Anesthetic mortality during surgery for hyphema.
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Biomedical subjects
Publications and source records attributed to E F Meyers.
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Toxic effects were observed in two healthy patients who received cocaine intranasally before dacryocystorhinostomy. One patient suffered an additional reaction to intranasally administered phenylephrine (Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of catecholamines and has a sympathetic potentiating effect, its use is dangerous in patients with hypertensive cardiovascular disease or in conjunction with sympathomimetic or alpha-modifying drugs. Use of dilute solutions carefully measured for select patients is mandatory. The total dose of cocaine should not exceed 3 mg/kg.
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Convulsions developed in two patients after retrobulbar block. The amount of local anesthetic agent that was used was considerably less than the intravenous toxic dose in both cases. No retrobulbar hemorrhage resulted. The probable cause of seizures was inadvertent injection of local anesthetic directly to the CNS via the ophthalmic artery or its sheath.
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A new surgical procedure, virtectomy, for alleviation of blindness caused by previously intractable vitreous disease, is described. Special demands of vitrectomy upon the anesthesiologist are enumerated. Problems presented by a patient population, 83 percent of whom suffered from severe diabetes mellitus and/or hypertension with a variety of complications, are discussed. Anesthetic technic used for 47 patients undergoing vitrectomy is described.
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A study of the post-hospitalization behavior of 122 children, 85 of whom underwent surgical anesthesia, revealed that an asleep anesthetic induction technic is not harmful to the young psyche; its use results in a greater likelihood of freedom from behavioral upset in the 1st postoperative month than when awake induction technics are employed.