RESUMO
Background: post-operative nausea and vomiting [PONV] following surgical operations requiring general anesthesia are common and distressing. The incidence of PONV may be as high as 70% during the first 24 hrs. of tonsillectomy
Objective: this study determines the effects of intraoperative well-hydration on postoperative nausea and vomiting
Methods: 90 ASA I patients with age of 6-12 years scheduled for tonsillectomy under general anesthesia randomly assigned to receive either routine iv fluid plus intraoperative well-hydration plus 4 ml/kg/h Ringer's solution [well hydrated group; n=45] and routine iv fluid requirements [control group; n=45]. All study preparations were administered in a double blinded fashion
Results: during the first postoperative day, the incidence of nausea and vomiting were significantly lower in the well-hydrated group as compared with control [p<0.05]. There was no significant differences between males and females regarding the incidence of nausea and vomiting [p>0.05]
Conclusion: the present study showed that well-hydration reduces the incidence of post tonsillectomy nausea and vomiting, and high iv fluid therapy is a simple, effective, safe and well-tolerated technique for prevention of postoperative nausea and vomiting
RESUMO
Background: Catheter-induced ectopic ventricular beats are observed in some patients. It is frequently stated that intracardiac foreign bodies such as an electrode catheters, a central venous line, or pulmonary artery catheter that migrates to the ventricle may give genesis to arrhythmia
Case Report: We report of life threatening ventricular arrhythmia occurring during insertion of a guide wire through the right jugular vein. A 41-years old man scheduled for elective coronary artery bypass graft [CABG], was referred to operating room. After induction of anesthesia and during insertion of the central venous catheter from right jugular vein, guide wire insertion resulted in sustained coarse ventricular fibrillation. The guide wire was removed immediately and treatment started. Defibrillation with 200, 300, 360 J, and antiarrhythmic drug therapy didn't convert this Coarse VF to normal rhythm. During the cardiopulmonary resuscitation [CPR] and chest compression the femoral artery and vein canulas were inserted and cardiopulmonary bypass was started. The surgical procedure was uneventful and at the end of operation patient's vital signs were stable. The patient stayed four days in ICU and at the 8th day after operation discharged from hospital with good general condition
Conclusion: Mechanical irritation of the cardiac chamber that commonly induces ectopic activity has abolished by removal of the stimulus, but in this case unresponsive life-threatening ventricular fibrillation was occurred
RESUMO
Background: Catheter-induced ectopic ventricular beats are observed in some patients. It is frequently stated that intracardiac foreign bodies such as an electrode catheters, a central venous line, or pulmonary artery catheter that migrates to the ventricle may give genesis to arrhythmia
Case report: We report of life threatening ventricular arrhythmia occurring during insertion of a guide wire through the right jugular vein. A 41-years old man scheduled for elective coronary artery bypass graft [CABG], was referred to operating room. After induction of anesthesia and during insertion of the central venous catheter from right jugular vein, guide wire insertion resulted in sustained coarse ventricular fibrillation. The guide wire was removed immediately and treatment started. Defibrillation with 200, 300, 360 J, and antiarrhythmic drug therapy didn't convert this Coarse VF to normal rhythm. During the cardiopulmonary resuscitation [CPR] and chest compression the femoral artery and vein canulas were inserted and cardio-pulmonary bypass was started. The surgical procedure was uneventful and at the end of operation patient's vital signs were stable. The patient stayed four days in ICU and at the 8[th] day after operation discharged from hospital with good general condition
Conclusion: Mechanical irritation of the cardiac chamber that commonly induces ectopic activity has abolished by removal of the stimulus, but in this case unresponsive life-threatening ventricular fibrillation was occurred