Acta anaesthesiologica Belgica
-
Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled Trial Comparative StudyA comparative evaluation of the Airtraq and King Vision video laryngoscope as an intubating aid in adult patients.
Airtraq has been shown to improve ease of intubation in patients with normal and difficult airway. King Vision video laryngoscope is a newly introduced intubating device with an attached monitor. We here hypothesized that the King Vision video laryngoscope with channeled blade performs better during intubation as compared to Airtraq. ⋯ The time required to intubate patients was significantly shorter when the King Vision video laryngoscope with channeled blade was used as compared to the Airtraq (p < 0.05). The number of attempts to successfully intubate patients was also significantly lower (p < 0.05) for the King Vision video laryngoscope than for the Airtraq. The use of the Kings Vision video laryngoscope with channeled blade should be encouraged in difficult intubation situations in adult patients with a mouth opening of more than 18 mm.
-
Acta Anaesthesiol Belg · Jan 2015
Cerebral tissue oxygen saturation during arthroscopic shoulder surgery in the beach chair and lateral decubitus position.
Arthroscopic shoulder surgery is a common procedure and can be performed with the patient in the lateral decubitus position (LDP) or beach chair position (BCP). Although the BCP is associated with better visualization and less bleeding, it has also been associated with hemodynamic changes and consequently cerebral hypoperfusion. Devastating events reported after surgery in the BCP were attributed to a combination of the upright position and hypotension. ⋯ Near infrared spectroscopy might be able to provide an early warning sign of cerebral hypoperfusion during shoulder surgery in the BCP. It was therefore recommended to continuously monitor cerebral oxygenation in patients undergoing shoulder surgery in the BCP, to potentially prevent devastating outcomes. However, more clinical research on the safe lower limits of cerebral tissue oxygen saturation is needed for this recommendation to gain broad acceptance.
-
Acta Anaesthesiol Belg · Jan 2015
Case ReportsA novel method of intubation and orogastric tube insertion using a C-MAC-D-blade videolaryngoscope-bougie technique.
Expertise in airway management is a fundamental aspect of anesthesia practice. Fortunately 'can't intubate, can't ventilate' scenarios are extremely rare. In particular, patients with tumors on the right side of the oropharynx and larynx can be very problematic to intubate. ⋯ The C-MAC D-Blade videolaryngoscope-bougie technique provides an alternative method to intubate patients with difficult airways, even in exceptional situations such as in patients with a large right-sided oropharynx-larynx tumor.
-
Acta Anaesthesiol Belg · Jan 2015
Case ReportsPostsurgical compartment syndrome of the forearm diagnosed in a child receiving a continuous infra-clavicular peripheral nerve block.
Opinions diverge as to whether or not regional anaesthesia delays the diagnosis of evolving acute compartment syndrome. Withholding regional anaesthesia from patients with painful orthopaedic injuries may be ethically unacceptable, however. In this report, we describe a case of acute compartment syndrome in a 4-year old child who underwent resection of a forearm osteochondroma. ⋯ Pain disappeared while motor function and sensation recovered. The child was discharged without any complications. Despite an effective peripheral nerve block and the young age of the patient, the diagnosis of acute compartment syndrome could be made thanks to a well-defined post-operative analgesia protocol, a high level of suspicion and careful clinical assessment when break-through pain occurred.
-
Acta Anaesthesiol Belg · Jan 2015
Case ReportsPhrenic nerve palsy following interscalene brachial plexus block; a long lasting serious complication.
Interscalene brachial plexus block (ISBPB) offers good analgesia for painful surgical procedures on the shoulder. We here describe two cases of long-term phrenic palsy following ISBPB that occurred in our practice in a relative short time period and both clearly illustrate the devastating impact of this complication for the patient. ⋯ When ISPBP is considered, the fact that the incidence of prolonged phrenic nerve palsy may be higher than previously expected should be taken into account carefully. A reevaluation on the indication and patient selection of ISBPB may even be warranted.