Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2000
Case ReportsA modified intubating laryngeal mask for endotracheal tube exchange.
It is often necessary to change a patient's breathing tube (endotracheal tube). This can be a risky procedure. This report describes a technique for changing an endotracheal tube by using a modified "intubating laryngeal mask" (a commonly used airway and breathing device) and a fiberoptic bronchoscope.
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Anesthesia and analgesia · Oct 2000
The nonimmobilizer 1,2-dichlorohexafluorocyclobutane does not affect thermoregulation in the rat.
Inhaled and other anesthetics profoundly affect the central nervous system, causing amnesia, immobility in the face of noxious stimulation, and depression of thermoregulation. Nonimmobilizers, inhaled compounds whose lipophilicity suggests that they should be anesthetics, do not produce immobility, but they do cause amnesia. Their effects on thermoregulation were the subject of the present study. ⋯ The specific outcome was increased metabolism, as reflected in increased output of carbon dioxide. Isoflurane decreased the temperature threshold for such increases and the maximum response intensity, doing so in a concentration-dependent manner, whereas 2N had a minimal or no effect at any concentration up to 0.9 minimum alveolar concentration (estimated from its lipophilicity). Thus, 2N may be a useful tool for studies of the mechanisms mediating the thermoregulatory depression produced by anesthetics: 2N should not affect such a mechanism.
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Anesthesia and analgesia · Oct 2000
Case ReportsArm pain as an unusual presentation of postdural puncture intracranial hypotension.
We report a case of a patient experiencing severe arm pain after dural puncture. This complication has not been reported previously. The patient was successfully treated with an epidural patch.
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Anesthesia and analgesia · Oct 2000
Comment Letter Comparative StudyNo need for claims: facts rule performance of jet ventilation.
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Anesthesia and analgesia · Oct 2000
Comparative StudyA magnetic resonance imaging study of modifications to the infraclavicular brachial plexus block.
A previously described infraclavicular brachial plexus block may be modified by using a more lateral needle insertion point, while the patient abducts the arm 45 degrees or 90 degrees. In performing the modified block on patients abducting 45 degrees, we often had problems finding the cords of the brachial plexus. Therefore, we designed an anatomic study to describe the ability of the recommended needle direction to consistently reach the cords. ⋯ Comparing the two arm positions, target precision and risk of contacting the pleura were more favorable with the greater arm abduction. We conclude that when the arm is abducted to 90 degrees, a 65 degrees -needle angle to the skin appears optimal for contacting the cords, still with a minimal risk of penetrating the pleura. However, this needs to be confirmed by a clinical study.