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Biomedical subjects

F L Seleny

Publications and source records attributed to F L Seleny.

16 recordsLinked to original sources

Anaesthetic management of Miller's syndrome.

Miller's syndrome is a rare congenital disorder with facial features similar to that of Treacher-Collins syndrome. This report details the anaesthetic management of an infant during multiple surgical procedures, beginning with pylormyotomy at one month of age. Airway management was difficult because of severe micrognathia and was accomplished using an awake intubation with a conventional straight blade modified for continuous administration of oxygen ("oxyscope"). Due to recurrent upper airway obstruction and the anticipated need for multiple surgical procedures in the first years of life, a tracheostomy was placed. Because of the multiple airway, orthopaedic, and nutritional difficulties, it is important that a prospective, multidisciplinary approach be used in these patients' care. Consideration should be given to early tracheostomy for airway maintenance.

Anesthesia, Inhalation↗

Home care for life-supported persons: an approach to program development.

Eighteen ventilator-dependent children were returned to their homes from Illinois. Each candidate was selected according to physician-designated guidelines for medical stability as well as predetermined social-environmental and reimbursement criteria. Each individualized occurrence was organized according to a comprehensive home care plan. Unanticipated improvement in medical condition and psychosocial development has resulted at home. The children and families have returned to a safe environment that best promotes the health of all involved. In addition, initial cost savings were at least 70%. These demonstrations have evolved into an organized regional approach to the ventilator-dependent child which utilizes available resources. The required continuum of health care and personal services includes intermediate intensive care, respiratory rehabilitation, transitional care, home care, and community-oriented alternatives to home. Problems of the ventilator-dependent child are those encountered by all children with handicaps and their families. The appropriate solutions will provide models for other complex health care and societal issues.

Adolescent↗

Comparison of oral pentazocine, oral diazepam and intramuscular pentazocine for paediatric premedication.

Oral pentazocine-atropine, oral diazepam-atropine and IM pentazocine-atropine were compared as preoperative medication in children. Observations in 300 children ages 1-14 years included the emotional state at time of induction of anaesthesia, smoothness of induction, dryness of oral mucosa and tongue, incidence of vomiting, and emotional state and length of stay in the recovery room. The incidence of a calm state at the time of induction and smoothness of induction of anaesthesia was the same following oral and IM premedication. There was satisfactory drying of salivary secretions. The incidence of vomiting in the recovery room was the same following oral and IM premedication. However, children in age groups 1-4 and 5-9 years who received diazepam-atropine were more restless in the recovery room than those who received oral or IM pentazocine-atropine. More children in groups 1-4 and 5-9 years who received IM pentazocine-atropine stayed longer in the recovery room. We conclude that oral diazepam-atropine and oral pentazocine-atropine are comparable as to preoperative medication IM pentazocine-atropine and that they can be given as an alternate to intramuscular injection.

Administration, Oral↗

Ketamine-pancuronium-narcotic technic for cardiovascular surgery in infants--a comparative study.

Ketamine, pancuronium, and alphaprodine were used as the primary anesthetic agents in 71 infants requiring cardiovascular operations during a recent 1-year period. This group of patients was compared with a similar group anesthetized 3 years before with d-tubocurarine, halothane, and/or N20-O2. Stability of the circulatory system was well maintained with ketamine-pancuronium-narcotic (KPN) during the induction period. However, once surgical dissection of the heart and great vessels began, hypotension/bradycardia, ventricular fibrillation, and 48-hour mortality were similar for the two groups. Therefore, using these criteria for analysis, the KPN technic, in spite of claims for its minimal adverse effect on the cardiovascular system, did not prove superior to the halothane-N2O-O2-curare technic.

Alphaprodine↗