Journal of clinical anesthesia
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Microbial contamination during preparation of the infusion drugs is an important issue in intensive care units. Objective of this study was to investigate in vitro antimicrobial properties of commonly used vasoactive drugs. ⋯ To limit microbial growth in case of contamination of the drug solution, it is advisable to use more concentrated dilutions of adrenaline, noradrenaline, and dopamine used in clinical practice.
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Comparative Study
The effect of serratus plane block performed under direct vision on postoperative pain in breast surgery.
To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. ⋯ Serratus block provides effective regional anesthesia, suitable for mastectomies, and currently appears to be superior to wound infiltration alone. However, further data will need to be collected to support this finding.
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We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. ⋯ Because of concerns of traumatizing his nare, we utilized a flexible fiberoptic bronchoscope to perform asleep transorbital intubation. Airway management in patients with severe trismus may require ingenuity.
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The benefits of cardiopulmonary exercise testing have been well established. Certain patient groups present challenges for conducting such a test. We were presented with a patient with a permanent tracheostomy at the preoperative assessment clinic. ⋯ We used a cuffed tracheostomy tube together with some widely available tubing from theaters to connect the patient to the gas analyzer. The test was only stopped because of excessive secretions from the patient, and we had already established enough data to tell us that the patient was fit enough to proceed to surgery. As more patients present with tracheostomies, we feel that this case would be a useful reference in managing and assessing such patients.