General anesthesia for cardiac catheterisation in children.
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Adolescent↗
Biomedical subjects
P Mundeleer
Publications and source records attributed to P Mundeleer.
Etomidate and tonsillectomy.
Tonsillectomy under general anesthesia, one of the most commonplace operations there are, is more of a problem for the anesthetist than for the surgeon. Once intubated, the child or adult will be protected from any operative risks by correct ventilation and the protection of his upper airways. The only problem is that arising from the anesthesia required to carry out this intubation and from the consequences of this anesthesia on the waking period, which should be brief in order to avoid, after detubation, any reactions which might induce excessively deep sleep at that moment. In this respect we found etomidate, with its short duration of action, even after reinjection, just as interesting as methohexital. We should mention, however, that his product presents certain disadvantages the most troublesome of which seemed to be the pain provoked when this substance is injected. A new solution (of basic etomidate) still hardly presented this disadvantage.
Child↗
Study on peroperative bleeding in ear, nose and throat surgery.
Some interventions in ENT surgery are very difficult or are even impossible if the slightest bleeding occurs. Microsurgery of the ear is the best example. For this reason we choose this particular intervention to test different anesthesia techniques. Bleeding in the surgical field is followed, while simultaneously respiratory, venous and arterial pressure tracings are recorded. These parameters are followed and changes can be attributed directly to observations by microscope of the surgical field. Successively neuroleptanalgesia in its pure form or with help of several drugs (trimetaphan, furosemide, enflurane) is studied. One conclusion can probably be made of the analysis of our series: an anesthesia with "light" analgesia gives better results than an anesthesia protecting completely the patient.
Anesthesia, General↗
Intramuscular premedication with lorazepam.
Lorazepam is recognized as a tranquillizer. It is presented for intramuscular and intravenous injection. In a study of this drug's possible effects in premedication, its action was studied systematically when it was used for preoperative premedication. The drug has no side-effects other than drowsiness, which occurs in almost all cases. It produces very good premedication, sometimes with anterograde amnesia in the doses used. This anterograde amnesia is dependent on the dosage used but it is always accompanied by profound drowsiness, from which the patient can be roused verbally. The dose will be selected in relation to whether amnesia is desired or not. However, whatever the dose administered (over 2.5 mg), the tranquillizing effect is always of high quality.
Adult↗
[Neuroleptics and microsurgery of the ear].
In the field of research into new methods, we attempted to determine the primary effect, i.e. neuroleptic effects following the intensity of reactions to stimulation in patients undergoing microsurgery of the ear, comparing in particular the quantities of analgesic necessary and used during general anesthetic to ensure both clinically visible protection and, above all, suppression of the effects of stimulation at the level of recordings of arterial and venous pressures. This permits, in our opinion, one to evaluate the dose necessary but also, determine whether or not a drug belongs to the category of neuroleptics which are interesting for the anesthetist.
Analgesics↗
Monitoring respiratory function by computer in ICU. Preliminary work.
The structure of the respiratory monitoring system under construction in Brussels University Hospitals is described. It is modular and hierarchized. It is based on the observation of the lung mechanics, of the flows of inspired and expired gases and of continuous blood measurements in patients artificially ventilated. Respiratory monitoring may be confined to the continuous observation of the natural evolution of a large number of parameters and the extraction of the most possible information with the aid of automatic calculations effected in real time. The authors propose to add deliberate and controlled aggressions of the pulmonary system in order to observe its dynamic behavior. Practical function tests are described. They lead to the calculation of functional residual capacity, continuous distribution of tidal volume, and pulmonary capillary blood flow. These tests can be performed automatically by using a new electronic unit built in our laboratory. It enables a digital computer to control the functioning of a commercially available ventilator.
Belgium↗