Current Issue : July - September Volume : 2021 Issue Number : 3 Articles : 5 Articles
Introduction: Cerebral venous thrombosis (CVT) is a rare complication of spinal anesthesia. The diagnosis is difficult when it occurs by isolated headache, following post spinal puncture headache (PSPH). We report a case of cerebral venous thrombosis complicating PSPH, following a spinal anesthesia. Observation: A 23-year-old man was admitted to the emergency room for PSPH appeared 6 hours after a spinal aesthesia for removal of osteosynthesis equipment from the right tibial plateau. The headache was fronto-occipital, relieved by lying down. Six days later, headache became permanent, not relieved by morphine, associated with vomiting. The neurological examination was normal. Brain magnetic resonance Magnetic venography showed superior sagittal sinus and right transverse sinus thrombosis. After administration of low molecular weight heparin at curative dose, and warfarin under INR control, the evolution was marked by a rapid regression of headaches on the same day. After a 1-year setback, the patient was asymptomatic..................
Objectives: Adequate control of hemodynamic parameters in patients undergoing otolaryngology-head and neck (OLHN) surgeries is one of the objectives of peri-operative anesthesia management. In this context, we seek to evaluate the effectiveness of metoprolol compared to clonidine in the postoperative control of systolic (SBP) and diastolic (DBP) blood pressures, and heart rate (HR), when these medications are used in the immediate pre-operative period. Method: this is a randomized double-blind clinical trial. Patients over 18 years old, according to the American Society of Anesthesiologists Physical Status Classification (ASA) I or II, who would undergo OLHN surgery, presenting with greater than 140 mmHg (SBP) or 90 mmHg (DBP), upon arrival at the surgical ward, were included in the study. 46 patients were randomized into two groups (C or M) who received clonidine (75 or 150 mcg) or metoprolol (5 or 10 mg), respectively.....................
Background: Some anesthetized patients present with expiratory airway obstruction (EAO) during mask ventilation (MV). EAO may occur more frequently among edentulous patients for whom a firmer grip of the mask and the mandible is needed to avoid gas leakage. We compared EAO grades before and after denture removal and identified predictors of EAO during MV in edentulous patients. Methods: One hundred and eight denture-wearing edentulous patients were anesthetized, their mouths were wrapped with film, their nasal masks and mandibles were held with two hands, and their lungs were ventilated in a pressure-controlled mode. Their dentures were subsequently removed, mouths were re-wrapped, and nasal MV was reapplied. EAO was graded based on capnography waveforms as follows: Grade I, normal waveform (no obstruction); II, loss of the alveolar plateau of the waveform (partial obstruction); and III, no waveform (total obstruction). EAO grades were compared before....................
cough and minimize postoperative pain for patients undergoing laparoscopic cholecystectomy. Methods: One hundred twenty patients were randomly divided into D1, D2, D3 and NS groups, and dexmedetomidine 0.4, 0.6, 0.8μg/kg and normal saline were administrated respectively. Patients’ heart rate, systolic blood pressure and diastolic blood pressure were measured at T1-T7. The incidence of cough was recorded. Other parameters were noted, the time of spontaneous respiratory recovery and extubation, visual analogue scale scores and dosage of tramadol. Results: The heart rate, systolic blood pressure and diastolic blood pressure of D2 and D3 groups has smaller fluctuations at T2–3 and T7 compared with NS and D1 groups (P < 0.05). The incidence of cough was lower in D2 and D3 groups than NS group (P < 0.05). The visual analogue scale scores and tramadol dosage of D2 and D3 groups were lower than NS group (P < 0.05). The time of spontaneous respiratory recovery and extubation in D3 group was longer than that in D1 and D2 groups (P < 0.05). Conclusions: Intravenous infusion of 0.6μg/kg dexmedetomidine before induction can maintain hemodynamic stability, decrease cough during emergence, relieve postoperative pain of patients undergoing laparoscopic cholecystectomy....
Background: High frequency jet ventilation (HFJV) is an open ventilating technique to maintain ventilation for emergency or difficult airway. However, whether jet ventilation or conventional oxygen therapy (COT) is more effective and safe in maintaining adequate oxygenation, is unclear among patients with airway stenosis during bronchoscopic intervention (BI) under deep sedation. Methods: A prospective randomized cohort study was conducted to compare COT (high flow oxygen) with normal frequency jet ventilation (NFJV) and HFJV in oxygen supplementation during BI under deep sedation from March 2020 to August 2020. Patients receiving BI under deep sedation were randomly divided into 3 parallel groups of 50 patients each: the COT group (fractional inspired oxygen (FiO2) of 1.0, 12 L/min), the NFJV group (FiO2 of 1.0, driving pressure of 0.1 MPa, and respiratory rate (RR) 15 bpm) and the HFJV Group (FiO2 of 1.0, driving pressure of 0.1 MPa, and RR of 1200 bpm). Pulse oxygen saturation (SpO2), mean arterial blood pressure and heart rate were recorded during the whole procedure. Arterial blood gas was examined and recorded 15 min after the procedure was initiated. The procedure duration, dose of anesthetics, and adverse events during BI in the three groups were also recorded. Results: A total of 161 patients were enrolled, with 11 patients excluded. The clinical characteristics were similar among the three groups. PaO2 of the COT and NFJV groups was significantly lower than that of the HFJV group....................
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