Anesthesia and analgesia
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Anesthesia and analgesia · Jan 2008
Case ReportsNonfatal cerebral air embolism after dental surgery.
After removal of four impacted third molars under general anesthesia, our patient developed subcutaneous emphysema, pneumothorax, pneumopericardium, and pneumomediastinum. Soon thereafter, coma with generalized epileptic status ensued. ⋯ The likely mechanism was injection of air by the high-speed dental drill through the soft tissue adjacent to the roots of the lower molars. We were unable to find any previous report of systemic air embolism after oral surgery.
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Anesthesia and analgesia · Jan 2008
Comparative StudyA comparison of two emergency cricothyroidotomy kits in human cadavers.
We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate. ⋯ In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.
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Anesthesia and analgesia · Jan 2008
Comparative StudyIntracardiac transvenous echocardiography is superior to both precordial Doppler and transesophageal echocardiography techniques for detecting venous air embolism and catheter-guided air aspiration.
Venous air embolism (VAE) is a potentially fatal complication during surgical procedures with patients in the sitting position. Since methods for detection of persistent low-volume VAE and targeted air aspiration are limited, we tested the hypotheses that transvenous intracardiac echocardiography (ICE) 1) improves detection of small air emboli in comparison to transesophageal echocardiography (TEE) and precordial Doppler monitoring (PCD) techniques, and that 2) image-guided multiorifice central venous catheter manipulation improves air recovery in moderate and large VAE, when compared with aspiration with the multiorifice central venous catheter in a static position. ⋯ Small air emboli are detected by ICE with much greater sensitivity compared with both PCD and TEE techniques. Furthermore, recovery of embolized air is enhanced by image-guided manipulation of a multiorifice central venous catheter. Clinical studies are required to assess this technique during surgery with patients in the sitting position.
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Anesthesia and analgesia · Jan 2008
Clinical TrialReal-time heart rate variability and its correlation with plasma catecholamines during laparoscopic adrenal pheochromocytoma surgery.
We studied sympathovagal activity using real-time heart rate variability (HRV) and determined its relationship with plasma catecholamines to characterize short-term cardioregulatory mechanisms during laparoscopic adrenal pheochromocytoma surgery. ⋯ This study demonstrated a strong correlation between low frequency HRV, plasma norepinephrine, arterial blood pressure, and heart rate during pheochromocytoma surgery.
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Anesthesia and analgesia · Jan 2008
The Pentax-AWS video-laryngoscope: the first experience in one hundred patients.
We studied the efficacy of the Pentax-AWS (Tokyo, Japan), a new portable, battery-operated video-laryngoscope, in 100 patients. It was possible to insert the blade of the Pentax-AWS and to see a full view of the glottis on the first attempt in 99 of 100 patients. ⋯ Tracheal intubation was successful in 98 patients. The median time taken for tracheal intubation was 35 s (range, 5-120 s).