Thomas P. Beach

Bio: Thomas P. Beach is an academic researcher from Ohio State University. The author has contributed to research in topics: Intubation & Lidocaine. The author has an hindex of 6, co-authored 7 publications receiving 217 citations. Previous affiliations of Thomas P. Beach include Boston Children's Hospital.

Succinylcholine-induced Hyperkalemia in Dogs with Transected Sciatic Nerves or Spinal Cords

Abstract: Hyperkalemia followed the intravenous injection of succinylcholine (0.25 mg/kg) in dogs with bilaterally-sectioned sciatic nerves or transected spinal cords. The hyperkalemia was significant beginning after the fourteenth day, and became highly significant at 28 days (P

Effects of lidocaine, succinylcholine, and tracheal intubation on intraocular pressure in children anesthetized with halothane-nitrous oxide.

Abstract: Both succinylcholine and tracheal intubation may increase intraocular pressure (IOP) in lightly anesthetized individuals (1,2). Controversy exists concerning the relative contributions of succinylcholine or intubation itself to the increase in IOP (2,3). Because increased IOP might further damage the eye with a perforating injury (1,3), several drugs to prevent or attenuate intraocular hypertension caused by succinylcholine and intubation have been evaluated, with mixed results. Lidocaine pretreatment has been utilized in at least four studies (3-6), with moderate success reported in one (6); most patients were adults and all were given thiopental for induction of anesthesia. To our knowledge, there has been no pediatric study specifically assessing the efficacy of lidocaine pretreatment in diminishing the increase in IOP associated in adults with succinylcholine and subsequent intubation. Furthermore, there has been no such study in patients undergoing an inhalation induction. We studied children in whom anesthesia was induced with halothane and nitrous oxide (N20). In addition to evaluating lidocaine pretreatment in preventing a succinylcholine-induced increase in IOP, we determined the effects of either lidocaine alone or succinylcholine alone on IOP and separately measured the additional effects of intubation on IOP. Preextubation measurements were also made.

Surgical and patient factors involved in postoperative nausea and vomiting.

Abstract: Seventy-five years ago, Flagg suggested that post-operative vomiting may result from causes other than anaesthetics: «there are at least three kinds of vomiting », the first of which he attributed to anaesthetics such as ether, the second to reflex responses, that is pain or ovarian surgery, and the last to opioids, for example morphine [30]. Before this report, anaesthetics alone were thought to be responsible for most postoperative nausea and vomiting (PONV)

Succinylcholine-Induced Hyperkalemia in Neuromuscular Disease

Abstract: The dangerously high levels of plasma potassium known to follow succinylcholine chloride administration in patients with burns or trauma have also been noted in patients with paraplegia or hemiplegia, muscular dystrophy, and multiple sclerosis. Of 40 patients with these neuromuscular diseases, 15 had increases in potassium levels between 1 and 6 mEq/liter after receiving succinylcholine chloride, 1 mg/kg of body weight. Most increases over 1 mEq/liter occurred in those patients who had been ill for less than six months or, if longer, who had disease of a progressive nature. The degree and extent of muscle paralysis seemed directly correlated with relaxant-induced hyperkalemia.

Advances in neurobiology of the neuromuscular junction: implications for the anesthesiologist.

Abstract: THE mammalian neuromuscular junction (NMJ) is one of the most studied and best understood synapses. Recent work has brought forth new information as to development, maturation, and function of this fundamental synapse, both in health and disease. The healthy function of the NMJ underlies one important measurement of the response to general anesthetics, immobility. “Neuromuscular blockers” acting directly at the NMJ are used as a component of many balanced anesthetic techniques, and the health of the NMJ profoundly influences anesthetic technique. For these reasons, it is imperative that anesthesiologists be aware of new developments in the field. The normal development, maturation, and function of the NMJ are discussed. Diseases of the NMJ are also reviewed with emphasis on new etiologic, pathologic, and treatment-oriented information.

Cardiac arrest after succinylcholine: mortality greater with rhabdomyolysis than receptor upregulation.

Abstract: THIS all began during the World Congress of Anaesthesiologists in Holland in June 1992, at an extramural multinational panel convened to prepare an educational videotape.† Speakers from the United States and Germany described pediatric cases of sudden rhabdomyolysis and hyperkalemic cardiac arrest after administration of succinylcholine. Despite prompt and apparently skilled resuscitation, the mortality rate was 40–55%. This surprising and puzzling mortality rate prompted considerable discussion and, over time, repeated reflection on what might be happening.

Anaesthesia for chronic spinal cord lesions

Abstract: Increasing numbers of patients with spinal cord injury present for surgery or obstetric care. Spinal cord injury causes unique pathophysiological changes. The most important peri-operative dangers are autonomic dysreflexia, bradycardia, hypotension, respiratory inadequacy and muscle spasms. Autonomic dysreflexia is suggested by headache, sweating, bradycardia and severe hypertension and may be precipitated by surgery, especially bladder distension. Patients with low, complete lesions, undergoing surgery below the level of injury, may safely do so without anaesthesia provided there is no history of autonomic dysreflexia or troublesome spasms. An anaesthetist should be present to monitor the patient in this situation. General anaesthesia of sufficient depth is effective at controlling spasms and autonomic dysreflexia but hypotension and respiratory dysfunction are risks. There is a growing consensus that spinal anaesthesia is safe, effective and technically simple to perform in this group of patients. We present a survey of 515 consecutive anaesthetics in cord-injured patients and a review of the current literature on anaesthesia for patients with chronic spinal cord lesions.