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Biomedical subjects

J G Stone

Publications and source records attributed to J G Stone.

66 records · Page 4Linked to original sources
PubMed1978

Hypotensive anesthesia for spinal fusion with sodium nitroprusside.

Deliberate induced hypotension for spinal fusion has been used in the past, but a search for better techniques continues. The authors used sodium nitroprusside by intravenous infusion to reduce the mean arterial pressure from 72 to 42 torr in 10 cases. This degree of hypotension provided an optimal surgical field and maintained adequate tissue perfusion as demonstrated by arterial oxygen tensions greater than 600 torr, no development of base deficit, and continuous urinary excretion. There were no complications related to hypotension. None of the patients received blood transfusions, whereas in the past, 2000 ml blood was usually required for this procedure.

Adult↗
PubMed1978

Pulmonary shunts in the prone position.

Pulmonary shunting (Qs/Qt with the FIO2 = 1) was determined in ten young healthy non-obese patients prior to anaesthesia, 30 min after induction in the supine position and 1 h later during surgery in the prone position. Respiration was spontaneous in awake patients and was controlled following the induction of anaesthesia. Halothane was the primary anaesthetic and tubocurarine provided muscle relaxation. Mean PaCO2 was 40.7, 29.5 and 27.9 mmHg respectively in the three study periods. The shunt remained unchanged at 5.7 +/- 0.8% in the awake patients, and 6.0 +/- 1.1% during anaesthesia in the supine position, and 5.2 +/- 1.2% during anesthesia and surgery in the prone position. It is concluded that in this population the prone position does not alter the magnitude of the pulmonary shunt even in those patients who develop shunts of over 10% after the induction of anaesthesia.

Adult↗
PubMed1976

Pulmonary shunting during anesthesia with deliberate hypotension.

Pulmonary shunting (Qs/Qt with FIO2 = 1) was measured in 18 anesthetized patients during deliberate hypotension. Hypotension was induced in 12 patients with sodium nitroprusside and light halothane anesthesia and in six others with deep halothane anesthesia and mechanical hyperventilation. Similar results were observed in the two groups. During the hypotensive period mean arterial pressure (MAP) was reduced to 49 +/- 2 torr, a 37 per cent decrease from the control level after the onset of operation and a 40 per cent decrease compared with the recovery level during closure of the wound. Qs/Qt, however, remained unchanged throughout the study: 5.2 +/- 0.9 per cent initially, 5.4 +/- 0.8 per cent during hypotension, and 4.7 +/- 0.5 per cent during recovery. It is concluded that pulmonary shunting need not develop during deliberate hypotension induced with either technique.

Adult↗
PubMed1975

Pulmonary shunting during anaesthesia in man.

Qs/Qt was determined during halothane and oxygen anaesthesia in 22 patients. All were believed to have no pulmonary dysfunction. A surgical operation was in progress and respiration was controlled. Qs/Qt was minimal in 15 of these patients (means 3.9 plus or minus 0.3%), indicating that anaesthesia and operation can be conducted in man without a significant increase of pulmonary shunting. The level of shunting was increased in the other seven patients. In neither group was Qs/Qt altered by the passage of time. Age varied between 23 and 61 years and was directly and significantly correlated to Qs/Qt (r=0.57,P less than0.01).

Adult↗
PubMed1975

Pulmonary shunting during alveolar hypoventilation in the dog.

Pulmonary shunting (Qs/Qt) was measured in 16 anesthetized and paralyzed healthy beagle puppies during a control period when the end-expired CO2 concentration was 5 per cent and during alveolar hypoventilation, when the PaCO2 increased to 100 plus or minus 13 torr (mean plus or minus SE) and the ;Ha vecame 7.04 plus or minus 0.04. A constant tidal volume was maintained throughout each study, and hypoventilation was achieved by slowing only the respiratory rate. During the control period Qs/Qt was 2.9 plus or minus 0.3 per cent; during hypoventilation Qs/Qt was 3.2 plus or minus 0.3 per cent (an insignificant difference). The puppies, therefore, responded to anesthesia and alveolar hypoventilation without development of increased pulmonary shunts.

Anesthesia, Intravenous↗
PubMedDate not supplied

Ventilatory complications of carbon dioxide laser laryngeal surgery.

STUDY OBJECTIVE: To evaluate complications associated with ventilatory techniques accompanying endolaryngeal carbon dioxide laser surgery. DESIGN: Retrospective survey of the Society of Academic Anesthesia Chairmen. SETTING: Operating room at an urban medical center. PATIENTS: Data from 15,701 patients were analyzed. MEASUREMENTS AND MAIN RESULTS: Twenty-six percent of patients were ventilated with Venturi jet ventilation and the rest through an endotracheal tube. Reported complications were classified as ventilation related and ventilation unrelated, as well as by severity. A total of 49 complications occurred in the Venturi jet group (1.2%). Of these complications, 24 were ventilation related (0.58%) and 18 were serious or life threatening (0.43%). There were no deaths in this group. Ventilation through an endotracheal tube was associated with a lower frequency of overall complications (0.36%), ventilation-related complications (0.15%), serious or life-threatening complications (0.15%), and serious or life-threatening ventilation-related complications (0.11%) (p less than 0.001). However, there were eight airway fires in this latter group, one resulting in a fatality. CONCLUSIONS: No clear choice of ventilatory technique is supported by this survey, but teamwork and experience give the best results.

High-Frequency Jet Ventilation↗