ABSTRACT
the height of the patients and the length of the left and right mainstem bronchi. CONCLUSIONS: These results provide reference data to help determine the precise margin of safety using a double lumen endobronchial tube for thoracic surgery.
Subject(s)
Adult , Humans , Bronchi , Thoracic SurgeryABSTRACT
Morbidity and mortality are higher in diabetics undergoing surgery, which most often reflect various cardiovascular complications. Ketoacidosis is the most serious acute metabolic complications of diabetes perioperatively. Ketoacidosis has adverse effects such as decreased myocardial contractility and peripheral vascular tone, dehydration and electrolyte imbalances. We encountered a case of a 47 year-old man who presented with ketoacidosis and severe hypotension 15 minutes after being administered epidural anesthesia for femoro-popliteal arterial bypass surgery. This case highlights the need for anesthesiologists to consider the possibility that ketoacidosis can mimic severe hypotension due to epidural anesthesia or cardiogenic shock.
Subject(s)
Humans , Middle Aged , Anesthesia, Epidural , Dehydration , Diabetes Mellitus , Diabetic Ketoacidosis , Hypotension , Ketosis , Mortality , Shock, CardiogenicABSTRACT
Percutaneous cordotomy is a useful method for cancer pain management. Candidates for cervical cordotomy include those patients with unilateral cancer pain below the shoulder, with a life expectancy of less than 1 year, who can not be adequately treated by other less invasive methods. However, various complications can occur following a cordotomy, with the most serious being respiratory dysfunction. Herein, we report a case of transient respiratory dysfunction following a percutaneous cervical cordotomy.
Subject(s)
Humans , Cordotomy , Life Expectancy , Pain Management , ShoulderABSTRACT
BACKGROUND: EDTA was added to the formulation of propofol to inhibit microbial growth due to accidental extrinsic contamination. This study was conducted to determine whether the EDTA in the propofol would affect the ionized calcium homeostasis, other electrolyte balance, blood urea nitrogen (BUN) and creatinine (Cr) in long time craniotomy patients. METHODS: Forty two patients undergoing surgery for clipping of a cerebral aneurysm were randomly assigned to receive either propofol without EDTA (propofol group; n = 20), or propofol with EDTA (propofol EDTA group; n = 22). The ionized calcium, total calcium, total magnesium, phosphate, potassium, sodium, BUN and Cr in the blood were measured at before anesthetic induction, 4 hours after induction and 1 hour after the operation. RESULTS: There were no significant differences in the ionized calcium, other electrolytes, BUN and Cr between the two groups. CONCLUSIONS: The addition of EDTA into propofol appears to have no significant effects on the electrolyte balance, BUN and Cr concentration.
Subject(s)
Humans , Blood Urea Nitrogen , Calcium , Characidae , Craniotomy , Creatinine , Edetic Acid , Electrolytes , Homeostasis , Intracranial Aneurysm , Magnesium , Potassium , Propofol , Sodium , Water-Electrolyte BalanceABSTRACT
BACKGROUND: Double-lumen endobronchial tube (DLT) malposition and displacement can occur easily by blind intubation or moving a patient into the lateral position. We compared a silicon DLT (Silbroncho(R)) with a polyvinyl chloride tube (Broncho-Cath(R)) to determine whether Silbroncho(R) can reduce the incidence of DLT malposition and displacement during anesthesia for one lung ventilation in right-side thoracic surgery. METHODS: Thirty nine patients requiring right lung deflation were randomly assigned to one of two groups. Eighteen patients received a Broncho-Cath(R) DLT and 21 patients received a Silbroncho(R) in the left mainstem bronchus. After blind intubation, we checked the incidence of right DLT intubation and tracheobronchial injury by fiberoptic bronchoscopy (FOB). After correcting DLTs for exact position and moving patients into the lateral position, we assessed the incidence of DLT displacement and changes of peak inspiratory pressure according to this position change during one lung ventilation. RESULTS: The incidence of right DLT intubation and tracheobronchial injury were not significantly different (P > 0.05) in the two groups (16.7% vs 0%, 38.9% vs 14.3%, Broncho-Cath(R) vs Silbroncho(R), respectively). After position change, the incidence of DLT displacement in the Silbroncho(R) group (4.8%) was lower (P 0.05). CONCLUSIONS: Our results suggest that Silbroncho(R) can reduce the incidence of DLT displacement because of the small-sized bronchial cuff, which is located more distally than the Broncho-Cath(R) cuff. We conclude that Silbroncho(R) is superior to Broncho- Cath(R) for one lung ventilation during thoracic surgery.
Subject(s)
Humans , Anesthesia , Bronchi , Bronchoscopy , Incidence , Intubation , Lung , One-Lung Ventilation , Polyvinyl Chloride , Polyvinyls , Silicones , Thoracic SurgeryABSTRACT
Some patient with T-tube tracheal stent may need to be anesthetized to be performed the non-airway related surgery. Without removal of the stent, general anesthesia with endotracheal intubation in these patents may cause serious complications, such as stent dislodgement, bleeding and breakage of stent. We describe a 43-year-old woman with a T-tube stent in situ, who was anesthetized using Laryngeal Mask Airway (LMA) for her ventriculo-peritoneal shunt operation. We occluded the top end of the LMA, thus employed it as a means of upper airway occlusion, while ventilation continued via the extratracheal portion of the T-tube stent, without any complications.