Acta anaesthesiologica Belgica
-
Acta Anaesthesiol Belg · Jan 2013
ReviewIs there a rationale for an anesthesiologist's role against cancer recurrence?
Growth of tumors can accelerate during the peri-operative period. Accordingly, early relapse of cancer occurs in some patients during the first two postoperative years. ⋯ Understanding the role of inflammation and its consequences (i.e., immune response, growth factors, dissemination of tumor cells) could lead to define a role of anesthesiologists in reducing cancer recurrence following surgery. We argue for peri-operative pharmacological interventions to reduce cancer relapse, with a focus on non-steroidal anti-inflammatory drugs.
-
Acta Anaesthesiol Belg · Jan 2013
Comparative StudyFirst experience of the use of the C-MAC PM videolaryngoscope in a clinical setting by anesthetic nurses: a comparison with anesthetists.
The Storz C-MAC videolaryngoscope has been found to facilitate endotracheal intubation and to be easy to use by novice users. However, it has never been studied in those who will probably use it most, anesthetists and anesthetic nurses. The aim of the present study was to identify the number of attempts needed before the participants were able to intubate 2 consecutive patients within 30 seconds. ⋯ This is the first clinical study assessing the use of the C-MAC videolaryngoscope by inexperienced anesthetists and anesthetic nurses indicating that it is easy to learn and to use in their hands.
-
Acta Anaesthesiol Belg · Jan 2013
Case ReportsUse of ultrasound-guided intercostal nerve block as a sole anaesthetic technique in a high-risk patient with Duchenne muscular dystrophy.
Duchenne muscular dystrophy is a progressive neuromuscular disease. Mortality is typically related to combined respiratory failure and dilated cardiomyopathy. Surgery under general anesthesia or deep sedation presents increased risks for pulmonary complications or ventilator dependency postoperatively. We describe the utility of ultrasound guided intercostal nerve blocks for surgery on the chest wall in a patient with Duchenne muscular dystrophy and severe respiratory compromise.
-
Acta Anaesthesiol Belg · Jan 2013
ReviewA review of the interest of sugammadex for deep neuromuscular blockade management in Belgium.
Oro-tracheal intubation and selected surgical conditions are facilitated by a deep neuromuscular block (NMB), but patient's security can be jeopardized by its residual effects at the time of tracheal extubation. Although neostigmine remains the reference reversal agent in many situations, the limitations of its efficacy must be well understood (ceiling effect, delay of action, side effects). It is best administered after re-emergence of the 3rd or 4th train-of-four (TOF) response. ⋯ In Belgium, the use of sugammadex and its reimbursement depend on specific conditions. The excellent clinical tolerance of sugammadex benefits to patients at risk of developing complications related to residual NMB or to the undesirable effects of neostigmine. In all cases, neuromuscular transmission monitoring is the key to adequate NMB management.