Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Purpose. Acoustic respiratory rate (RRa) monitoring provides an accurate estimation of the respiratory rate (RR).We investigated\nthe incidence of oxygen desaturation under RRa monitoring in a postoperative setting and identified its related factors. Methods.\nThis study was a retrospective chart review of postoperative patients outside an intensive care unit setting. Using the data collected\nduring the first 8 h postoperatively, patients were divided into oxygen desaturated (SpO2 < 90% for >10 s) and nondesaturated\ngroups under oxygen administration. Multivariate analysis was used to determine oxygen desaturation-associated explanatory\nfactors. Results. Oxygen desaturation was detected in 102 of 935 patients (10.9%). % vital capacity [odds ratio (OR), 0.885 per 10%\nincrease; 95% confidence interval (CI), 0.790 to 0.992], coexisting chronic obstructive pulmonary disease (OR, 2.195; 95% CI, 1.088\nto 4.428), and absence of a critical RRa change (RR > 30 or <8 beats/min for >2 min) (OR, 1.972; 95% CI, 1.226 to 3.172) were\nindependently associated with oxygen desaturation. Conclusion. Postoperative oxygen desaturation was observed in more than\n10% of the patients whose RR was monitored by RRa under oxygen therapy. It is more likely to occur in patients with impaired\npulmonary function or morbid pulmonary status and can also occur in the absence of abnormal RR....
The authors encountered a case involving difficult intubation during anesthesia\nfor revision of cervical fixation angle in a 62-year-old woman, with a history\nof chronic rheumatoid arthritis, who experienced dysphagia after initial\nposterior occipitocervical fusion to correct atlantoaxial subluxation. Two days\nafter initial surgery, she developed trismus with neck flexion and dysphagia,\nand underwent revision surgery. General anesthesia was planned; however,\ntracheal intubation using the McGrath laryngoscope and bronchofiberscope\nwas difficult, which prolonged anesthesia induction. Narrowing of the oral\nand pharyngeal cavities associated with overcorrection of the cervical spine\nwas believed to be the reason for difficulty in manipulating the tracheal intubation\ndevices. In posterior occipitocervical fusion, intraoperative evaluation\nof the occipito-second cervical vertebra (O-C2) angle is reported to be useful\nin preventing postoperative dyspnea and/or dysphagia, and avoids the need\nfor revision of fixation angle. However, when revision surgery is needed, selection\nof airway management methods and tracheal intubation devices are\nimportant considerations because patients are likely to have restricted mobility\nin the cervical spine and narrowing of the oral and pharyngeal cavities....
Background.The aim of this retrospective study was to compare immediate postoperative pain scores and need for rescue analgesia\nin children who underwent pulpotomies and restorative treatment and those who underwent restorative treatment only, all under\ngeneral anaesthesia. Methods. Ninety patients aged between 3 and 7 years who underwent full mouth dental rehabilitation under\ngeneral anaesthesia were enrolled in the study and reviewed. The experimental group included patients who were treated with at\nleast one pulpotomy, and the control group was treated with dental fillings only.TheWong-Baker FACES scale was used to evaluate\nself-reported pain and need for rescue analgesia. The data were analysed using the Kruskal-Wallis test, two sample ...
Introduction. Pain after cardiac surgery affects long-term patient wellness. This study investigated the effect of preoperative\npregabalin on acute and chronic pain after elective cardiac surgery with median sternotomy. Methods. Prospective double blind\nstudy. 93 cardiac surgery patients were randomly assigned into three groups: Group 1 received placebo, Group 2 received oral\npregabalin75mg, andGroup 3 receivedoral pregabalin150mg.Datawere collected8hours, 24hours, and3months postoperatively.\nResults. Patients receiving pregabalin required fewer morphine boluses (10 in controls versus 6 in Group 1 versus 4 in Group 2,\n...
Background: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty\nis challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis\nsuccessfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block.\nCase presentation: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe\nankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints. A combination of T12\nparavertebral block, lumbar plexus and sacral plexus block was successfully used for the surgery without any additional\nintravenous anesthetic or local anesthetics infiltration to the incision, and none of the patients complained of discomfort\nduring the operations.\nConclusions: The combination of T12 paravertebral block, lumbar plexus and sacral plexus block, which may block all\nnerves innervating the articular capsule, surrounding muscles and the skin involved in total hip arthroplasty, might be a\npromising alternative for total hip arthroplasty in ankylosing spondylitis....
Background: Pneumatic arterial tourniquet is a very commonly used technique\nin limb surgeries to provide bloodless field to facilitate dissection and\ndecrease blood loss. However, arterial tourniquet has many deleterious effects\nincluding hemodynamic changes, serum lactate and potassium level changes\nand tourniquet-induced pain which sometimes can be severe and intolerable.\nAim of the study: To evaluate the effect of different regional blocks: femoralsciatic,\nspinal and epidural blocks on serum lactate and potassium levels and\nthe degree of arterial tourniquet-induced pain in patients undergoing lower\nlimb orthopedic surgeries. Methods: 60 patients underwent lower limb orthopedic\nsurgery with application of tourniquet for duration not more than 90\nminutes. Patients were assigned randomly to one of three groups (20 each)\nGroup I had sciatic-femoral block, Group II: patients had spinal anesthesia\nand Group III: patients had epidural anesthesia. Intraoperative hemodynamics,\nchanges in serum potassium and lactate levels and tourniquet pain after\ntourniquet inflation & deflation, were recorded. Results: There was no statistically\nsignificant difference among the three groups regarding tourniquet\npain after tourniquet inflation (p = 0.872) and deflation (p = 0.902), and regarding\nserum levels changes of potassium (p = 0.067) and lactate (p =\n0.051). However, each group showed statistically significant increase in post\ndeflation tourniquet pain (p = 0.003, 0.002, 0.003, in groups F, S, E respectively)\nand serum potassium (p = 0.004, 0.006, 0.000, in groups F, S, E respectively)\nand lactate levels (p = 0.004, 0.000, 0.000, in groups F, S, E respectively)\nwhen compared to the pre-deflation values, and the increase was directly proportional to the duration of tourniquet. Conclusion: the three\ndifferent types of anesthesia (femoral- sciatic, spinal and epidural block) have\nthe same effect on serum lactate and potassium levels and the degree of tourniquet\npain, which were related to the duration of tourniquet inflation....
Objective. We aimed to investigate the effect of peritubal local anesthetic and opioid infiltration on pain scores and analgesic\nconsumption in patients who underwent percutaneous nephrolithotomy. Material andMethods. Patients aged between 18 and 65\nyears and ASA I-III were included in this double-blind, randomized study. The patients were divided into two groups. All patients\nunderwent spinoepidural anesthesia. 20mL of 0.25 percent bupivacaine + 5mg morphine (0.5 mL), in Group P (...
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