RESUMEN
A tracheal mass was detected in a woman who complained progressive cough and dyspnea developed 3 months ago. Tumor was located just 1 cm above carina almost obstructing the tracheal lumen and it was mobile with respiration. Curative tracheal resection & anastomosis was attempted with a right thoracotomy approach. In this patient, complete tracheal obstruction by the mass can occur during the induction of the anesthesia and the pre-resection period; therefore, we made cardiopulmonary bypass available before the induction. We successfully maintained the airway and provided the adequate ventilation during that critical period without using cardiopulmonary bypass. Here we report this case with a literature review.
Asunto(s)
Femenino , Humanos , Anestesia , Puente Cardiopulmonar , Tos , Período Crítico Psicológico , Disnea , Respiración , Toracotomía , VentilaciónRESUMEN
BACKGROUND: There are quite a few studies examining the relative efficacy of different doses of intrathecal sufentanil for labor analgesia. The authors designed this prospective, randomized, double blind study to compare the efficacy and side effects of 5 and 10 microgram intrathecal sufentanil. METHODS: Forty healthy, laboring, term parturients, in the active phase of labor participated in this study. In a randomized, double-blind fashion, patients received 5 or 10 microgram intrathecal sufentanil as a part of combined spinal-epidural technique. Scores of pain, itching, nausea, and sedation were taken on visual analog scales before and every 10 minutes after drug injection for one hour. We also recorded maternal blood pressure, respiratory rate and peripheral oxygen saturation during the same time period. RESULTS: Both doses of sufentanil provided adequate analgesia. Although 10 microgram sufentanil produced a slightly more profound analgesia, the duration of pain relief did not differ between the two groups. Both drug doses were associated with significant increase in itching. The 10 microgram dose was associated with more sedation and a greater decrease in arterial oxygen saturation (SaO2). CONCLUSIONS: Both 5 and 10 microgram intrathecal sufentanil provided adequate labor analgesia. Both doses were associated with increased spinal (itching) and supraspinal (sedation, respiratory depression) side effects, the intensity of which appeared to be more profound in the 10 microgram group.
Asunto(s)
Humanos , Analgesia , Presión Sanguínea , Método Doble Ciego , Náusea , Oxígeno , Estudios Prospectivos , Prurito , Frecuencia Respiratoria , Sufentanilo , Escala Visual AnalógicaRESUMEN
BACKGROUND: There are quite a few studies examining the relative efficacy of different doses of intrathecal sufentanil for labor analgesia. The authors designed this prospective, randomized, double blind study to compare the efficacy and side effects of 5 and 10 microgram intrathecal sufentanil. METHODS: Forty healthy, laboring, term parturients, in the active phase of labor participated in this study. In a randomized, double-blind fashion, patients received 5 or 10 microgram intrathecal sufentanil as a part of combined spinal-epidural technique. Scores of pain, itching, nausea, and sedation were taken on visual analog scales before and every 10 minutes after drug injection for one hour. We also recorded maternal blood pressure, respiratory rate and peripheral oxygen saturation during the same time period. RESULTS: Both doses of sufentanil provided adequate analgesia. Although 10 microgram sufentanil produced a slightly more profound analgesia, the duration of pain relief did not differ between the two groups. Both drug doses were associated with significant increase in itching. The 10 microgram dose was associated with more sedation and a greater decrease in arterial oxygen saturation (SaO2). CONCLUSIONS: Both 5 and 10 microgram intrathecal sufentanil provided adequate labor analgesia. Both doses were associated with increased spinal (itching) and supraspinal (sedation, respiratory depression) side effects, the intensity of which appeared to be more profound in the 10 microgram group.