Multiple↗
PubMedDate not supplied

Thermal grill illusion and complex regional pain syndrome type I (reflex sympathetic dystrophy).

BACKGROUND AND OBJECTIVES: In normal humans, placing a hand on a thermal grill containing warm elements separated by cool ones produces a burning sensation. In this case report, responses to a thermal grill in a patient with neuropathic pain were examined. METHODS: The responses of a 31-year-old woman with complex regional pain syndrome type I (reflex sympathetic dystrophy) to a thermal grill were evaluated before and after stellate ganglion block. RESULTS: The patient experienced a burning sensation when the unaffected hand was placed on the grill and could distinguish which element was warm and which was cool. An intolerable burning sensation caused the patient to quickly (within 4 seconds) withdraw the affected hand when it was placed on the grill. Touching cool elements with the affected hand produced an intense burning sensation (cold allodynia), whereas touching warm elements produced a pleasant warm sensation. Stellate ganglion block with phenol, local anesthetic, and steroid resulted in long-lasting absence of cold allodynia. CONCLUSION: The thermal grill may be a useful a tool to help understand the pathophysiology of complex regional pain syndrome type I.

Adult↗