RESUMO
A 45 years old female with huge goiter presented for thyroidectomy. She had history of snoring and dysnea, airway evaluation revealed Mallampatti 2, IIG 3F, but temporomendibular distance [TMD] and sternomendibular distance [SMD] were impossible to measure due to grossly enlarged thyroid. Radiological examination revealed displacement of trachea towards right. After induction and depolarizer relaxation laryngoscopy was performed and Cormack Lehane 4, POGO zero was observed. With our technique of antigravity lifting, vocal cords were visualized making intubation possible with endotracheal tube on stylet
Assuntos
Humanos , Feminino , Remoção , BócioRESUMO
To evaluate the role of metoclopramide and dimenhydrinate in controlling postoperative nausea and vomiting [PONV] and its cost effectiveness in gynaecological laparoscopy. This study was conducted in the department of anaesthesiology and intensive care unit, Pakistan Institute of Medical Sciences, Islamabad from June 2004 to March 2006. Ninety nine female patients belonging to American society of Anaesthesiologist [ASA] grading ASA-1 to ASA-111, scheduled for laparoscopic surgery, who did not fall in exclusion criteria were finally included. Anaesthetic technique was standardized for all patients. Injection Metocloparamide 10 mg and injection Dimenhydrinate 50 mg were administered 20 min before the procedure was over. At the end of procedure patients were transferred to the recovery room for observation for 10 hours. Four point verbal descriptive scale [VDS] was used to identify the presence and severity of PONV. Four out of 99 [4.04%] patients developed nausea soon after regaining consciousness and did not demand any medication for relief. Three [3.03%] patients developed vomiting. It was single episode and no rescue medication was needed. Most of the symptoms developed with in 10 -30 minutes of reversal. Metocloparamide and dimenhydrinate is a good combination to combat PONV and is costeffective in laparoscopic gynaecological surgery