Saudi journal of anaesthesia
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Tracheal intubation using the 2nd-generation video laryngoscope sometimes cannot be performed easily because there is no functional endotracheal tube (ETT) guide. Therefore, a rigid stylet is often required during tracheal intubation. The Endotrol® tracheal tube (Endotrol) is a single use ETT that whole tube can be bent and slide easily into the trachea. We studied the intubation ease of a combination of an Endtrol and the McGrath® video laryngoscope (McGrath), which is one of the 2nd-generation video laryngoscopes. ⋯ A combination of an Endtrol and a McGrath is effective for shortening intubation time and avoiding sore throats.
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The erector spinae plane block (ESP) is a novel interfascial block described in 2016 by Forero. Although it has been used to provide analgesia for planned abdominal and thoracic surgery, it has never been used as a rescue technique for abdominal surgery. Pain control can be a challenge for anaesthesiologists in laparotomic surgery when epidural analgesia is contraindicated. We report two cases in which the ESP block has been successfully used as a rescue technique to provide pain relief after laparotomic surgery.
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Suprascapular nerve block (SSNB) is an effective method for the treatment of shoulder disorders. The present study was conducted to evaluate and compare the effectiveness of SSNB under ultrasonographic guidance with anatomical landmark-guided (LMG) technique in the treatment of chronic shoulder pain. ⋯ In our study, both the techniques have produced comparable relief of pain, improvement in shoulder movement, and decreased SPADI 4 weeks after the block.
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The postoperative pain management in open thoracotomy is very crucial as the effective analgesia can prevent respiratory and thrombotic complications and lead to early mobilization and discharge. The thoracic epidural analgesia is the gold standard in such surgeries; however, there are few adverse effects such as hypotension, dural puncture, and contralateral block that always warrants safer alternative. ⋯ We are reporting here the continuous ESP block as a primary mode of postoperative analgesia which was continued for 48 h. The intraoperative opioid requirement was very less, and the maximum NRS score in postoperative period was 4 at 12 h, which was well managed with multimodal analgesic regimen along with rescue doses of opioid.
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Interstitial lung diseases are diseases that need histology diagnosis or obtaining a lung biopsy to establish the diagnosis. Surgical biopsies are performed usually using the thoracoscopy technique under general anesthesia (GA) although this procedure is still associated with morbidity rate. The aim of this study is to determine the effectiveness and safety of regional anesthesia (RA) compared with GA in thoracoscopic lung biopsy procedures done on patients with idiopathic pulmonary fibrosis (IPF). ⋯ There was a significant decrease in chest tube duration and ICU stay in RA group compared to the GA group. There was no statistical difference between both types of anesthesia in the number of biopsy, representation, and postoperative complications although the rate of these complications was much less in the RA group. Based on this outcome, we can conclude that VAT lung biopsy procedure on patients with IPF under RA is safe, representative, and effective operation. In addition, high-risk patients for GA can go through this procedure under RA as an alternative and safe option with no added complications.