One year prospective analysis of morbidity and mortality associated with thoracic surgery

To evaluate the morbidity and mortality associated with thoracic surgery in adult patients over a period of one year. Prospective, descriptive, clinical study. Thirty patients [24 men and 6 women], who underwent various thoracic surgeries over a period of one year [1 December 2008 to 31 December 2009], were studied. The primary outcome was discharge from the hospital within 14 days after surgery. The mean age of the patients was 28.37 +/- 14.12 yrs. The surgical procedures were as follows: 13[43%] decortications, 6[20%] thoracoplasty, 6[20%] excision of a cyst, 2[7%] segmentectomy, 2[7%] lobectomy, and 1[3%] pneumonectomy. Mean duration of surgery and anaesthesia were 134.5 +/- 44.79 min and 144.5 +/- 45.59 min respectively and most of the patients [26/30[87%]] were extuabted in the operating room. Twenty [68.97%] patients were discharged from the hospital 14 days. Factors associated with prolonged hospital length of stay [>14 days] included: long duration of smoking, low FEV1, metabolic acidosis; higher intraoperative blood loss and longer duration of surgery. We conclude that patients having above risk factors should be aggressively managed and monitored intra and postoperatively

New insights in hypertension

Hypertension is one of the most common chronic illnesses encountered in the perioperative period. Therefore, the preoperative assessment of hypertensive patient is both a common and an important problem for the anesthesiologists, because of the deleterious and predictable effects of hypertension on cardiovascular, renal and cerebrovascujar function, individuals with untreated hypertension have significant perioperative morbidity. This article presents an overview on the current literature regarding the hypertensive patients and a simple graphic strategy for the perioperative management of hypertension and its impact on perioperative outcome

Women emerge from general anesthesia faster than men

Interest in the speed with which patients recover post operatively, the type of deficits that anesthesia may induce in them and the overall profile of their physiologic and psychological states, has grown rapidly over the last two decades. Recovery from general anesthesia is dependent on factors governing drug sensitivity and drug disposition. In our study of 60 males and 60 females we have tried to find out if there is any significant difference in males and females, in their emergence from the effects of general anesthesia. This was a double blind study carried out in hundred and twenty patients, aged 18-70 years scheduled to undergo elective general surgical procedures. Patient recovery was observed continuously after the termination of anesthesia. Timings of initial wake up events were recorded by the anesthesiologist who was blinded to this study. The time from discontinuation of anesthesia to eye opening was 6.87 +/- 2.54 min [P < 0.001; t test] for women versus 8.78 +/- 2.66 min in men; time to respond to verbal comm and was 7.53 +/- 2.05 and 9.61 +/- 2.14 min in women and men, respectively [P < 0.001; t test]. Considering the multitude of factors that may influence recovery, the gender effect appears to be a strong one. The difference could probably be explained by differences in physiology, enzyme activity etc. Investigators have noted that normal differences account for changes in function of the GABA receptor known to be important in the action of many anesthetics

Kinking of epidural catheter. A case report

Kinking of an epidural catheter with resultant failure to inject drug is a complication of lumbar epidural analgesia. Here, we report a case of kinking of epidural catheter 1 cm proximal to its tip after 20 days of insertion. It was inserted to a female for pain relief, suffering from carcinoma of the cervix