Subject(s)
Anal Canal/surgery , Anesthesia , Ketamine , Rectum/surgery , Adolescent , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Prospective StudiesABSTRACT
Two thousand one hundred consecutive administrations of ketamine as an anaesthetic agent are reviewed. On the basis of the experience described, the authors assess that this agent could be used with safety in the average patient presenting for surgery and that it would be likely to suffice as the sole anaesthetic agent in 40% of such cases but would require supplementation by other anaesthetic agents in the remaining 60% of cases. They recommend it as being particularly useful in children submitting to dental surgery as it can be used without sedative premedication and permits of rapid recovery.
Subject(s)
Anesthesia, Intravenous , Ketamine/administration & dosage , Adolescent , Adult , Aged , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Injections, Intramuscular , Injections, Intravenous , Middle Aged , Time Factors , Tooth ExtractionABSTRACT
Appendectomy through the peritoneal cul-de-sac by a low transverse incision as described herein is perfectly safe and practical. It is also easier and esthetically superior to appendectomy through other surgical approaches and could be routinely used in patients suspected of having acute appendicitis. It is particularly valuable in female patients in whom the pelvic organs may need exploration during appendectomy and for whom the postoperative esthetic result may be most gratifying.
Subject(s)
Appendectomy/methods , Appendicitis/surgery , Abscess/drug therapy , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Child , Female , Hospitalization , Humans , Male , Ovarian Cysts/surgery , Pregnancy , Surgical Wound Infection/drug therapyABSTRACT
Ligation and cannulation of the anterior septal artery in 43 canine hearts caused changes in ST-T segment of the electrocardiogram in all animals. Perfusions of 0.9% NaCl, one to ten micrograms of acetylcholine, isoproterenol, epinephrine and norepinephrine, into the anterior septal artery caused variations in the ECG ranging from exaggerated ST-T changes to PR prolongation, ectopic atrial, nodal and ventricular beats, A-V blocks and dissociations, atrial fibrillation and ventricular fibrillation. The response seemed to be somewhat specific for cholinergic versus adrenergic agents showing more conduction defects by the former against greater changes in automaticity by the latter agents.
Subject(s)
Arrhythmias, Cardiac/chemically induced , Heart Conduction System/drug effects , Perfusion/adverse effects , Acetylcholine/administration & dosage , Acetylcholine/adverse effects , Animals , Catheterization/adverse effects , Dogs , Electrocardiography , Epinephrine/administration & dosage , Epinephrine/adverse effects , Isoproterenol/administration & dosage , Isoproterenol/adverse effects , Ligation/adverse effects , Norepinephrine/administration & dosage , Norepinephrine/adverse effects , Sodium Chloride/administration & dosage , Sodium Chloride/adverse effectsABSTRACT
Aorta-circumflex coronary artery bypass using a saphenous vein graft may present technical inadequacies with angulation, kinking, compression, tension and finally thrombosis and occlusion of the graft. As these problems are mainly secondary to incorrect length and direction of the vein graft, a new technique is described which allows the placement of a shorter graft in a more parallel direction to the physiologic aortocoronary flow. The transverse sinus of the heart is used as a natural protected channel whereby the graft passes behind the great vessels from the right posterior wall of the aorta to the circumflex coronary artery. Thus, redundancy, angulation and kinking are avoided and flow in the graft takes a more natural course.
Subject(s)
Coronary Artery Bypass/methods , Heart Diseases/surgery , HumansABSTRACT
In 221 patients (0.48% of hospital admissions) with hydatid disease (122 female and 99 males), 81% had single and 19% multiple organs involved. Lungs, liver and spleen as single sites of echinococcosis together represented 83.24% of cases and the liver alone represented 95.24% of instances with multiple organ involvement. One hundred seventy-nine single and 74 multiple cysts (ratio of 2.42/1) represented a total of 363 cysts (1.64 cysts/patient). The incidence of intact cysts was 51.52% and 48.48% had ruptured. Ruptures numbered highest in the lungs (73.44%) and greater in multiple (79.66%) than in single cysts (68.12%). In the liver, 27.14% of single and 54.55% of multiple cysts (40.44% of all liver cysts) had ruptured. Cysts varied in size from 0.8 to 35 cm diameter. Single cysts averaged significantly higher (14.16 cm) and multiple ones lower (5.71 cm) as did intact (6.75 cm) versus reptured cysts (4.33 cm). Except for 10 silent and 15 symptomatic cysts treated medically, all the rest were treated surgically by removal of the endocyst or resection of both endo and exocysts including 205 first, 31 second and 5 third procedures (1.75% of all major operations). Complications occurred in 28.57%. Surgical mortality (3.57%) was markedly lower than with conservative treatment (60%) and significantly less than that of the whole group (14.48%).
