Perioperative cardiac arrhythmias in digitalized patients with ischemic heart disease (author's transl)

The purpose of this study was to establish the incidence of pre-operative digitalization by intravenous digoxin on cardiac arrhythmias in 24 patients with ischemic heart disease who underwent abdominal surgery. Ambulatory electrocardiographic monitoring was performed for 12 hours before digitalization, for 12 hours during digitalization (before surgery), for the whole period of anesthesia. General anesthesia used thiopentone, phenoperidine, pancuronium and suxamethonium for endotracheal intubation. No more premature ventricular (PVC) and auricular contractions were detected after digitalization and during anesthesia and surgery. But PVC with begeminism or severe bradycardia were recorded in two patients and episodes of "torsades de pointes" occurred in two other patients during endotracheal intubation. "Torsades de pointes" have never been reported after suxamethonium and endotracheal intubation in digitalized patients. Digitalization, ischemic heart disease, cardiac effects of suxamethonium might be factors of the onset of these first reported "torsades de pointes". In conclusion, after a pre-operative digitalization in the coronary patients the frequency of arrhythmias is not exaggerated during the pre- or per-operative period except during induction and intubation. As the role of suxamethonium seems to be important as a trigger for severe arrhythmias endotracheal intubation in digitalized coronary patients should be performed without suxamethonium.     

Congenital heart block and pacemaker implantation (author's transl)

A six years old boy was sent to our service due to a loss of conscience spell. He had no preceding history E.K.G. showed a complete A-V block. Laboratory findings were within normal limits. Cardiac catheterism was performed and it ruled out any antomic abnormality, making evident a good contraction ability. To decide pacemaker implantation we evaluted: 1. That cardiac frequency was not increased by exercise neither by action of pharmacologyc agents (atropine, insoproterenol).-2. The existence of wide and bizarre QRS ocmplex.-3. And dizziness spels. The patient has been controlled during the past two years. Parasistolia has appeared, not showing modification till today.     

Evaluation of laser surgery against brain tumor (author's transl)

A surgical carbon dioxide laser unit (Laser) has been used in 26 cases of various brain tumors, including 10 meningioma (4 sphenoid ridge, 3 parasagittal, 1 falx, 1 olfactory, 1 posterior fossa); 12 glioma (7 glioblastoma, 5 astrocytoma); two metastatic brain tumors; 1 hemangioblastoma, and 1 AVM. Criteria for Laser use based on evaluation and location of meningioma were: grade 1, convenient but adjuvant; grade 2, also necessary; grade 3, indispensable. Most meningioma in convexity and parasagittal were grade 1-2, with those in the sphenoid ridge grade 2-3. In the glioma group, hemorrhage in 3 cases of glioblastoma was easily Laser-controlled, and the tumors wasted away in a short time with vaporization. There was minimal mechanical effect on the adjacent tissue. Conclusion: In neurosurgery, Laser is obligatory in sphenoid ridge meningioma to dissect the internal carotid artery, middle cerebral artery, cavernous sinus, sphenoid ridge, etc. It is very useful in glioma, especially glioblastoma, considering shortened surgical duration, decreased blood loss and extended tumor resection. Laser surgery is proposed as most appropriate for brain tumors in elderly and poor risk cases mainly for its vaporizing function.     

Anesthetic management for delivery of 38 cardiac patients (author's transl)

The choice of anesthesia is discussed in connection with a serie of 38 women cardiac and pregnant cared from 1976 to 1979, 32 of them having delivered a child. Peridural analgesia improves the labour and the delivery without inconveniene for either mother of child, but general anesthesia must be prefered for cesarean section. Anticoagulant therapy is a contra-indication for peridural analgesia.     

Di Giorge's syndrome with congenital heart disease (author's transl)

Authors describe three cases of Di Giorge's syndrome (thymic and parathyroid aplasia) proved through anatomical study postmorten, associated with cardiac malformations (Tetralogy of Fallot with pulmonary atresia, persistent truncus arteriosus and large patent ductus arteriosus). Clinical characteristics of the stated syndrome are analized with special reference to congenital heart diseases that are included in it.     

Dumping-prophylaxis (author's transl)

The dumping syndrome is due to a vigorous reflex distension of the jejunum, caused by the stomach violently evacuating its contents. The aim of treatment is to overcome the drastic evacuation by restoring the rhythmic peristalsis of the stomach (eukinetics). This can be achieved by a special diet. Every meal should begin with well chewed solids (pulp) and avoid all fluids. With a well organised medical staff a complete success can be achieved. Surgical measures in Dumping can be avoided.