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Biomedical subjects

E Vatashsky

Publications and source records attributed to E Vatashsky.

At least 37 records · Page 2Linked to original sources

Bronchoscopy and bronchography in children. Experience with 110 investigations.

The results of 92 bronchoscopic examinations and 18 bronchograms in infants and children performed during a two-year period were reviewed. Of 62 patients with suspected foreign-body aspiration, the diagnosis was confirmed in 36 (58%); of 18 patients mainly suspected of having congenital anomalies, a positive diagnosis was made in 12 (66%); but of nine patients with lobar atelectasis only two had abnormal findings. In three patients a transbronchial biopsy specimen did not provide diagnostic material. Bronchography for suspected localized bronchiectasis was performed in 11 patients and a positive diagnosis was made in seven. In all seven patients suspected of having congenital anomalies, bronchography provided a definitive diagnosis. There was no mortality and morbidity was minimal but three patients died of their primary disease. Nearly 60% of the investigations yielded abnormal results, but many of the normal findings were of equal clinical value.

Bronchiectasis↗

A comparison of flunitrazepam and diazepam in the prevention of local anesthetic-induced convulsions.

The anticonvulsive effects of equivalent strengths (ED50) of flunitrazepam and diazepam were compared in 60 Sabra mice injected i.p. with median convulsive (CD50) doses of lidocaine or bupivacaine. Convulsions occurred in 40% of those pretreated with diazepam but were completely prevented in those injected with flunitrazepam. Mortality was much higher in those mice pretreated with diazepam, three having died after the administration of lidocaine and four after bupivacaine. With flunitrazepam pretreatment, there were no deaths after lidocaine and only one after bupivacaine. Flunitrazepam protected these mice against local anesthetic-induced convulsions more effectively than did diazepam.

Animals↗

Neonatal outcome in cesarean section under general anesthesia, related to gestational age, induction-delivery and uterus-delivery intervals.

Neonatal outcome after cesarean section under general anesthesia was studied in 568 women in whom no prior signs of fetal distress were evident. Low Apgar 1-minute scores were not related to induction-delivery and/or to uterus-delivery intervals, which were all within the accepted safe limits, but were related to the gestational age. Thus, Apgar scores less than 7 were found in 62% of newborns whose gestational age was less than 35 weeks, but in only 17% of those greater than or equal to 35 weeks. The importance of gestational age, in addition to the induction-delivery and uterus-delivery intervals, is discussed in relation to neonatal outcome following cesarean section.

Adolescent↗

Intravenous flunitrazepam in the prevention of the side effects of succinylcholine.

Muscular fasciculations, plasma potassium levels and postoperative muscle pains following succinylcholine injection were studied in 64 patients who had been given either dilute flunitrazepam or sodium thiopental to induce anesthesia. In the 32 patients with flunitrazepam-induced anesthesia, muscle fasciculations were present in only 8 and postoperative muscle pains in 4, while none of the patients had elevated plasma potassium. In the thiopental group, muscle fasciculations and postoperative muscle pains were present in 28 and 22 of the other 32 patients, respectively, while all had significantly elevated plasma potassium levels. Flunitrazepam appears to be a useful alternative anesthesia-induction agent that prevents some of the side effects of succinylcholine without reducing its efficiency.

Adolescent↗

Flunitrazepam.

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Anesthesia, Dental↗

Low i.v. regional analgesia with bupivacaine for hand surgery.

A forearm tourniquet for i.v. regional analgesia of the hand, using doses of bupivacaine smaller than in the conventional (upper arm) method, produced successful analgesia in 98 of 102 patients. In 63 patients bupivacaine 50 mg or less was adequate, while in 33 the dosage was between 60 and 75 mg. No toxic effect was noted. This technique permits surgery of the hand, wrist and distal forearm.

Adolescent↗

Anesthesia in a hand surgery unit.

Impressions of two different regional anesthetic techniques used in the management of 670 cases in a hand surgery unit are described. For operations at or below the wrist, subcutaneous ring anesthesia for the forearm tourniquet, together with local nerve block or local infiltrative anesthesia using Lignocaine, is very satisfactory. It is effective, simple, and safe, and it permits patient cooperation with the surgeon, who can readily evaluate motor activity because the flexor and extensor extrinsic muscles of the hand are then not paralyzed. For more extensive upper limb surgery, intravenous regional anesthesia with Bupivacaine is very effective, though toxicity might result if the tourniquet is unreliable or is released too rapidly. These effects are minimized by the intravenous infection of diazepam (5 to 10 mg) immediately prior to release the tourniquet.

Adult↗