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Biomedical subjects

M Sosis

Publications and source records attributed to M Sosis.

At least 37 records · Page 2Linked to original sources
PubMed1987

Jaw dislocation during general anaesthesia.

A case is reported of jaw dislocation on placement of an oral airway and nasogastric tube during an otherwise unremarkable exploratory laparotomy under general anaesthesia. The pathophysiology, diagnosis and treatment of jaw dislocation are described.

Adult↗
PubMed1987

An evaluation of priming with vecuronium.

Priming with vecuronium was evaluated in three groups of patients. Group 1 (n = 10) received tubocurarine 0.05 mg kg-1, group 2 (n = 19) received physiological saline and group 3 (n = 21) received vecuronium 0.012 mg kg-1. After 4 min maximum inspiratory pressure was measured. Anaesthesia was induced with thiopentone 6-8 mg kg-1 and controlled ventilation with nitrous oxide and oxygen via a face mask instituted. The ulnar nerve was stimulated at the wrist. At 5 min group 1 patients received suxamethonium 1.5 mg kg-1, group 2 received vecuronium 0.072 mg kg-1, and group 3 received vecuronium 0.060 mg kg-1. Intubation was accomplished at 6.5 min in all patients in group 1, 89% in group 2 and 90% in group 3. Patients in group 1 had no twitch response to stimulation at the time of intubation. Mean T4:T1 ratios at 6.5 min were 0.82 in group 2 and 0.61 in group 3 (P less than 0.05). Intubating conditions were excellent in all group 1 patients, and in 53% and 67% of groups 2 and 3, respectively. Two patients in group 3 did not tolerate the priming dose and many had subjective complaints. Four group 3 patients could not sustain head lift and five showed decreased inspiratory pressure. Priming did not improve intubating conditions when compared with a single bolus technique and was not well tolerated.

Adult↗
PubMed1987

Comparison of atracurium and d-tubocurarine for prevention of succinylcholine myalgia.

We compared the incidence of postoperative myalgia (POM) and fasciculations when atracurium (ATR) or d-tubocurarine (DTC) was given prior to succinylcholine (SDC) for tracheal intubation in 44 ASA class I or II outpatient females undergoing laparoscopy. The subjects were assigned to one of three groups: group 1 received 0.025 mg/kg ATR; group 2 received 0.05 mg/kg DTC; and group 3 received saline (NS), all in a double-blind manner. Thiopental was administered 1 min and 45 sec after pretreatment in doses adequate to allow control of ventilation. Three minutes after pretreatment, SDC 1.5 mg/kg was given, and fasciculations were recorded on a scale of 0-3. All patients were questioned 1 and 3 days postoperatively about POM, using a scale of 0-3. Fasciculations occurred in 79% of patients given saline, in 46% of those receiving ATR, and in 12% of those given DTC. Eighty-five percent of ATR patients were free of POM on postoperative day 1. The corresponding figures for DTC and NS were 59% and 43%, respectively. Only the difference between ATR and NS achieved statistical significance. On the third postoperative day, POM was rare and there were no significant differences among the groups. We conclude that DTC is a better defasciculant than ATR. DTC was, however, not significantly better than NS in the prevention of POM. The findings suggest that ATR may be the drug choice for the prevention of POM.

Adolescent↗
PubMed1987

Priming with atracurium.

Priming with atracurium was evaluated by dividing 39 patients into 2 groups. All received 0.2 mg IV glycopyrrolate and fentanyl, 50 micrograms IV. Group 1 received saline, group 2 received 0.06 mg/kg atracurium and a stop watch was started. After 3.5 min the patients were asked to lift their heads and maximum negative inspiratory pressure (MIP) was measured. Anesthesia then commenced with thiopental and a twitch monitor was applied to the ulnar nerve. At 5 min group 1 received 0.36 mg/kg atracurium and group 2 was given 0.30 mg/kg atracurium. At 6.5 min intubation was accomplished in all but one patient in group 1 and all but one in group 2. Mean T4/T1 ratios at 90 sec were 0.73 in group 1 and 0.51 in group 2. This difference was statistically significant (P less than 0.001). Bucking on the endotracheal tube occurred in 72% of patients in group 1 and 62% of those in group 2 (not significant). Intubating conditions were "excellent" in 56% of those in group 1 and 75% in group 2 (not significant). "Good" conditions were seen in 33% of group 1 and 15% of group 2 patients (not significant). "Fair" conditions were noted in 6% of patients in group 1 and 5% of group 2 patients (not significant). The time to maximum twitch depression was 11.3 min and 11.5 min in groups 1 and 2 respectively (not significant). All patients in group 1 could sustain head lift whereas four patients in group 2 could not (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Iatrogenic oesophageal perforation due to tracheal or nasogastric intubation.

Oesophageal perforation, due to a difficult endotracheal or nasogastric intubation occurred in a 49-year-old female. Perforation of the oesophagus is a rare complication of intubation of the trachea or oesophagus. Endotracheal intubation alone is most often blamed for iatrogenic oesophageal trauma following surgery. The incidence of iatrogenic oesophageal trauma is similar after nasogastric or endotracheal intubation. Iatrogenic oesophageal perforation occurs principally over the cricopharyngeus muscle on the posterior wall of the oesophagus. Here the oesophagus is thin and is markedly narrowed. Contamination of the perioesophageal space with gastric contents leads to diffuse cellulitis and infection. Diagnosis is made by evidence of cervical subcutaneous emphysema, cervical pain, dysphagia, temperature elevation and leukocytosis. Plain roentenograms of the neck and a contrast media swallow will confirm the diagnosis. Treatment consists of massive antibiotic therapy followed by surgical repair and drainage of the area. Mortality ranges from 10-15 per cent with early diagnosis to 50 per cent if surgery is delayed.

Esophageal Perforation↗