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Biomedical subjects

Zahid Hussain Khan

Publications and source records attributed to Zahid Hussain Khan.

10 recordsLinked to original sources
PubMed2005

Pressure measurements during cardiac surgery--internal jugular vs central venous.

Although central venous pressure (CVP) is a valuable guide and measurement during cardiac surgery anesthesia, there are many occasions however, when the time consumed in inserting a peripheral catheter, defeats the actual purpose. The purpose of this study was to compare central venous pressure and internal jugular veins pressure, and to see whether the jugular veins pressures were a reliable guide to central venous pressure monitoring. Simultaneous measurements of the internal jugular (both left and right side) and right atrial venous pressures were made in 70 patients undergoing cardiac surgery both at times when the chests were closed and when they were opened. After induction of anesthesia, a 16 gauge catheter was inserted into the internal jugular vein on each side of the neck, and another catheter was passed into the right atrium. Then the CVP and internal jugular veins were measured six times during anesthesia and postoperatively. A good correlation was found between pressures of right and left internal jugular veins with that of CVP both at times when the chests were closed and when they were opened. It is concluded that left and right internal jugular vein pressures are reliable guides to central venous pressures during anesthesia in cardiac surgery.

Blood Pressure↗
PubMed2005

Vigilant surgical hemostasis challenged by ketamine or hypervolemia induced hemodynamic stress to minimize postoperative hemorrhage in patients with parasagittal/or parafalcian meningiomas: an interventional study.

BACKGROUND: Prevention of postoperative intracranial hemorrhage, a serious and sometimes fatal complication remains the cornerstone for successful neurosurgical procedures. The aim of this study was to test the hypothesis whether vigilant rehemostasis challenged by ketamine or hypervolemia-induced hemodynamic stress could minimize postoperative hemorrhage. METHODS: During a five-year period between 1995 and 2000, in an interventional study, 37 patients having parasagittal or parafalcian meningiomas were randomly allocated into three groups. After accomplishing tumor resection and securing initial surgical hemostasis, the patients received one of the following treatment regimens, i.e. group 1, 1.5 mg/kg of ketamine given intravenously, group II, 1 liter of isotonic saline, and group III, as the control group receiving conventional maintenance fluids intraoperatively, and in all the three groups, the time consumed to achieve rehemostasis at the tumor bed was recorded. Twenty four hours later, a brain computed tomogram was obtained to evaluate the hematoma volume to tumor volume ratio and extent of perifocal edema and the results were recorded. RESULTS: The calculated hematoma volume to tumor volume ratio and the edema score in the ketamine group was significantly less than the control group (P < 0.05). These measurements were also less in the hypervolemia group compared with the control group although the differences were not statistically significant. The rehemostasis time was also significantly more in the ketamine group compared with the control group (P < 0.05). The postoperative hospital stay however, was significantly shorter in the ketamine group (P < 0.05). On the other hand the occurrence of postoperative edema was significantly less in the ketamine group (P = 0.02) compared with the control group. CONCLUSIONS: It is concluded from our data that, vigilant rehemostasis challenged by ketamine or hypervolemia-induced hemodynamic stress minimizes postoperative hemorrhage without producing troublesome brain edema.

Adult↗
PubMed2004

An accidental intra-arterial injection of thiopental on the dorsum of the foot--a case report.

Since its maiden clinical use decades back, innumerable instances of accidental intra-arterial injection of the drug have been reported mostly in the upper extremities. We report an accidental intra-arterial injection of thiopental into one of the tributaries of the arterial arch of the dorsum of the foot, but timely and prompt treatment with lidocaine and heparin together with leg rising prevented a gangrenous episode of the extremity and resulted in an uneventful recovery. This report emphasizes the importance of extreme caution while cannulating the veins on the dorsum of the foot. Attention should be focused on the patient's reactions, the feeling of an intense pain and withdrawal of the leg during injection so that timely therapeutic measures are undertaken and the sad episode is prevented.

Accidents↗
PubMed2003

A comparison of the upper lip bite test (a simple new technique) with modified Mallampati classification in predicting difficulty in endotracheal intubation: a prospective blinded study.

We explored the possibility that a simple and single test could replace the modified Mallampati score for either a difficult or an unaccomplished tracheal intubation in an impending hypoxic patient. Three hundred adult patients were enrolled in this study. They were subjected to the following assessments: 1) oropharyngeal class according to the modified Mallampati criteria; 2) the new, upper lip bite criteria-class I = lower incisors can bite the upper lip above the vermilion line, class II = lower incisors can bite the upper lip below the vermilion line, and class III = lower incisors cannot bite the upper lip; and 3) laryngeal view grading according to Cormack's criteria. The incidence of difficult intubation was 5.7%. The upper lip bite test showed significantly higher specificity and accuracy than the modified Mallampati test (P < 0.001). Comparisons of sensitivity, positive and negative predictive values, between the two tests, however, did not reveal any significant differences (P > 0.05). In conclusion, the upper lip bite test is an acceptable option for predicting difficult intubation as a simple, single test.

Adolescent↗
PubMed2002

A comparison of metoclopramide and lidocaine for preventing pain on injection of diazepam.

UNLABELLED: We compared the ability of metoclopramide with IV lidocaine pretreatment to abolish pain from a diazepam injection. In a randomized, prospective, double-blinded, placebo-controlled clinical trial, 159 patients (ASA physical status I and II), aged 20-70 yr old, were allocated to one of three groups. Placebo and study drugs were injected IV immediately before 0.1 mg/kg of diazepam into a dorsal hand vein. Patients in Groups 1, 2, and 3 received 2 mL of placebo, 2 mL of lidocaine 1%, and 2 mL of metoclopramide (10 mg), respectively. The patient's response was graded using a 4-point scale. Any score other than 0 represented pain on injection. We observed that the incidence of pain on diazepam injection was 83% in the placebo group, which was decreased to 70% and 39% in patients pretreated with metoclopramide and lidocaine, respectively. Although there was no significant difference in the incidence of pain in Groups 1 and 3 (P > 0.05), Group 3 showed significantly less patients with severe pain scores than Group 1 as diazepam was injected (P < 0.000). Group 2 showed a significantly less frequent incidence of pain than the saline (P < 0.000) and the metoclopramide (P < 0.002) groups as diazepam was injected. The intensity of pain in Group 2 was significantly less than Group 3 (P = 0.012). The intensity of diazepam injection pain was intense with placebo as compared with other groups (P < 0.000). Metoclopramide, rather than lidocaine pretreatment, may be a reasonable analgesic alternative for painful injections. IMPLICATIONS: Metoclopramide, rather than lidocaine pretreatment, may be a reasonable analgesic alternative to decrease pain from a diazepam injection, especially when there is a medical condition in which lidocaine should be used very cautiously.

Adjuvants, Anesthesia↗