ABSTRACT
This paper discusses the advantages and disadvantages of the use of double-lumen tubes in pulmonary surgery. The method to be used has to be determined in each individual case. Regular peroperative determination of arterial blood gas values is part of the monitoring required in pulmonary surgery (Acta anaesth. belg., 1980, 31, 29-34).
Subject(s)
Intubation, Intratracheal/instrumentation , Lung/surgery , Humans , Intubation, Intratracheal/adverse effects , Pulmonary Embolism/etiology , Thoracic Surgery/instrumentationABSTRACT
Tumor embolus as a cause of death during lung surgery is not a common occurrence. Aspects of this uncommon observation are discussed, and 4 cases from the literature about this subject are reviewed. A brief discussion of treatment and the possibility of prevention is presented.
Subject(s)
Anesthesia , Embolism/etiology , Lung/surgery , Neoplasms/complications , Humans , Lung Neoplasms/surgery , Male , Middle Aged , Postoperative ComplicationsSubject(s)
Anesthesia, Conduction , Hospital Units , Monitoring, Physiologic/instrumentation , Environment , Humans , Safety , SterilizationABSTRACT
A case of mechanical airway obstruction is described. The cause of the obstruction proved to be an internal berniation resulting from detachment of the innermost latex layers of the tube. The various measures to avoid the hazards are briefly mentioned.
Subject(s)
Airway Obstruction/etiology , Intubation, Intratracheal/instrumentation , Aged , Humans , Intubation, Intratracheal/adverse effects , MaleSubject(s)
Anesthesia, General , Scoliosis/surgery , Anesthesia, Inhalation , Child , Female , Humans , Male , Nitrous Oxide , Postoperative Care , Postoperative Complications , Preoperative CareABSTRACT
Abolition of a temporary occlusion of the circulation in the legs during surgical reconstruction of the abdominal aorta generally exerts but little influence on the patient's acid-base status. The changes in acid-base status can be corrected by the patient himself. Routine administration of sodium bicarbonate or Tham is unnecessary. However, respiration, circulation and electrolyte balance should be carefully monitored to ensure that any disturbances in this respect can immediately be given adequate treatment. Determination of the acid-base status during the operation is a valuable aid in evaluation of the patient's condition and can be used as a guideline in therapy.
Subject(s)
Acid-Base Imbalance/prevention & control , Aorta, Abdominal/surgery , Arterial Occlusive Diseases/surgery , Acid-Base Imbalance/drug therapy , Aged , Arteriosclerosis/surgery , Bicarbonates/blood , Carbon Dioxide/blood , Humans , Hydrogen-Ion Concentration , Middle Aged , Partial PressureABSTRACT
An operation and anesthesia for patients suffering from true sickle-cell anemia, carries a substantially increased risk for these patients. This article describes the implications for the anesthetist and the measures to be taken during the phases the patient is in his care. For a better understanding of the background of these measures of brief discussion of the pathogenesis and clinical course of the disease is presented.
Subject(s)
Anemia, Sickle Cell , Anesthesia , Anemia, Sickle Cell/blood , Anemia, Sickle Cell/complications , Humans , Oxygen Inhalation Therapy , Sickle Cell Trait/complications , Surgical Procedures, Operative , Thrombosis/etiologyABSTRACT
A patient known to suffer from CNSLD was to undergo cervical lymph node dissection for gingival carcinoma. Pneumothorax developed immediately after introduction of anesthesia. In addition to the usual physical diagnostic signs, an abrupt decrease in amplitude of the QRS- complex and T -waves was observed in the ECG on the scope, the sensitivity of which remained unchanged. The ECG changes disappeared after abolition of the pneumothorax.
Subject(s)
Anesthesia, General/adverse effects , Electrocardiography , Pneumothorax/etiology , Aged , Humans , Male , Pneumothorax/physiopathologyABSTRACT
This paper describes a case of a difficult intubation in a neonate with the Pierre-Robin syndrome. Direct laryngoscopy was impracticable due to the atypical anatomy of the oropharyngeal cavity. The importance of adequate pre-anesthetic examination is stressed. Deep anesthesia during spontaneous respiration can facilitate endotracheal intubation in such cases.
Subject(s)
Epiglottis/abnormalities , Intubation, Intratracheal , Trachea/abnormalities , Humans , Infant, Newborn , Pierre Robin Syndrome/complicationsABSTRACT
Thirty-six patients with respiratory distress syndrome (RDS) were treated with mechanical ventilation with positive end-expiratory pressure (PEEP). In 16 patients the RDS was the result of direct pulmonary injury due to chest trauma (group A), and in 20 patients the RDS followed non-direct injury of the lungs (group B). Fifteen patients died. At the moment of death the RDS had disappeared. No difference in mortality existed between groups A and B. Four patients died from causes unrelated to the RDS, one patient died from an avoidable error in the treatment. The ultimate outcome did not seem to be related to age, use of mechanical ventilation or PEEP, or occurrence of complications (e.g. a pneumothorax, which appeared to be related rather to the chest trauma). Of probably prognostic significance was the presence of a combination of massive aspiration and RDS. Of the 12 patients who suffered from this combination, nine died. PEEP ventilation was more unsuccessful in raising PaO2 appreciably in these patients than in others. The combination of massive aspiration and RDS posses a therapeutic dilemma. PEEP ventilation is invaluable in the treatment of RDS. Interruption of the PEEP within the first 1-2 days may sometimes result in massive recurrence of the RDS. Endotracheal suctioning which is a prerequisite for the treatment of massive aspiration, may under these circumstances be virtually impossible within this period. A compromise, including PEEP ventilation for as short a period as possible (usually no longer than 2 to 3 days) without interruption, followed thereafter by intensive physiotherapy with endotracheal suctioning, may succeed in saving some of the patients.
