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Biomedical subjects

S S Moorthy

Publications and source records attributed to S S Moorthy.

81 records · Page 5Linked to original sources
PubMedDate not supplied

A series of truly failed spinal anesthetics.

This report describes five patients with failed continuous spinal anesthetics with lidocaine. Lidocaine concentrations of 420 to 880 micrograms/ml were assayed in the spinal fluid despite lack of anesthesia. There was free flow of cerebrospinal fluid (CSF) through the catheter in all patients before and after the injection of lidocaine. Inactive lidocaine was not responsible for the failures, since lidocaine from the same manufacturing batch produced anesthesia in other patients. Incorrect catheter placement could not explain the failures, since bupivacaine injected through the same intraspinal catheter produced anesthesia in four of the five patients. The authors, therefore, suggest that some patients have a physiologic resistance to lidocaine.

Adult↗
PubMedDate not supplied

The anesthetic and perioperative management of a patient with documented hereditary angioneurotic edema.

A patient with documented hereditary angioneurotic edema was admitted for elective surgical extraction of 3 impacted 3rd molars under local anesthesia. In order to increase his C'1-INH level, he was prepared for operation with 2 units of fresh-frozen plasma 24 hours preoperatively. Postoperatively, he was observed in the ICU for 24 hours and on the ward for 2 days, and was discharged without any complications from the surgical trauma.

Adult↗
PubMedDate not supplied

Chest radiograph changes after cardiopulmonary bypass in children.

To determine the spectrum of pediatric chest radiograph changes after cardiopulmonary bypass, 98 children (mean age = 5.9 yr, range 4 wk-16 yr) were studied for 3 days postoperatively. Daily A-P radiographs were evaluated for atelectasis, cardiomegaly, pleural effusions, diaphragmatic elevation, mediastinal widening, and pulmonary infiltrates. The overall incidence of atelectasis was 82%, with left lower lobe atelectasis the most common (64%). Right upper lobe atelectasis occurred in 35% of patients, far more common than in the adult. Radiographic changes were then compared with independent variables including patient weight, age, duration of bypass, and fluid balance by multiple linear regression. Pleural effusion correlated with patient weight and duration of bypass. Diaphragmatic elevation correlated with patient weight. Cardiomegaly correlated with patient age. Net fluid balance was a poor predictor of postoperative chest radiograph changes. We conclude that radiographic changes are common after cardiopulmonary bypass in children, that the overall incidence is not markedly different from adults, and that right upper lobe atelectasis occurs more frequently in children.

Adolescent↗
PubMedDate not supplied

Brachial plexus block. A comparison of the supraclavicular lateral paravascular and axillary approaches.

BACKGROUND AND OBJECTIVES: Anesthesia of the brachial plexus has been associated with injuries to adjacent structures (e.g., pneumothorax, vascular penetration). It is not uncommon to have only partial block of the upper extremity, hindering completion of the surgical procedure. The supraclavicular lateral paravascular approach to brachial plexus anesthesia has been proposed as an effective, safe alternative to the traditional approaches to brachial plexus anesthesia. METHODS: This prospective, randomized study sought to determine if the supraclavicular lateral paravascular (SCLP) approach is as effective as the transarterial axillary approach, the most common brachial plexus block used at our institution. RESULTS: 16/20 (80%) of SCLP blocks were good. 13/20 axillary blocks were good. The success rate with the SCLP approach was 95%. The success rate with the axillary approach was 90%. CONCLUSIONS: The supraclavicular lateral paravascular approach is as effective as the axillary approach.

Adult↗
PubMedDate not supplied

Respiratory distress with left aortic arch, right descending aorta, and right ligamentum arteriosum: a case report.

A 7-year-old girl manifested the rare anomaly of a ventricular septal defect (VSD) with left aortic arch, right descending aorta, and right ligamentum arteriosum. After open-heart surgery to correct the VSD, symptoms of tracheal obstruction on spontaneous breathing developed, due to tracheal compression by the right ligamentum arteriosum. The compressed segment of the trachea was found to be thin and unstable following division of the ligamentum. Positive-pressure breathing and continuous positive airway pressure breathing effectively splinted the patient's airway during the postoperative period, with recovery of the patient.

Aortic Arch Syndromes↗