Should drugs be injected via stopcocks when caring for children?
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Anesthesia, Intravenous↗
Biomedical subjects
J B Gunter
Publications and source records attributed to J B Gunter.
Minimum alveolar concentration of halothane for tracheal intubation in children.
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Anesthesia, Endotracheal↗
Hydrogen transfer in catalysis by adenosylcobalamin-dependent diol dehydratase.
Studies [bachovchin, W. W., et al. (1978) Biochemistry 17, 2218] of the mechanism of inactivation of adenosylcobalamin-dependent diol dehydratase have led to the development of a general method to describe the kinetics of a reaction pathway containing a reservoir of mobile hydrogen. Analysis by this method of catalytic rate measurements for mixtures of 1,2-propanediol and 1,1-dideuterio-1,2-propanediol supports a mechanism involving an intermediate with three equivalent hydrogens, in which hydrogen transfer from this intermediate to product is the major rate-contributing step. Other results using tritium as a trace label [essenberg, M. K., et al. (1971) J. Am. Chem. Soc. 93, 1242] are considered in light of these deuterium isotope studies.
Cobamides↗
Thoracic epidural anesthesia via the modified Taylor approach in infants.
BACKGROUND AND OBJECTIVES: Advancement of catheters from the caudal to the thoracic level is an alternative to thoracic epidural anesthesia in infants and younger children; however, contamination of the insertion site may occur. This study examined the feasibility of the midline modified Taylor approach (L(5)-S(1)) for the advancement of epidural catheters to the thoracic level in infants. METHODS: After Institutional Review Board (IRB) approval and parental consent, the L(5)-S(1) interspace of infants 3 months to 2 years old was entered with an 18-gauge Crawford needle using the saline loss of resistance technique. A 20-gauge catheter with stylet (Abbott; North Chicago, IL) was then advanced the distance from the L(5)-S(1) interspace to the desired thoracic level. If resistance was encountered, the catheter was withdrawn 1 to 2 cm, rotated along its long axis, and readvanced. The stylet was left in place, and a radiograph of the thoracolumbar spine was taken. The stylet was then removed, and the catheter was secured, tested, and dosed. RESULTS: Sixteen infants (mean age, 14.4 +/- 5.7 months and mean weight, 9.3 +/- 1.4 kg) were studied. Fifteen of 16 catheters were inserted the full length planned. Fourteen of 16 catheters were straight (1 had a single bend, and 1 had multiple loops). Mean discrepancy between level desired and obtained was -1.7 +/- 1.7 segments (median, -1.75). Discrepancy did not correlate with either desired level or length inserted, but did decrease with experience. CONCLUSIONS: The midline modified Taylor approach allows access to the thoracic epidural space via catheter advancement, while being below the terminus of the spinal cord and less likely to suffer contamination than the caudal approach.
Anesthesia, Epidural↗