PubMed Health⌕ Search

Biomedical subjects

J A Jebeles

Publications and source records attributed to J A Jebeles.

8 recordsLinked to original sources
PubMed1998

Endoscopic optic nerve decompression: the Graz experience.

Recommendations for management of traumatic injuries to the optic nerve in the literature include expectant management, medical therapy, surgical treatment, and medical therapy combined with surgical decompression. Traditional surgical approaches to optic nerve decompression (OND) are a neurosurgical or craniotomy approach, extranasal transethmoidal approach, transorbital approach, transantral approach, and intranasal microscopic approach. Recent advances in instrumentation and surgical techniques have made an endoscopic approach to OND possible. Since 1991 endonasal endoscopic decompression of the optic nerve has been the surgical approach of choice in patients requiring OND in the authors' hospital. The endoscopic method offers many advantages over the traditional approaches. Decreased morbidity, preservation of olfaction, rapid recovery time, more acceptable cosmetic results with no external scars, no risk of injury to the developing teeth in children, and less operative stress in a patient who may have multisystem trauma are only some of the benefits associated with the endoscopic OND. The authors' technique of endonasal endoscopic approach to OND, medical management, and indications for surgery and the results in 22 patients undergoing this procedure are discussed.

Adolescent↗
PubMed1995

The endoscopic endonasal surgical technique in the treatment of chronic recurring sinusitis in children.

Chronic recurring sinusitis (CRS) is a difficult diagnosis to make in the paediatric patient. However, increased awareness by physicians and improved technology are contributing to an increasing frequency of this diagnosis. Children with their immature development of the paranasal sinuses and immunological systems present special problems in the treatment of CRS. Concern must be given to potential alteration of the development of the paranasal sinus system and tooth buds in the maxilla by a surgical procedure in children. Various surgical procedures have been recommended in the past in the treatment of CRS failing medical management. A review of 124 paediatric patients undergoing endoscopic endonasal sinus surgery using the technique of Messerklinger and Stammberger in the treatment of CRS over an 11-year period is presented. A detailed questionnaire regarding patient's satisfaction and symptomatic relief has been sent to all patients. The results indicate a successful outcome from this technique and a high level of patient satisfaction. No complications such as CSF leak or orbital injury have been encountered, and no evidence of altered facial growth and development has been noted. We find the endoscopic endonasal technique to be a safe and effective method in the treatment of children with CRS failing medical management.

Child↗
PubMed1993

Tonsillectomy and adenoidectomy pain reduction by local bupivacaine infiltration in children.

Experimental data in humans and animals suggest that during surgery, pain impulses enter the CNS creating a hyperexcitable state in spite of general anesthesia. In a prospective double blind study, pain levels in 22 children undergoing tonsillectomy and adenoidectomy under general anesthesia were compared from day of surgery to Day 10. Patients received pre-incisional infiltration with either bupivacaine (A) or saline (B). Subjective pain was assessed by visual analog scale, and objective pain by deglutition time (100 ml). Subjective constant pain was less (P < 0.05) in group (A) on Day 1: 16 (A) vs. 59 (B) and Day 5: 4 (A) vs. 45 (B). We conclude that local nerve blockade by bupivacaine reduces short- and long-term pain in children undergoing tonsillectomy and adenoidectomy in the presence of general anesthesia.

Adenoidectomy↗
PubMed1986

Spinal and supraspinal mechanisms for morphine-pentobarbital antinociceptive interaction in relation to cardiac acceleration response in rats.

In rat experiments, morphine-pentobarbital antinociceptive interaction affecting cardiac acceleration in response to somatic noxious stimulation was analyzed with the use of intrathecal and intracerebroventricular injections of morphine. Cardiac acceleration response was induced by tail compression, and heart rate was monitored by electrocardiogram. Pentobarbital, in a subanesthetic intravenous dose, antagonized the antinociceptive effect of morphine in relation to cardiac acceleration response when morphine was administered intracerebroventricularly. Without pentobarbital, morphine, 8 micrograms, almost completely blocked the cardiac acceleration response, which was only 1 +/- 1 beats/min. When pentobarbital (10 mg/kg intravenously) was administered in a combination with the same dose of morphine, the cardiac acceleration response was 29 +/- 3 beats/min (P less than 0.0001). In contrast, when morphine was administered intrathecally, the antagonism by pentobarbital of the cardiac acceleration response was absent. The results suggest that supraspinal mechanisms play a decisive role in morphine-pentobarbital antagonism in relation to cardiac acceleration response to somatic noxious stimulation.

Animals↗
PubMed1984

Halothane antagonizes effect of morphine on the motor reaction threshold in rats.

The ability of halothane (used in "sub-MAC" concentrations) to modify the effect of morphine on motor response threshold to pressure was studied and compared with pentobarbital in 241 rat experiments. It was found that halothane (0.5-0.7%, insp.) decreased the reaction threshold to pressure, as did pentobarbital. Halothane (0.5%) increased morphine ED50 for the reaction threshold to pressure from 0.21 mg . kg-1 (95% fiducial limits: 0.13-0.29 mg . kg-1) to 0.52 mg . kg-1 (0.28-0.73 mg . kg-1, P less than 0.0001). Pentobarbital in a dose of 3 mg . kg-1 demonstrated a similar antanalgesic effect. Neither halothane nor pentobarbital antagonized the effect of morphine with motor response to the tail clamp. On the contrary, both agents strengthened this effect. It has been suggested that the effect of morphine on the motor response threshold to pressure results primarily from activation of inhibitory control mechanisms concerned with this response; halothane in a subanesthetic concentration depresses the inhibitory control mechanisms and, therefore, weakens the effect of morphine.

Animals↗
PubMed1984

Pentobarbital antagonizes the effect of morphine on cardiac acceleration response to noxious stimulation.

The effects of morphine alone and in combination with pentobarbital on the cardiac acceleration response to somatic noxious stimulation were studied in 145 rats. It was found that pentobarbital in subanesthetic doses (1-10 mg X kg-1) weakened the inhibitory effect of morphine on the cardiac acceleration response; it antagonized the effect of morphine in a dose-dependent manner. The maximal antagonism was observed with a pentobarbital dose of 10 mg X kg-1. With this dose of pentobarbital, even 200 mg X kg-1 or morphine was unable to block the cardiac acceleration response (without pentobarbital, morphine blocked the response in a dose of 10 mg X kg-1). Caffeine (10 mg X kg-1), on the contrary, strengthened the effect of morphine on the cardiac acceleration response: there was a significant (P less than 0.05) shift to the left along the dose axis in the position of morphine dose-effect curve for the cardiac acceleration response. It has been suggested that the effect of morphine on the cardiac acceleration response to noxious stimulation results primarily from activation of inhibitory control mechanisms concerned with this response; pentobarbital depresses the inhibitory control mechanisms and, therefore, weakens the effect of morphine.

Animals↗