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S Siddik

Publications and source records attributed to S Siddik.

7 recordsLinked to original sources
PubMed2000

Sevoflurane anesthesia in a myasthenic patient undergoing transsternal thymectomy.

Myasthenia gravis (MG) is an autoimmune disease resulting from the production of antibodies against the acetylcholine receptors of the neuromuscular synapse. The thymus gland is involved in the autosensitization process, and there is a consensus that all adults with generalized MG should have a thymectomy. Removal of a much thymic tissue as possible via the transsternal approach in the logic goal of thymectomy in the treatment of MG. Because of the unpredictable response to succinylcholine and the marked sensitivity to nondepolarizing muscle relaxants in the MG patients, some anesthesiologists avoid the use of muscle relaxants in the myasthenic patients, and depend on deep inhalation anesthesia, such as halothane, isoflurane or sevoflurane. In the present report, we used sevoflurane 4%, without supplementation by muscle relaxants, for the induction and maintenance of anesthesia in a MG patient undergoing transsternal thymectomy. The report reviews the anesthetic technique, and describes the electromyographic (EMG) changes following sevoflurane.

Adult↗
PubMed1999

Cisatracurium in a myasthenic patient undergoing thymectomy.

PURPOSE: The report investigates cisatracurium neuromuscular block in a myasthenic patient undergoing thymectomy. CLINICAL FEATURES: A myasthenic patient (Osserman II B) was prepared preoperatively with 240 mg x day(-1) pyridostigmine. The neuromuscular block produced by 0.05 mg x kg(-1) cisatracurium was monitored by Datex electromyography. The electromyographic response was compared with that in a control group of five non-myasthenic patients. In the myasthenic patient, cisatracurium resulted in a rapid onset of complete (97-98%) neuromuscular block, while a slow onset of partial (80-90%) block was achieved in the control group. Also, administration of 0.05 mg x kg(-1) neostigmine at the end of surgery reversed the neuromuscular block of cisatracurium in the non-myasthenic patients, but did not change the rate of spontaneous recovery in the myasthenic patient. CONCLUSION: The myasthenic patient is sensitive to cisatracurium, as evidenced by a more rapid onset and more marked neuromuscular block compared with the control non-myasthenic patients. This may be attributed to the decreased number of functional endplate acetylcholine receptors in the myasthenic patient, with a consequent decrease of the safety margin of neuromuscular transmission. Also, in contrast with the control group, the rate of recovery from neuromuscular block in the myasthenic patient was not enhanced by neostigmine at the end of surgery. This may be attributed to the prior inhibition of acetylcholinesterase by the preoperative pyridostigmine, as well as by possible desensitization of the cholinergic receptors secondary to prolonged pyridostigmine therapy.

Adult↗
PubMed1999

Multifetal pregnancies.

Parturients with multiple gestation challenge all members of the perinatal team. Satisfactory maternal and fetal outcome require the experience and expertise of the obstetrician, anesthesiologist and neonatologist, all of whom must be well informed in terms of the total care and management plan.

Anesthesia, Obstetrical↗
PubMed1998

Supplementation of general anaesthesia with tramadol or fentanyl in parturients undergoing elective caesarean section.

PURPOSE: Tramadol has been recommended for analgesia in parturients undergoing vaginal delivery. The present report investigated the effect of tramadol versus fentanyl on umbilical vein (UV) blood gases and Apgar scores of neonates delivered via elective Caesarean section under general anaesthesia. METHODS: Forty ASA I or II parturients undergoing elective Caesarean section were included in a randomized double-blinded study. The patients were divided into a tramadol (n = 20) and fentanyl groups (n = 20). During preoxygenation, one group received 100 mg tramadol i.v., while the second received 100 micrograms fentanyl. Anaesthesia was induced in both groups by 3 mg.kg-1 thiopentone and 1.5 mg.kg-1 succinylcholine was given to facilitate tracheal intubation. Anaesthesia was maintained during the induction-delivery period with nitrous oxide 50% in oxygen. RESULTS: The umbilical vein PO2 was higher in the fentanyl (34 +/- 5 mmHg) than in the tramadol group (24 +/- 6 mmHg) (P < 0.01), while the UV PCO2 was higher in the tramadol group (50 +/- 5 vs 45 +/- 4 mmHg) (P < 0.01). The Apgar scores at one and five minutes were not different between the two groups. Post operatively, two patients in the tramadol group recalled the crying of their newborn at delivery. CONCLUSION: Tramadol is associated with a high incidence of intraoperative maternal recall and can result in lower umbilical vein PO2 and higher PCO2 than in the fentanyl group.

Adjuvants, Anesthesia↗
PubMed1991

Action of propofol on resistance and capacitance vessels during cardiopulmonary bypass.

The peripheral vascular action of propofol on the resistance and the capacitance vessels was investigated in 16 patients during cardiopulmonary bypass. The venous reservoir (RV) and mean arterial pressure (MAP) were used as indices of the changes in venous capacitance and systemic vascular resistance (SVR), respectively. Propofol 2 mg.kg-1 produced a decrease in MAP without a significant change in RV, suggesting that propofol preferentially decreases SVR without a significant change in venous capacitance.

Adult↗