Iatrogenic hydrothorax complicated by reactive pleural effusion.
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Adolescent↗
Biomedical subjects
D L Coppel
Publications and source records attributed to D L Coppel.
Propofol anesthesia for major thoracic surgery.
One hundred patients undergoing elective thoracic surgery were anesthetized with propofol as a continuous intravenous infusion. In 60 patients, nitrous oxide was used for supplementation. The technique proved satisfactory, but induction of anesthesia was associated with significant decreases in blood pressure. The use of nitrous oxide markedly reduced the propofol requirements, and prolonged the time to the first spontaneous breath during recovery. The mean infusion rate of propofol was 7.2 +/- 2.72 mg/kg/h with air-oxygen, and 5.7 +/- 1.97 mg/kg/min with nitrous oxide-oxygen (P less than 0.01). This technique seems to be a satisfactory alternative for patients primarily requiring an intravenous anesthetic during thoracic surgery.
Anesthesia Recovery Period↗
Propofol infusion for sedation of patients with head injury in intensive care. A preliminary report.
Propofol was given by continuous intravenous infusion to 10 patients with severe head injuries in the intensive care unit. Heart rate, mean arterial blood pressure, intracranial pressure, cerebral perfusion pressure, pupil size and arterial carbon dioxide tension were recorded throughout the study period. A mean infusion rate of 2.88 mg/kg/hour provided satisfactory sedation, and recovery from the propofol was often rapid. Cerebral perfusion pressure was significantly increased at 24 hours.
Adolescent↗
Intravenous injection of liquid halothane.
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Blood Pressure↗
A new technique for sleeve resection and major bronchial resection using twin catheters and high frequency jet ventilation.
A new anaesthetic technique that uses two catheters combined with high frequency jet ventilation for sleeve resection of the major bronchus and carina is described. The advantages and disadvantages are discussed and compared with other techniques.
Aged↗
High frequency jet ventilation for bilateral bullectomy.
This case report describes the use of high frequency jet ventilation for resection of bilateral lung bullae. Low airway pressures reduced the risk of pulmonary barotrauma. A continuous infusion of ketamine provided acceptable anaesthesia.
Adult↗
High-frequency jet ventilation for tracheal surgery.
The anaesthetic requirements for tracheal resection include a clear airway, adequate ventilation and good surgical access. Many techniques have been described, none of which is entirely satisfactory. This case reports on the use of high-frequency jet ventilation with 10Fg catheter combined with muscle relaxants and intravenous anaesthesia in a patient with tracheal stenosis.
Aged↗
High frequency jet ventilation. A method for thoracic surgery.
High frequency jet ventilation for thoracic surgery offers some practical advantages over intermittent pressure ventilation using bronchial tubes. Satisfactory blood gases were obtained in 50 patients and good operating conditions were provided.
Anesthesia, Intravenous↗
High frequency jet ventilation.
A case is described where high frequency jet ventilation was used to avoid the cardiovascular depressant effects associated with conventional ventilation. Early weaning from inotropic and ventilatory support proved possible.
Blood Pressure↗
Management of quinine overdose.
The successful management of a case of quinine overdose with blindness is described. From a review of the literature, treatment of moderate poisoning with ingestion of less than 10 g of quinine should consist of immediate and thorough gastric lavage, forced acid diuresis, immediate bilateral stellate ganglion blockage repeated if there is clinical improvement in vision. With a larger overdose or when coma or convulsions occur haemodialysis, peritoneal dialysis or preferably haemoperfusion should be considered.
Adult↗
High frequency jet ventilation and aspirin poisoning.
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Aspirin↗
Reversal of neuromuscular blockade: dose determination studies with atropine and glycopyrrolate given before or in a mixture with neostigmine.
Glycopyrrolate and atropine were studied in doses of 5, 10, or 15 microgram/kg and 10, 20, or 30 microgram/kg, respectively, given intravenously either before or in a mixture with neostigmine, 50 microgram/kg, at the time of reversal of neuromuscular block. When given first, both anticholinergic drugs produced a dose-related increase in heart rate; following the administration of neostigmine the heart rates decreased. When administered in a mixture with neostigmine, the 20- and 30-microgram/kg doses, but not the 10-microgram/kg dose of atropine were associated with an initial increase in heart rate. This was, however, absent with all the doses of glycopyrrolate. The 5-microgram/kg dose of glycopyrrolate and 10-microgram/kg dose of atropine given either before or in a mixture with neostigmine were associated with unacceptable decreases in heart rate and needed further anticholinergic drug administration. The 10-microgram/kg dose of glycopyrrolate, when administered in a mixture with neostigmine, was associated with the most stable heart rates. Increasing the dose to 15 microgram/kg was not associated with undue tachycardia and is not hazardous. Atropine, 20 microgram/kg, necessitated a further administration of atropine in nearly a third of patients in this group due to bradycardia (heart rate of 50 beats/min or less) and would be considered inadequate. Increasing the dose to 30 microgram/kg prevented bradycardia but was accompanied by significant initial tachycardia and a higher incidence of dysrhythmias when administered before neostigmine. The frequency of dysrhythmias was otherwise similar. It is recommended that anticholinergic drugs be administered in a mixture with neostigmine. Glycopyrrolate, administered in this way in a dose of 10 microgram/kg, is associated with stable heart rates.
Atropine↗
Blast injuries of the lungs.
Up until 1968 Northern Ireland was a relatively peaceful community. The outbreak of civil disturbance has resulted in many patients being admitted to hospital with severe injuries from bullets and bomb explosions. Initial resuscitation must not be unduly delayed to be effective and should be carried out by experienced personnel. Respiratory failure from bomb explosions is rare and invariably fatal. The mechanism is discussed and is thought to be due to direct compression.
Blast Injuries↗
Resuscitation and trauma.
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Blast Injuries↗
Surgery of violence. III. Intensive care of patients with bomb blast and gunshot injuries.
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Abdominal Injuries↗
The effect of non-depolarizing relaxants on plasma potassium.
Plasma potassium concentrations were measured in four groups of unpremedicated patients in whom anesthesia was induced with thiopentone 5 mg/kg followed by tubocurarine 0.5 mg/kg, gallamine 2 mg/kg, pancuronium 0.1 mg/kg or AH 8165 1.25 mg/kg, prior to elective dental surgery. There was a small but consistent decrease in plasma potassium following the injection of pancuronium and, to a lesser extent, following gallamine. No changes were found during the first 10 min following tubocurrarine. With AH 8165 there was an early reduction in plasma potassium but the values returned to within normal limits by 5 min.
Adult↗