Biomedical subjects

G E Hammouda

Publications and source records attributed to G E Hammouda.

3 recordsLinked to original sources

PubMed1997

Morphine-midazolam combination doses for presurgical analgesia in children.

We have examined the use of presurgical morphine-midazolam combination in 80 children aged 2-10 y undergoing repair of hypospadias. They were allocated randomly, in a double-blind study, to receive one of four morphine-midazolam combination doses (n = 20 each); (group I: 75 microg/kg each) [corrected] (group II: 75 microg/kg [corrected] morphine, 50 microg/kg [corrected] midazolam); (group III: 50 microg/kg [corrected] morphine, 75 microg/kg [corrected] midazolam); (group IV: 50 microg/kg [corrected] each). Drugs were given after induction of anesthesia and before the start of surgery. Observational scoring system, using crying, movement, agitation, posture and localization of pain as scoring criteria, was used to assess the children during their stay in the recovery room together with their sedative and/or analgesic requirement. Pre-surgical morphine-midazolam administration produced stable hemodynamic variables with satisfactory postoperative analgesia suggesting 75 microg/kg [corrected] dose of both morphine and midazolam as upper permissible dose, and 50 microg/kg [corrected] each as lower effective dose.

Analgesics, Opioid↗

PubMedDate not supplied

Does spinal anesthesia affect cerebral oxygenation during transurethral prostatectomy?

BACKGROUND AND OBJECTIVES: Transurethral resection of the prostate (TURP) is associated with the unique complication of transurethral resection of prostate syndrome (TURS), which is attributed to the absorption of irrigating fluid. This study was initiated to investigate the effects of spinal anesthesia and TURP on cerebral oxygen balance. METHODS: Thirty patients scheduled for TURP were included. Jugular bulb oxygen saturation (SjbO2) was measured via retrograde cannulation of jugular venous bulb. Spinal anesthesia was initiated by 3 mL hyperbaric 0.5% bupivacaine injected at L3-L4 in the sitting position, producing a block to the T10 dermatome. Hemodynamic measurements and arterial and jugular bulb blood gasometry were performed before and after spinal anesthesia, throughout surgery, and during the postoperative period. RESULTS: A significant decrease of cerebral perfusion pressure after spinal anesthesia was accompanied by a significant decrease of SjbO2 below a preoperative value of 61% +/- 1. Eight patients developed yawning, irritability, restlessness, and nausea toward the end of surgery, and these were considered to be early signs of TURS. These patients demonstrated SjbO2 below 55% and 50% in 63% and 42% of respective data set points. CONCLUSION: The neurologic symptoms in patients undergoing TURP during spinal anesthesia might not only be caused by absorption of irrigating fluid but also by impairment of cerebral oxygenation.

Aged↗

PubMedDate not supplied

Plasma bupivacaine concentrations following epidural administration in kidney transplant recipients.

BACKGROUND AND OBJECTIVE: The typical hemodynamic and biochemical characteristics of kidney transplant recipients may influence the pharmacokinetic profile of bupivacaine following its epidural administration. The objective of this study was to test this hypothesis in kidney transplant recipients compared with kidney surgery patients. METHODS: In a prospective open comparative study, 10 kidney transplant recipients and 10 kidney surgery patients received bupivacaine by the lumbar epidural route during the course of their operations. Arterial blood sampling was carried out before administration of bupivacaine and at 2, 5, 10, 15, 20, 25, 30 minutes and subsequently at 1, 1.5, 2, 4, 8, and 24 hours, after its administration. RESULTS: The calculated pharmacokinetic variables did not show any significant difference between the two groups. CONCLUSIONS: Lumbar epidural administration of bupivacaine is not associated with higher plasma bupivacaine concentrations in kidney transplant recipients than in nonuremic patients undergoing kidney surgery.

Adult↗