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Biomedical subjects

M Freysz

Publications and source records attributed to M Freysz.

At least 91 records · Page 5Linked to original sources
PubMed1987

Pharmacokinetics of bupivacaine after axillary brachial plexus block.

Severe cardiovascular complications have been associated with regional anesthesia using bupivacaine. Furthermore, in our practice, axillary brachial plexus block is commonly used for surgical emergencies of the hand in out-patients. The pharmacokinetics parameters: peak height (Cmax), peak time (tmax), half life of plasma elimination (t1/2), total apparent clearance (Cl), mean time of plasma retention (t) were studied in 20 male and female patients (mean age 35 and 32 years) receiving axillary local anesthesia by bupivacaine (BU) only (A group = 100 mg), B group BU = 200 mg, or BU + lidocaine (LI) (C group = BU 100 mg + LI 200 mg), plasmatic BU and LI were simultaneously measured by HPLC method. There were no significant differences in the pharmacokinetic data observed in groups A, B and C; total apparent clearances and half times of plasma elimination of BU after brachial plexus block are similar compared to those observed after i.v. administration. Absorption of BU seems to be total while the value of Cmax are very low compared to usual neurotoxic plasma levels, but near that of plasma concentrations observed in cardiac complications. All the tmax observed were under 2 h and the dose independence of the kinetic of BU is not admissible in this study. The association of LI induce no modification of the kinetic of BU. This work concludes that in this way of administration, the absorption of BU seems to be total. Pharmacokinetics of BU is dose dependent and the association of LI induces no significant modification of BU kinetics.

Adolescent↗
PubMed1987

Electrophysiological study in the dog of the risk of cardiac toxicity of bupivacaine.

The risk of toxic effects on the heart of bupivacaine following several kinds of locoregional anaesthesia has been investigated in the dog in situ heart by determining conduction time and effective refractory period in the various parts of the conduction system and the ventricular muscle, as well as the discharge rate of the sinus node. Bupivacaine, i.v. infused at 3 rates, 0.2, 0.3 and 0.4 mg X kg-1 X min-1, proved to have depressant effects on conduction, automatism and excitability. It slows down conduction in all the parts of the myocardium, considerably at high stimulation frequencies, but always much more in the His-Purkinje system and the ventricular contractile fibres than in the atrioventricular node, because it tends to block the sodium rather than the calcium or potassium channel. Its effect remain more moderate, indeed, on sinus automatism and atrial and mainly ventricular refractoriness. Its danger lies, therefore, in the inhibition of conduction, with atrioventricular or His bundle branch block, but more frequently reentrant arrhythmias, likely to result in ventricular fibrillation. However: these alterations are observed with very high plasma levels (about 4 to 9 micrograms X ml-1), much higher than usual peak concentrations following spinal anaesthesia (0.10 micrograms X ml-1) or even epidural anaesthesia or brachial plexus block (1.20 micrograms X ml-1); reversal of these alterations occurs rapidly (reduction by 50% within 30 min for instance), when they have not led to ventricular fibrillation or they have not been associated with circulatory collapse.

Action Potentials↗
PubMed1985

[Bacteriologic monitoring of bronchial secretions in surgical intensive care].

Quantitative bacteriologic monitoring of bronchial secretions obtained by protected distal catheterism was performed in 60 critically ill patients under mechanical ventilation. A number of factors which have significant bearing on bacterial growth in the respiratory tract were demonstrated. A statistical correlation was found between aspiration pneumonia and presence of Enterobacteriaceae, as well as between hospital-acquired pneumonia and recovery of opportunistic pathogens. S. aureus was especially prevalent in patients under corticosteroids. Aminoglycoside treatments increased the frequency of Acinetobacter infections, whereas prevalence of S. aureus and P. aeruginosa appeared unrelated to the use of any specific antibiotic. The value of bacteriology on protected distal catheter bronchoscopy specimens is to allow accurate diagnosis of lower respiratory tract infections and provide guidelines for the choice of appropriate antibiotics.

Acinetobacter↗
PubMed1983

[Hemothorax and fractures of the dorsal spine].

The frequency of pleural complications was examined in 72 patients with recent fractures of the thoracic spine. 17 patients (24%) were found to have pleural hemorrhage. In 8 cases this was the result of isolated spinal fracture, without fracture of the ribs. In these cases, posterior mediastinal effusion, which was readily visible on chest films, always occurred prior to or concomitantly with the pleural effusion. Most of the spinal fractures were located between the fourth and eighth vertebrae. Bone lesions were always serious unstable fractures with vertebral collapse and kyphosis. Acute respiratory distress and/or cardiovascular collapse in a patient with thoracic spine injury should suggest pleural hemorrhage.

Fractures, Bone↗
PubMed1981

[Peroperative plasma catecholamine levels during cardiovascular surgery].

Peroperative catecholamine levels were taken as a method for the assessment of automatic protection. Plasma adrenalin and nonadrenalin levels (spectro-fluometric technique) were measured at different pre-, per- and postoperative times in twenty eight surgical patientS: fifteen undergoing cardiac surgery and ten surgery involving the aortic bifurcation. Anaesthesia included high doses of fentanyl associated with droperidol. During aortic grafts variations in catecholamine levels were not significant, whilst during and after ECC there was a significant increase in the values. These variations were slight in comparison with those which may be seen during the excision of a phaeochromocytoma and were very similar to those obtained during effort. There were wide individual variations.

Adult↗
PubMed1981

[Adult respiratory distress syndrome. Two post-operative cases (author's transl)].

The authors describe two post-operative Adult Respiratory Distress Syndrome (A. R. D. S.) due to Mycoplasma pneumoniae. Mycoplasma pneumoniae infection is attested by serologic arguments and isolement of Eaton Agent in throat cultures. In the first case, exists an activation of the altern way of complement. The unusual relations between Mycoplasma infection and the A. R. D. S., diagnostic and therapeutic are commented.

Adult↗