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Biomedical subjects

E Lampl

Publications and source records attributed to E Lampl.

14 recordsLinked to original sources
PubMed1992

[Propofol anesthesia for ophthalmologic surgery in the elderly].

Fifty patients more than 70 years old, ASA I and II, NYHA I and II, were anaesthetized by propofol for cataract or retinal detachment surgery. Induction was carried out by a propofol slow injection (0.5-1 mg.s-1) until loss eyelash reflex (mean dose 0.728 mg.kg-1) and completed by fentanyl 2 micrograms.kg-1 and vecuronium 0.08 mg.kg-1. After intubation, anaesthesia was maintained with nitrous oxide and continued infusion of propofol (mean dose 4.48 mg.kg-1.h-1) according to haemodynamic parameters. These were noted repeatedly and statistically analyzed. No significative differences were observed with younger patients undergoing identical surgical procedures. Haemodynamic effects were the same during cataract or retinal detachment surgery and in hypertensive treated patients vs non hypertensive ones. Recovery was as fast and good as in younger patients. It should be emphasized that propofol doses must be reduced in elderly patients so as to preserve a satisfactory haemodynamic stability. Reasons for increased sensitivity to propofol in elderly patients are briefly discussed.

Aged↗
PubMed1990

[Anesthesia using propofol during surgery of strabismus in children. A comparison of two different protocols of induction and maintenance].

The purpose of this study is an investigation of two protocols using propofol as induction and maintenance agent in 100 children scheduled for strabismus surgery (4-8 year, ASA I, NYHA I). Protocol I; Propofol 6 mg.kg-1 in 60 s with fentanyl 2 micrograms.kg-1 and vecuronium bromide 0.08 mg.kg-1 for induction, followed by propofol 11 mg.kg-1 for maintenance; Protocol II; Propofol 3 mg.kg-1 in 20 s with fentanyl 3 micrograms.kg-1 for induction, followed by propofol 12 mg.kg-1.h-1 for maintenance. It appears that the use of protocol I offers significant advantages compared with protocol II: a better quality of induction with a lesser incidence of pain during injection of propofol; a better quality of maintenance with very infrequent bradycardia from oculocardiac reflectivity; and a better recovery with a greatly reduced frequency of nausea and vomiting.

Anesthesia, Intravenous↗
PubMed1988

Enterococcal bacteremia in a medical intensive care unit.

We reviewed retrospectively from 1982 through 1984 35 cases of enterococcal bacteremia in a medical ICU. Of these, 27 patients acquired nosocomial infections; their mean previous hospital stay was 17 +/- 4 days. Thirteen had a serious debilitating disease; 20 received previous antibiotic therapy. The infection focus was not found in 16 patients. The deaths of nine patients were related directly to enterococcal bacteremia. Mortality was significantly lower in patients with nosocomial infections, with appropriate antibiotic therapy just after the start of the infection, without debilitation, and when the infection focus was discovered. In a medical ICU, some patients appear to be particularly predisposed to enterococcal bacteremia. When these patients develop a serious infection without obvious source, an appropriate antibiotic therapy for Enterococcus should be promptly initiated.

Adult↗
PubMed1986

[Maintenance of obstetrical analgesia by continuous perfusion into the peridural space].

Two methods of epidural analgesia were compared in two randomized groups each of 16 normal women in labour, using bolus or continuous infusion. Analgesia was provided by a mixture of bupivacaine 0.25% and fentanyl. Patients did not differ in age, weight, term as well as in parity and neonatal weight. Group A received a total dose of 34 +/- 7.5 mg bupivacaine and 87 +/- 23.8 micrograms fentanyl as a bolus and group B a total dose 40.6 +/- 11.5 mg bupivacaine and 131 +/- 43.5 micrograms fentanyl as a starter dose followed by constant infusion. There was no statistical difference between the two groups concerning length of labour, number of forceps, Apgar score and patient, obstetrician and anaesthetist satisfaction score. Although continuous epidural infusion was greatly appreciated by the obstetrical team, it would seem to be of interest only when labour is long enough to require larger doses, especially when labour is induced.

Anesthesia, Epidural↗
PubMed1986

[Pharmacokinetics of fentanyl administered via peridural route in the woman in labor].

Seven women in labour received a single epidural dose of 0.8 mcg/kg of fentanyl together with bupivacaine. A pharmacokinetic study was performed of the fentanyl. As previously described, plasma concentrations were low. However, wide variations and important fluctuations were observed between different individuals with frequent late second peaks. The explanation for these second peaks of plasma fentanyl is discussed. The dose of fentanyl used in epidural administration for pain relief in labour must not be over 1 mcg/kg in order to avoid toxic levels, in the fetus.

Adult↗
PubMedDate not supplied

[Hepatic and renal toxicity of paracetamol in chronic alcoholic patient].

After taking paracetamol regularly in therapeutic doses, a non-cirrhotic alcoholic subject developed hepatic necrosis and acute renal failure. This case is compared with 13 others found in the literature, and the clinical, biochemical and histological characteristics of such accidents are described. The severity of the acute renal failure is proven by the fact that 50% of the patients had to be put under dialysis. The potentiation of acetaminophen renal and hepatic toxicity by alcohol toxicity is discussed. The principal mechanism of enhancement is the activation of the cytochrome P 450 system associated with depletion of intracellular glutathione.

Acetaminophen↗