RESUMO
Erector spinae plane block (ESPB) has been performed as a method of postoperative analgesia for breast, thoracic, and abdominal surgery. Most of those cases were carried out at T4–7 level and the main targets for postoperative analgesia were the thoracic nerves. However, there are few studies on the effect of ESPB on the cervical nerves. We report that ESPB at the T2 level was effective for postoperative pain management of arm surgery due to the blocking effect of thoracic and cervical nerve.
RESUMO
A 78-year-old Jehovah’s Witnesses women with hepatitis B viral liver cirrhosis scored as Child-Pugh A was scheduled for debulking operation of peritoneal carcinomatosis due to right ovarian cancer. Despite the need for preoperative strategies for correction of anemia and coagulopathy due to the risk of significant intraoperative hemorrhage, preoperative management was missing. In addition, she exhibited preoperative hemoglobin, hematocrit levels, and platelet count of 10.5 g/dL, 33.6%, and 85,000/μL, respectively. To minimize intraoperative blood loss, we used the combination of tranexamic acid and hemocoagulase, intraoperative blood loss counted about 700 mL, and the immediate postoperative hemoglobin was 9.0 g/dL. She recovered well without any anemic complications or thromboembolic events.
RESUMO
Erector spinae plane block (ESPB) has been performed as a method of postoperative analgesia for breast, thoracic, and abdominal surgery. Most of those cases were carried out at T4–7 level and the main targets for postoperative analgesia were the thoracic nerves. However, there are few studies on the effect of ESPB on the cervical nerves. We report that ESPB at the T2 level was effective for postoperative pain management of arm surgery due to the blocking effect of thoracic and cervical nerve.
RESUMO
A 78-year-old Jehovah’s Witnesses women with hepatitis B viral liver cirrhosis scored as Child-Pugh A was scheduled for debulking operation of peritoneal carcinomatosis due to right ovarian cancer. Despite the need for preoperative strategies for correction of anemia and coagulopathy due to the risk of significant intraoperative hemorrhage, preoperative management was missing. In addition, she exhibited preoperative hemoglobin, hematocrit levels, and platelet count of 10.5 g/dL, 33.6%, and 85,000/μL, respectively. To minimize intraoperative blood loss, we used the combination of tranexamic acid and hemocoagulase, intraoperative blood loss counted about 700 mL, and the immediate postoperative hemoglobin was 9.0 g/dL. She recovered well without any anemic complications or thromboembolic events.
RESUMO
The objective of this study was to evaluate the effects of several different commercial disinfectants on the embryogenic development of Ascaris suum eggs. A 1-ml aliquot of each disinfectant was mixed with approximately 40,000 decorticated or intact A. suum eggs in sterile tubes. After each treatment time (at 0.5, 1, 5, 10, 30, and 60 min), disinfectants were washed away, and egg suspensions were incubated at 25℃ in distilled water for development of larvae inside. At 3 weeks of incubation after exposure, ethanol, methanol, and chlorohexidin treatments did not affect the larval development of A. suum eggs, regardless of their concentration and treatment time. Among disinfectants tested in this study, 3% cresol, 0.2% sodium hypochlorite and 0.02% sodium hypochlorite delayed but not inactivated the embryonation of decorticated eggs at 3 weeks of incubation, because at 6 weeks of incubation, undeveloped eggs completed embryonation regardless of exposure time, except for 10% povidone iodine. When the albumin layer of A. suum eggs remained intact, however, even the 10% povidone iodine solution took at least 5 min to reasonably inactivate most eggs, but never completely kill them with even 60 min of exposure. This study demonstrated that the treatment of A. suum eggs with many commercially available disinfectants does not affect the embryonation. Although some disinfectants may delay or stop the embryonation of A. suum eggs, they can hardly kill them completely.