Levon M Capan, M.D.

In vitro performance evaluation of two rapid fluid infusion devices
Capan L.M.; Chakiryan N.; Miller S.M.; O'Neill D.K.; Jacobson J.; Martinez E.A.
2011 ;112(5 SUPPL 1):?-?, Anesthesia & analgesia
Introduction : Rapid infusion devices are becoming increasingly popular for the administration of warm fluids and blood in hypovolemic patients. A recently developed system, Thermacor 1200 (Smisson-Cartledge Biomedical LLC, Macon, GA), consists of a central device to which a disposable cartridge of fluid lines attaches. Performance characteristics of this device have yet to be evaluated. We compared the Thermacor 1200 with a currently utilized infusion device, FMS 2000 (Belmont Instrument Corp., Billerica, MA), to evaluate maximum flow rates, accuracy of actual versus set flow rates, fluid warming capabilities, and air bubble elimination. Methods : A ThermaCor 1200 and an FMS 2000, owned by our institution, were evaluated in vitro after being tested for proper functioning. FMS 2000 was tested with the packaged 4.5ft patient line, and Thermacor 1200 with packaged 3ft (TC3) and 6ft (TC6) patient lines. Maximum flow rates of lactated Ringer's (LR) and expired packed red blood cells (PRBCs) were measured with 22, 20, 18, 16, 14 and 8.5F gauge catheters, using a graduated cylinder and stopwatch. Flow rate accuracy was determined by comparing the actual versus displayed flow rates, for LR and PRBCs. Temperature was measured, at various flow rates, with an electronic probe (Wavetek 23XT, San Diego, CA) positioned 3cm from the distal port of the outflow tubing, for LR and PRBCs. Air elimination capability was determined, for LR only, by infusing fluid into an inverted 20mL syringe submerged in a bucket of water, and measuring the resulting air trapped in the syringe. All measurements were repeated six times. Data were analyzed using one-factor ANOVA, and the Tukey multiple comparisons method. Statistical significance was defined as p<0.05. Results : Maximum flow rates were higher with TC3 and TC6 than with FMS 2000 in most instances, especially when using larger catheter bores (Table 1). Flow rates were more accurate with TC3 and TC6 than with FMS 2000 for LR (1.4, 1.6, and 3.5% variance from target rate, respectively; p<.001) and for PRBCs (2.1, 2.6, and 5.9% variance from target rate, respectively; p<.001). Temperatures of delivered fluid were higher with TC3 and TC6 as compared to the FMS 2000 for LR (38.0, 37.8, and 36.8degreeC. respectively; p<.001) and PRBCs (38.2, 38.1, and 37.2degreeC, respectively; p<.001). Air was not detected in fluid infused from either device. Discussion : In this experiment, the performance of the Thermacor 1200, at both lengths of patient line, was superior to that of the FMS 2000 in that it infused LR and PRBCs at higher and more accurate flow rates, at higher temperatures. (Table presented)
— id: 146280, year: 2011, vol: 112, page: ?, stat: Journal Article,

Blood Banking and Transfusion Medicine Educational Deficiencies Are Common Among Resident and Attending Physicians
Jacobson, JL; Capan, L
2009 SEP ;49(1):272A-272A, Transfusion
— id: 102451, year: 2009, vol: 49, page: 272A, stat: Journal Article,

Feasibility of an infraclavicular block with a reduced volume of lidocaine with sonographic guidance
Sandhu, Navparkash S; Bahniwal, Charanjeet S; Capan, Levon M
2006 Jan;25(1):51-56, Journal of ultrasound in medicine
OBJECTIVE: A successful brachial plexus block requires a large volume of a local anesthetic. Sonography allows reliable deposition of the anesthetic around the cords of the brachial plexus, potentially lowering the anesthetic requirement. METHODS: Fifteen sonographically guided infraclavicular blocks were performed in 14 patients with 2% carbonated lidocaine with epinephrine through a 17-gauge Tuohy needle. The amount of lidocaine injected at several points around each cord was based on satisfactory spread observed sonographically. A 19-gauge catheter was then placed with its tip between the posterior cord and axillary artery, and tip position was confirmed by observing the spread of 1 to 2 mL of injected air. Lidocaine was injected through the catheter if necessary to prolong the blocks. RESULTS: Surgery was performed in all patients without general anesthesia, rescue blocks, or infiltration. A heroin user was given an additional 50 microg of fentanyl before the block. One patient required 5 mL of lidocaine through the catheter for an incomplete radial nerve block 5 minutes after initial injection. Seven patients received additional midazolam (mean, 2.5 mg) for alleviation of anxiety despite excellent blocks. The mean +/- SD volume of lidocaine for the initial block was 16.1 +/- 1.9 mL (4.2 +/- 0.9 mg/kg). In 4 patients, additional lidocaine 1 hour after an initial successful block increased the total volume to 19.5 +/- 7.1 mL (5 +/- 1.9 mg/kg). The mean times to perform the block, onset of the block, and achieving surgical anesthesia and the duration of surgery were 10.8 +/- 3.3, 2 +/- 1.3, 5.9 +/- 2.6, and 92.7 +/- 54.4 minutes, respectively. CONCLUSIONS: A successful infraclavicular block in adults with 14 mL of lidocaine is feasible with the use of sonography. The reduced volume does not seem to affect the onset but shortens the duration of the block
— id: 64131, year: 2006, vol: 25, page: 51, stat: Journal Article,

Sonographically guided infraclavicular brachial plexus block in adults: a retrospective analysis of 1146 cases
Sandhu, Navparkash S; Manne, Joseph S; Medabalmi, Praveen K; Capan, Levon M
2006 Dec;25(12):1555-1561, Journal of ultrasound in medicine
OBJECTIVE: The aim of this study was to analyze our experience in 1146 cases of sonographically guided infraclavicular brachial plexus block (ICBPB) performed over 32 months. METHODS: Anesthetic records of 1146 cases of sonographically guided ICBPB performed by our staff were studied retrospectively with the use of a database created by an automated anesthesia record-keeping system. The rates of successful blocks, failed blocks necessitating conversion to general anesthesia or requiring supplementation with local anesthetics, those requiring larger-than-usual doses of sedation, and complications were determined. Analysis included an attempt to determine the possible causes of inadequate blocks and complications. RESULTS: In 1138 patients (99.3%), the block was successful. Six patients had incomplete blocks requiring general anesthesia, and another 2 patients needed local anesthetic supplementation by the surgeons. Ninety-seven percent of the blocks were performed by residents directly supervised by an attending anesthesiologist who held the ultrasound probe. The mean age+/-SD of the patients was 39+/-15 years; the mean duration of surgery was 165+/-114 minutes; and the male-female ratio was 4:1. More than 50% of patients were obese. There were no reported cases of nerve injury, pneumothorax, or local anesthetic toxicity. Arterial punctures occurred in 8 (0.7%) patients, but all were inconsequential. CONCLUSIONS: The data from this retrospective study suggest that sonographic guidance provides a high success rate (99.3%) and improved safety for ICBPB. The increased operator team experience virtually eliminates failure and complications
— id: 70875, year: 2006, vol: 25, page: 1555, stat: Journal Article,

Deep venous thrombosis revealed during ultrasound-guided femoral nerve block
Sutin, K M; Schneider, C; Sandhu, N S; Capan, L M
2005 Feb;94(2):247-248, British journal of anaesthesia
Ultrasound imaging used to facilitate performance of a femoral nerve block also affords imaging of adjacent anatomical structures. Following a fracture of the femur, an ultrasound guided femoral nerve block (UGFNB) was performed to provide analgesia; this led to the incidental finding of a previously undiagnosed femoral vein thrombosis (DVT), resulting in a change in patient management before surgery. An inferior vena cava (IVC) filter was placed before intramedullary nailing of the fracture
— id: 48878, year: 2005, vol: 94, page: 247, stat: Journal Article,

The cost comparison of infraclavicular brachial plexus block by nerve stimulator and ultrasound guidance
Sandhu, NavParkash S; Sidhu, Deepal S; Capan, Levon M
2004 Feb;98(1):267-268, Anesthesia & analgesia
— id: 45682, year: 2004, vol: 98, page: 267, stat: Journal Article,

Ultrasound-guided intraclavicular brachial plexus block ...
Sandhu NS; Capan LM
2003 March;3(1):59-59, Pain practice
— id: 41132, year: 2003, vol: 3, page: 59, stat: Journal Article,

Ultrasound-guided infraclavicular brachial plexus block
Sandhu, NS; Capan, LM
2003 JAN ;90(1):U10-U10, British journal of anaesthesia
— id: 33625, year: 2003, vol: 90, page: U10, stat: Journal Article,

Ultrasound guided infraclavicular brachial plexus block
Sandhu NS; Capan LM
2002 ;2(5):293-298, British journal of anaesthesia. South African excerpts edition
— id: 33627, year: 2002, vol: 2, page: 293, stat: Journal Article,

Ultrasound-guided infraclavicular brachial plexus block
Sandhu, N S; Capan, L M
2002 Aug;89(2):254-259, British journal of anaesthesia
BACKGROUND: Peripheral nerve blocks are almost always performed as blind procedures. The purpose of this study was to test the feasibility of seeing individual nerves of the brachial plexus and directing the block needle to these nerves with real time imaging. METHODS: Using ultrasound guidance, infraclavicular brachial plexus block was performed in 126 patients. Important aspects of this standardized technique included (i) imaging the axillary artery and the three cords of the brachial plexus posterior to the pectoralis minor muscle, (ii) marking the position of the ultrasound probe before introducing a Tuohy needle, (iii) maintaining the image of the entire length of the needle at all times during its advancement, (iv) depositing local anaesthetic around each of the three cords and (v) placing a catheter anterior to the posterior cord when indicated. RESULTS: In 114 (90.4%) patients, an excellent block permitted surgery without a need for any supplemental anaesthetic or conversion to general anaesthesia. In nine (7.2%) patients local or perineural administration of local anaesthetic, and in three (2.4%) conversion to general anaesthesia, was required. Mean times to administer the block, onset of block and complete block were 10.0 (SD 4.4), 3.0 (1.3) and 6.7 (3.2) min, respectively. Mean lidocaine dose was 695 (107) mg. In one patient, vascular puncture occurred. In 53 (42.6%) patients, an indwelling catheter was placed, but only three required repeat injections, which successfully prolonged the block. CONCLUSION: The use of ultrasound appears to permit accurate deposition of the local anaesthetic perineurally, and has the potential to improve the success and decrease the complications of infraclavicular brachial plexus block
— id: 33624, year: 2002, vol: 89, page: 254, stat: Journal Article,

Monitoring for suspected pulmonary embolism
Capan LM; Miller SM
2001 Dec;19(4):673-703, Anesthesiology clinics of North America
It is fortunate that serious embolic phenomena are uncommon because, with the exception of neurosurgery in the sitting position and cardiac surgery, thoracic echocardiography and the precordial Doppler device, the most sensitive indicators of embolism, are seldom used. Vigilance is required of the anesthesiologist to recognize the rapid fall in end-tidal PCO2, the usual first indicator of a clinically significant PE. Any sudden deterioration in the patient's vital signs should include embolism in the differential diagnosis, particularly during procedures that carry a high risk of the complication
— id: 39461, year: 2001, vol: 19, page: 673, stat: Journal Article,

Trauma and burns
Capan LM; Miller SM
Clinical anesthesia Philadelphia : Lippincott Williams & Wilkins, 2001,
— id: 3358, year: 2001, vol: , page: 1255, stat: Chapter,

Ultrasound guidance reduces local anesthetic requirement for intraclaviular brachial plexus block
Sandhu NS; Bahniwal CS; Capan LM
2001 ;95:A851-A851, Anesthesiology
Large dose (7-18mg/kg) and high volume (30-60ml) of local anesthetics (LA) have been used to improve the success rate of brachial plexus blocks.1 Ultrasound (US) guidance permits deposition of LA closely around each cord.2 We hypothesized that this method permits using smaller than usual dose and volume. Methods: After Institutional Review Board approval, 14 consecutive consenting patients undergoing upper extremity surgery were given an US guided infraclavicular block using carbonated (1ml/10ml) lidocaine, 2%, with 1:200,000 epinephrine. The Block was administered using a 2.5 MHz probe (HP 77020A, Andover, MA) and 17G Tuohy needle. Each patient was administered midazolam,1-2 mg, and fentanyl,25-50 mcg prior to the block. A 19G catheter with its tip placed between the axillary artery and the posterior cord, served to inject 10 ml LA if block began to fade during surgery. The final dose of LA was determined based on satisfactory spread observed sonographically around each cord; the maximal dose did not exceed 340 mg in any patient. Time to perform the block,onset of analgesia and motor weakness, complete sensory and motor block, and the time to intraoperative dissipation of block, if it occurred, were recorded. Results:In all patients surgery was completed without any need for general anesthesia, additional opioid or intravenous anesthetic agents, and/or LA infiltration of the surgical field. Time to perform the block was 11.1± 2.7 minutes. Mean±SD body weight of patients was 72.6 ± 13.4 kg. In all patients mean± initial dose of lidocaine was 296 ±39.1mg (4.1 ±0.9 mg/kg), and LA solution volume was 16.24 ± 1.74 SD ml, respectively. Complete sensory and motor block occurred in 4.8 ± 2.6 min. Mean ± SD duration of surgery was 103±47.min. One patient had a patchy sensory block in radial nerve distribution at 5 min after injection, requiring 5ml at 5 minutes and 10 ml each at second and third hour during surgery through the catheter. Two other patients required 10 ml after one and 1.5 hours of initial successful blockade, respectively. Discussion: US guidance may permit reduction of dose and volume of LA, but the duration of block may also be shortened. This may be overcome by placement of an indwelling catheter. Reduction of dose by this method may have clinical implications: minimizing the likelihood of toxicity, ability to administer regional anesthesia at multiple areas of the body at the same time, and short recovery room stay
— id: 41133, year: 2001, vol: 95, page: A851, stat: Journal Article,

Ultrasound guided infraclavicular brachial plexus block
Sandhu NS; Capan LM
2001 ;92(Suppl):S341-S341, Anesthesia & analgesia
— id: 33628, year: 2001, vol: 92, page: S341, stat: Journal Article,

Ultrasound guided popliteal fossa block
Sandhu NS; Capan LM
2001 ;92(Suppl):S342-S342, Anesthesia & analgesia
— id: 33848, year: 2001, vol: 92, page: S342, stat: Journal Article,

Prevention of airborne exposure during endotracheal intubation
Sandhu NS; Schaffer S; Capan LM; Gill JS
1999 Oct;89(4):1067-1068, Anesthesia & analgesia
— id: 23467, year: 1999, vol: 89, page: 1067, stat: Journal Article,

Comparison of the WuScope and Macintosh #3 blade in normal and cervical spine stabilized patients
Sandhu, NS; Schaffer, S; Capan, LM; Turndorf, H
1999 SEP ;91(3A):U253-U253, Anesthesiology
— id: 53863, year: 1999, vol: 91, page: U253, stat: Journal Article,

Succinylcholine cannot relieve an airway obstruction caused by pharyngeal and laryngeal edema - In response
Capan, LM; Sutin, K; Ibarra, PF; Wahlander, S
1998 JUL ;87(1):229-230, Anesthesia & analgesia
— id: 53415, year: 1998, vol: 87, page: 229, stat: Journal Article,

Guidelines for the treatment of acidaemia with THAM [published erratum appears in Drugs 1998 Apr;55(4):517]
Nahas GG; Sutin KM; Fermon C; Streat S; Wiklund L; Wahlander S; Yellin P; Brasch H; Kanchuger M; Capan L; Manne J; Helwig H; Gaab M; Pfenninger E; Wetterberg T; Holmdahl M; Turndorf H
1998 Feb;55(2):191-224, Drugs
THAM (trometamol; tris-hydroxymethyl aminomethane) is a biologically inert amino alcohol of low toxicity, which buffers carbon dioxide and acids in vitro and in vivo. At 37 degrees C, the pK (the pH at which the weak conjugate acid or base in the solution is 50% ionised) of THAM is 7.8, making it a more effective buffer than bicarbonate in the physiological range of blood pH. THAM is a proton acceptor with a stoichiometric equivalence of titrating 1 proton per molecule. In vivo, THAM supplements the buffering capacity of the blood bicarbonate system, accepting a proton, generating bicarbonate and decreasing the partial pressure of carbon dioxide in arterial blood (paCO2). It rapidly distributes through the extracellular space and slowly penetrates the intracellular space, except for erythrocytes and hepatocytes, and it is excreted by the kidney in its protonated form at a rate that slightly exceeds creatinine clearance. Unlike bicarbonate, which requires an open system for carbon dioxide elimination in order to exert its buffering effect, THAM is effective in a closed or semiclosed system, and maintains its buffering power in the presence of hypothermia. THAM rapidly restores pH and acid-base regulation in acidaemia caused by carbon dioxide retention or metabolic acid accumulation, which have the potential to impair organ function. Tissue irritation and venous thrombosis at the site of administration occurs with THAM base (pH 10.4) administered through a peripheral or umbilical vein: THAM acetate 0.3 mol/L (pH 8.6) is well tolerated, does not cause tissue or venous irritation and is the only formulation available in the US. In large doses, THAM may induce respiratory depression and hypoglycaemia, which will require ventilatory assistance and glucose administration. The initial loading dose of THAM acetate 0.3 mol/L in the treatment of acidaemia may be estimated as follows: THAM (ml of 0.3 mol/L solution) = lean body-weight (kg) x base deficit (mmol/L). The maximum daily dose is 15 mmol/kg for an adult (3.5L of a 0.3 mol/L solution in a 70kg patient). When disturbances result in severe hypercapnic or metabolic acidaemia, which overwhelms the capacity of normal pH homeostatic mechanisms (pH < or = 7.20), the use of THAM within a 'therapeutic window' is an effective therapy. It may restore the pH of the internal milieu, thus permitting the homeostatic mechanisms of acid-base regulation to assume their normal function. In the treatment of respiratory failure, THAM has been used in conjunction with hypothermia and controlled hypercapnia. Other indications are diabetic or renal acidosis, salicylate or barbiturate intoxication, and increased intracranial pressure associated with cerebral trauma. THAM is also used in cardioplegic solutions, during liver transplantation and for chemolysis of renal calculi. THAM administration must follow established guidelines, along with concurrent monitoring of acid-base status (blood gas analysis), ventilation, and plasma electrolytes and glucose
— id: 7701, year: 1998, vol: 55, page: 191, stat: Journal Article,

Flexiguide intubation guide to facilitate airway management with WuScope system
O'Neill D; Capan LM; Sheth R
1998 Aug;89(2):545-545, Anesthesiology
— id: 23468, year: 1998, vol: 89, page: 545, stat: Journal Article,

Trauma and burns
Capan LM; Miller SM
Clinical anesthesia Philadelphia PA: Lippincott-Raven, 1997,
— id: 2641, year: 1997, vol: , page: 1173, stat: Chapter,

Difficult airway management in a patient with traumatic asphyxia [see comments]
Ibarra P; Capan LM; Wahlander S; Sutin KM
1997 Jul;85(1):216-218, Anesthesia & analgesia
— id: 7168, year: 1997, vol: 85, page: 216, stat: Journal Article,

Initial evaluation and resuscitation
Capan LM; Miller SM
1996 ;14(1):197-238, Anesthesiology clinics of North America
— id: 23501, year: 1996, vol: 14, page: 197, stat: Journal Article,

Acute biceps compartment syndrome associated with the use of a noninvasive blood pressure monitor
Sutin KM; Longaker MT; Wahlander S; Kasabian AK; Capan LM
1996 Dec;83(6):1345-1346, Anesthesia & analgesia
— id: 18160, year: 1996, vol: 83, page: 1345, stat: Journal Article,

TRACHEAL LENGTH IN LITHOTOMY AND TRENDELENBURG POSITIONS
KARPINOS, RD; SCHAFFER, SL; CAPAN, LM; TURNDORF, H
1995 SEP ;83(3A):A1219-A1219, Anesthesiology
— id: 86724, year: 1995, vol: 83, page: A1219, stat: Journal Article,

Anesthetic considerations in McCune-Albright syndrome: case report with literature review
Langer RA; Yook I; Capan LM
1995 Jun;80(6):1236-1239, Anesthesia & analgesia
— id: 56668, year: 1995, vol: 80, page: 1236, stat: Journal Article,

Vascular injuries
Miller SM; Capan LM
1995 ;13(1):187-216, Anesthesiology clinics of North America
— id: 8107, year: 1995, vol: 13, page: 187, stat: Journal Article,

Perioperative anesthetic management of spine injuries
Capan LM; Miller SM; Sommer RM
1994 ;8(3):377-400, Problems in anesthesiology
— id: 45961, year: 1994, vol: 8, page: 377, stat: Journal Article,

Intraoperative anesthetic maintenance: pharmacology
Capan LM
Textbook of trauma anesthesia and critical care St. Louis : Mosby, 1993,
— id: 3392, year: 1993, vol: , page: 453, stat: Chapter,

Intravenous agents
Capan LM
Textbook of trauma anesthesia and critical care St. Louis : Mosby, 1993,
— id: 3391, year: 1993, vol: , page: 468, stat: Chapter,

Fat embolism
Capan LM; Miller SM; Patel KP
1993 ;11(1):25-54, Anesthesiology clinics of North America
— id: 45956, year: 1993, vol: 11, page: 25, stat: Journal Article,

Embolism II
Capan, Levon M.; Miller, Sanford M
Philadelphia : W. B. Saunders, 1993,
— id: 434, year: 1993, vol: , page: , stat: ,

Embolism I
Capan, Levon M.; Miller, Sanford M
Philadelphia : W.B. Saunders Co., c1992,
— id: 572, year: 1992, vol: , page: , stat: ,

Trauma : anesthesia and intensive care
Capan LM; Miller SM; Turndorf H
Philadelphia : Lippincott, 1991,
— id: 802, year: 1991, vol: , page: , stat: ,

A method of introducing aerosolized medications into the anesthesia circuit
Ruskin KJ; Capan L
1991 Nov;73(5):676-676, Anesthesia & analgesia
— id: 23478, year: 1991, vol: 73, page: 676, stat: Journal Article,

An aid in cases of difficult tracheal intubation
Sommer RM; Capan LM
1991 May;74(5):964-964, Anesthesiology
— id: 23469, year: 1991, vol: 74, page: 964, stat: Journal Article,

Airway management
Capan LM
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3403, year: 1990, vol: , page: 43, stat: Chapter,

General principles of anesthesia for major acute trauma
Capan LM; Gottlieb G; Rosenberg A
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3404, year: 1990, vol: , page: 259, stat: Chapter,

Anesthetic managment of ocular injuries
Capan LM; Mankikar D; Eisenberg WM
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3405, year: 1990, vol: , page: 357, stat: Chapter,

Management of facial injuries
Capan LM; Miller SM; Glickman R
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3406, year: 1990, vol: , page: 385, stat: Chapter,

Mangement of neck injuries
Capan LM; Miller SM; Turndorf H
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3407, year: 1990, vol: , page: 409, stat: Chapter,

Trauma overview
Capan LM; Miller SM; Turndorf H
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3408, year: 1990, vol: , page: 3, stat: Chapter,

Maximizing oxygenation during one-lung anesthesia
Capan LM; Turndorf H; Miller S
1990 ;2(4):282-304, Problems in anesthesiology
— id: 45964, year: 1990, vol: 2, page: 282, stat: Journal Article,

Trauma : anesthesia and intensive care
Capan, Levon M.; Miller, Sanford M.; Turndorf, Herman
Philadelphia : Lippincott, c1990,
— id: 238, year: 1990, vol: , page: , stat: ,

Flow rates and temperatures of resuscitation fluids by new infusion systems
Kavee E; Boolbol J; Capan LM
1990 ;73:A516-A516, Anesthesiology
— id: 47368, year: 1990, vol: 73, page: A516, stat: Journal Article,

Acute renal failure in the injured
McGoldrick MD; Capan LM
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3413, year: 1990, vol: , page: 755, stat: Chapter,

Management principles for microvascular surgery
Patel KP; Capan LM; Grant GJ; Miller SM
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3417, year: 1990, vol: , page: 547, stat: Chapter,

Musculoskeletal injuries
Patel KP; Capan LM; Grant GJ; Miller SM
Trauma : anesthesia and intensive care Philadelphia : Lippincott, 1990,
— id: 3418, year: 1990, vol: , page: 511, stat: Chapter,

Management of one-lung anesthesia in an anticoagulated patient
Herenstein R; Russo JR; Moonka N; Capan LM
1988 Nov;67(11):1120-1122, Anesthesia & analgesia
— id: 10899, year: 1988, vol: 67, page: 1120, stat: Journal Article,

Spinal anesthesia - measurement of hemodynamics with bioimpedance technique
Lubarsky D; Capan L; Turndorf H
1988 ;13:1S37-1S37, Regional anesthesia
— id: 47296, year: 1988, vol: 13, page: 1S37, stat: Journal Article,

Pro: Application of constant positive airway pressure to the nondependent lung is preferable to high-frequency ventilation for optimal oxygenation during pulmonary surgery
Capan, L M; Miller, S; Patel, K P
1987 Dec;1(6):584-588, Journal of cardiothoracic anesthesia
— id: 70094, year: 1987, vol: 1, page: 584, stat: Journal Article,

MEASUREMENT OF EJECTION FRACTION BY BIOIMPEDANCE METHOD
Capan, LM; Bernstein, DP; Patel, KP; Sanger, J; Turndorf, H
1987 Apr;15(4):402-402, Critical care medicine
— id: 31247, year: 1987, vol: 15, page: 402, stat: Journal Article,

Another case of probable seizure after sufentanil
Rosman EJ; Capan LM; Turndorf H
1987 Sep;66(9):922-922, Anesthesia & analgesia
— id: 23470, year: 1987, vol: 66, page: 922, stat: Journal Article,

Prolongation of lidocaine spinal anesthesia with phenylephrine
Vaida GT; Moss P; Capan LM; Turndorf H
1986 Jul;65(7):781-785, Anesthesia & analgesia
The effect of added phenylephrine on the duration of sensory analgesia during lidocaine spinal anesthesia was determined in 65 ASA class I-III patients randomly divided into three groups. Group 1 (n = 25) received 62.5 mg lidocaine in 7.5% glucose; group 2 (n = 21) received lidocaine with 2 mg phenylephrine; and group 3 (n = 19) received lidocaine with 5 mg phenylephrine. The level of analgesia to pin prick was assessed by an anesthesiologist unaware of the drug combination used. The mean +/- SD cephalad level of analgesia did not differ among the groups. In group 1, the times for two- and for four-segment regression of the level of analgesia, and the time for regression of analgesia to the T-12 dermatome, were 77 +/- 19 (1 SD), 99 +/- 24, and 109 +/- 26 min, respectively. The corresponding values were 98 +/- 25, 118 +/- 27, and 130 +/- 36 min in group 2 and 124 +/- 32, 142 +/- 31, and 162 +/- 35 min in group 3. All the regression times in group 2 were significantly longer than those in group 1 (P less than 0.05). All the regression times in group 3 were significantly longer than those in group 2 (P less than 0.02). It is concluded that clinically useful prolongation of sensory analgesia may be obtained by addition of phenylephrine to lidocaine during spinal anesthesia
— id: 23471, year: 1986, vol: 65, page: 781, stat: Journal Article,

Regional anesthesia in the emergency department
Capan LM; Patel K; Turndorf H
Clinical procedures in emergency medicine Philadelphia : Saunders, 1985,
— id: 3470, year: 1985, vol: , page: ?, stat: Chapter,

Arterial to end-tidal CO2 gradients during spontaneous breathing, intermittent positive-pressure ventilation and jet ventilation
Capan LM; Ramanathan S; Sinha K; Turndorf H
1985 Oct;13(10):810-813, Critical care medicine
Arterial to end-tidal CO2 tension gradients were measured in 18 dogs during spontaneous breathing (SB), intermittent positive-pressure ventilation (IPPV), and both low-frequency and high-frequency jet ventilation (LFJV and HFJV). The dogs were anesthetized with nembutal and permitted to breathe spontaneously through an 8-mm internal diameter endotracheal tube; blood gas tensions, cardiac output, and end-tidal CO2 partial pressure (PetCO2) were measured. IPPV, LFJV, and HFJV were then instituted in a random sequence and measurements repeated. PaO2, PaCO2 and cardiac output were similar during all four ventilatory modes. The mean PaCO2 differed significantly (p less than .001) from PetCO2 during IPPV, LFJV, and HFJV but not during SB. The mean PaCO2-PetCO2 gradient was 3.7 +/- 1 (SD), 12.6 +/- 5.0, and 24.3 +/- 8 torr during IPPV, LFJV and HFJV, respectively. The large gradients during LFJV and HFJV were not produced by dilution of tracheal CO2 by entrained air or by oxygen delivered by the jet. These results suggest that both LFJV and HFJV may be associated with a large PaCO2-PetCO2 gradient
— id: 23472, year: 1985, vol: 13, page: 810, stat: Journal Article,

Precurarization inhibits maximal ventilatory effort
Bruce DL; Downs JB; Kulkarni PS; Capan LM
1984 Nov;61(5):618-621, Anesthesiology
— id: 23473, year: 1984, vol: 61, page: 618, stat: Journal Article,

Antidepressants do not increase the lethality of ketamine in mice
Bruce DL; Capan L
1983 May;55(5):457-459, British journal of anaesthesia
Swiss-Webster mice were allocated to 35 groups of 20 each, including controls, to evaluate the effect of pretreatment with antidepressant drugs on the LD50 of ketamine i.p. Deaths occurred only in groups given ketamine 400 or 600 mg kg-1. Within these groups, there were no consistent differences among untreated mice and those given one of three daily doses of either a tricyclic (amitriptyline) or monoamine oxidase inhibitor (tranylcypromine) antidepressant in their drinking water for 19 days before the ketamine injections. The ketamine LD50 values for the three major pretreatment groups were: controls 400 mg kg-1; amitriptyline 478 mg kg-1; tranylcypromine 483 mg kg-1. Although non-fatal additive toxicity is not ruled out by these findings, mortality from ketamine was not increased by pretreatment with either type of antidepressant
— id: 23479, year: 1983, vol: 55, page: 457, stat: Journal Article,

Succinylcholine-induced postoperative sore throat
Capan LM; Bruce DL; Patel KP; Turndorf H
1983 Sep;59(3):202-206, Anesthesiology
— id: 23474, year: 1983, vol: 59, page: 202, stat: Journal Article,

Acute pulmonary embolism during therapeutic arterial embolization with silicone fluids
Capan LM; Lardizabal S; Sinha K; Ashok U; Berenstein A; Turndorf H
1983 Jun;58(6):569-571, Anesthesiology
— id: 23475, year: 1983, vol: 58, page: 569, stat: Journal Article,

Effect of cimetidine-metoclopromide combination of gastric fluid volume and acidity
Capan LM; Rosenberg AD; Carni A; Patel KP; Sheth R; Kitain E; Turndorf H
1983 ;59:A402-A402, Anesthesiology
— id: 47414, year: 1983, vol: 59, page: A402, stat: Journal Article,

Efficacy of gastroesophageal balloon in preventing passive reguritation in dogs
Rosenberg AD; Sommer RM; Capan LM; Arismendy J; Ramanathan S; Turndorf H
1983 ;59:A155-A155, Anesthesiology
— id: 47417, year: 1983, vol: 59, page: A155, stat: Journal Article,

Prolongation of lidocaine-induced subarachnoid block with phenylephrine
Vaida G; Moss P; Capan LM; Turndorf H
1983 ;59:A186-A186, Anesthesiology
— id: 47418, year: 1983, vol: 59, page: A186, stat: Journal Article,

Airway management
Capan LM; Turndorf H
Principles and practice of trauma care Baltimore : Williams & Wilkins, 1982,
— id: 3482, year: 1982, vol: , page: 2, stat: Chapter,

Arterial-end-tidal CO2 gradients with different ventilatory modes
Capan L; Ramanathan S; Sinha K; Poscablo T; Chalon J; Turndorf H
1981 ;55:A363-A363, Anesthesiology
— id: 47429, year: 1981, vol: 55, page: A363, stat: Journal Article,

ASSESSMENT OF NEUROMUSCULAR BLOCKADE WITH SURFACE ELECTRODES
Capan, LM; Satyanarayana, T; Patel, KP; Turndorf, H; Ramanathan, S
1981 ;60(4):244-245, Anesthesia & analgesia
— id: 30255, year: 1981, vol: 60, page: 244, stat: Journal Article,

BRONCHOFIBERSCOPIC JET VENTILATION - REPLY
SATYANARAYANA, TV; CAPAN, LM; RAMANATHAN, S
1981 ;60(1):68-68, Anesthesia & analgesia
— id: 40273, year: 1981, vol: 60, page: 68, stat: Journal Article,

A possible hazard with use of the Ohio Ethrane vaporizer
Capan L; Ramanathan S; Chalon J; O'Mera JB; Turndorf H
1980 Jan;59(1):65-68, Anesthesia & analgesia
— id: 23481, year: 1980, vol: 59, page: 65, stat: Journal Article,

Optimization of arterial oxygenation during one-lung anesthesia
Capan LM; Turndorf H; Patel C; Ramanathan S; Acinapura A; Chalon J
1980 Nov;59(11):847-851, Anesthesia & analgesia
— id: 23476, year: 1980, vol: 59, page: 847, stat: Journal Article,

Cardiac output estimation by the CO2 rebreathing method in dogs anesthetized on the bain anesthesia circuit
Ramanathan S; Capan L; Chalon J; Pearlstein S; Turndorf H
1980 ;59:555-555, Anesthesia & analgesia
— id: 47255, year: 1980, vol: 59, page: 555, stat: Journal Article,

Bronchofiberscopic jet ventilation
Satyanarayana T; Capan L; Ramanathan S; Chalon J; Turndorf H
1980 May;59(5):350-354, Anesthesia & analgesia
The suction-biopsy channel of a flexible bronchofiberscope was used to provide subglottic jet ventilation in six dogs and eight adult human subjects. In dogs, after 75 minutes of ventilation at a driving pressure of 2580 torr/cm2 (50 lb/in2) the PaO2 was 412 +/- 18 torr and the PaCO2 32 +/- 3 torr with a peak airway pressure of 6 torr. In patients, after 30 minutes of jet ventilation, the PaO2 varied from 347 to 480 torr, the PaCO2 from 17 to 36 torr, and peak tracheal pressure from 6 to 8 torr. The method is convenient, simple and applicable in a variety of clinical situations
— id: 23480, year: 1980, vol: 59, page: 350, stat: Journal Article,

A new double-lumen tube adapter
Tanguturi S; Capan LM; Patel K; Turndorf H
1980 Jul;59(7):507-508, Anesthesia & analgesia
— id: 23477, year: 1980, vol: 59, page: 507, stat: Journal Article,

Humidity and the anesthetized patient
Chalon J; Patel C; Ali M; Ramanathan S; Capan L; Tang CK; Turndorf H
1979 Mar;50(3):195-198, Anesthesiology
Damage to the ciliated cells of the tracheobronchial tree and incidence of postoperative pulmonary complications were measured by point-scoring systems in 202 patients who breathed dry and humidified anesthetic gases for 225 +/- 78 min. The incidence of postoperative pulmonary complications decreased as the humidity of administered anesthetic gases increased from 0 to 32.5 mg H2O/l. A similar relationship was found between the amount of inhaled moisture and the damage to the ciliated epithelium of the tracheobronchial tree. These results appear to indicate that a high inspired humidity is beneficial for operations on normothermic patients, and that cellular damage caused by dryness is a possible contributory factor in the production of the pulmonary atelectasis that follows stoppage of the mucociliary transport system in the immmediate postoperative period
— id: 23482, year: 1979, vol: 50, page: 195, stat: Journal Article,

BREATHING CHARACTERISTICS OF BAIN ANESTHESIA CIRCUIT
Chalon, J; Ramanathan, S; Capan, L
1978 ;57(3):378-379, Anesthesia & analgesia
— id: 29682, year: 1978, vol: 57, page: 378, stat: Journal Article,

Minienvironmental control under the drapes during operations on the eyes of conscious patients
Ramanathan S; Capan L; Chalon J; Rand PB; Klein GS; Turndorf H
1978 Apr;48(4):286-288, Anesthesiology
— id: 23483, year: 1978, vol: 48, page: 286, stat: Journal Article,

Rebreathing characteristics of the Bain anesthesia circuit
Ramanathan S; Chalon J; Capan L; Patel C; Turndorf H
1977 Nov-Dec;56(6):822-825, Anesthesia & analgesia
The humidity output and CO2 elimination of the Bain circuit were tested on a simulated adult patient. The moisture content of inspired gases was found to be adequate when the circuit was used with a minute volume of 8.4 L/min and a fresh gas inflow of 4.9 L/min (65 percent relative humidity at room temperature at the onset of experimentation, rising to 100 percent after 80 minutes). However, the mean inspired CO2 concentration increased from 0.8 percent to 5.5 percent when the fresh gas inflow was decreased from 8 L/min to 3.5 L/min. It is recommended, therefore, that the circuit should not be used for long periods of time without measuring arterial CO2 tension or in situations where intentional hypocarbia is desired
— id: 23484, year: 1977, vol: 56, page: 822, stat: Journal Article,

Prevention of misconnection of the air-shields ventimeter-ventilator
Turndorf H; Capan L; Kessel JW
1974 ;53:342-343, Anesthesia & analgesia
— id: 45950, year: 1974, vol: 53, page: 342, stat: Journal Article,