ABSTRACT
General anaesthesia using endo-tracheal intubation, carried out to provide pain- free, surgical and medical procedures, sometimes results in Traumatic Dental Injuries [TDIs]. Among the rarely reported TDI complication is tooth avulsion. We present two cases of such complications, factors which can be responsible, management of such cases, and the need to educate medical and paramedical personnel on what to do if such complications arise before definitive management can be carried out by the dentist. Such awareness will go a long way in preventing unnecessary litigations which might likely occur from such routine procedures.
Subject(s)
Dental Occlusion, Traumatic , Surgery, Oral , Tooth Avulsion , Intubation, IntratrachealABSTRACT
Background: To evaluate effect of gabapentin in attenuation of haemodynamic responses to direct laryngoscopy and tracheal intubation. Methods: Hundred patients undergoing elective surgery were randomly allocated to two groups of 50 patients each. Patients in group A received gabapentin 800 mg and patients in group B received placebo capsules the night before and on the morning of surgery. Anaesthesia was induced with propofol and vecuronium. Systolic; diastolic; mean arterial blood pressures (SAP; DAP; MAP) and heart rate (HR) were recorded before and after the induction of anesthesia and 0; 1; 3; 5 and 10 min after tracheal intubation. Results: SAP was significantly lower in the gabapentin as compared to the control group 0; 1; 3; 5 and 10 min after intubation [121 vs 135 ( P0.001); 117 vs 132 (P0.001); 112 vs 124 (P0.001); 110 vs 118 ( P0.05) and 107 vs 112 ( P0.05) respectively]. DAP also was lower in the gabapentin group 0; 1; 3; and 5 min after intubation [77 vs 87 (P0.001); 74 vs 84 (P0.001); 70 vs 78 (P0.001) and 68 vs 74 (P0.05)]. MAP also was lower in the gabapentin group 0; 1; 3; and 5 min after intubation [92 vs 103 (P0.001); 88 vs 100 (P0.001); 84 vs 93 (P0.001) and 82 vs 88 (P0.05)]. HR also was lower in the gabapentin group 0; 1 and 3 min after intubation [90 vs 98 (P0.05); 88 vs 95 (P0.001) and 84 vs 90 (P0.05)]. Conclusion: Gabapentin; under the present study design attenuates the pressor response associated with laryngoscopy and tracheal intubation but tachycardiac response is not completely eliminated
Subject(s)
Gabapentin , Intubation, Intratracheal , LaryngoscopyABSTRACT
Objectif : Rappeler les principales caracteristiques etiopathogeniques des stenoses tracheales post-intubation; preciser le bilan preoperatoire et discuter les differentes modalites therapeutiques. Materiel et methodes : Notre travail porte sur une etude retrospective de vingt huit stenoses tracheales cicatricielles traitees de 1987 a 2003 au service d'ORL et de chirurgie cervico-faciale du CHU Farhat Hached de Sousse. Resultats : Elles sont toutes acquises; secondaires a une intubation et/ou a une tracheotomie. Les resultats de notre travail montrent le role primordial du traitement medical et endoscopique. Cependant; le meilleur traitement des stenoses tracheales reste le traitement chirurgical base sur la resection anastomose tracheale dont on a precise les indications et evalue les resultats; juges bons avec 89de cas favorables. Conclusion : Nos resultats montrent que le traitement endoscopique des STPI peut etre considere comme un traitement de premiere ligne. Les stenoses complexes et resistantes au traitement endoscopique relevent d'un traitement chirurgical