International journal of clinical and experimental medicine
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Endovascular aortic repair was first performed nearly two decades ago and has become a well-established alternative therapy for many thoracoabdominal aortic diseases. Early survival results with the endovascular aortic repair were impressive, but it also brought many complications. Aortoesophageal fistula is little-known and may be underestimated because it is an unusual complication of thoracic endovascular aortic repair. ⋯ Selecting flexibility and appropriate size stent graft, avoiding the thin aortic wall, and identifying the risk factors may reduce the morbidity of complications with aortoesophageal fistula after thoracic aortic aneurysm endovascular repair.
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To investigate the effects of different strategies of flurbiprofen axetil (FA) administration on postoperative pain and sufentanil (SF) consumption after open colorectal cancer (CRC) surgery. Forty patients undergoing elective CRC resection were divided into two groups (n = 20 each). Patients in the F50+50 group received 50 mg of intravenous FA 30 min before skin incision and six hours after the first dose; patients in the F100 group received 100 mg of intravenous FA 30 min before skin incision. ⋯ At postoperative 6 and 24 h, CFA was significantly higher, CSF was significantly lower, and the number of patients that pressed the PCIA trigger and the consumption of SF were significantly lower in the F50+50 group compared with the F100 group. At postoperative 4 h, VAS and BCS were significantly lower in the F50+50 group compared with the F100 group (P < 0.05). An administration strategy that maintains a relatively high plasma FA concentration at 6-24 h post-operatively may reduce postoperative inflammatory pain and SF-requirement in patients undergoing CRC resection.
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Several studies have suggested that the menstrual cycle has the impact on sedation. No previous study has evaluated the effects of the menstrual cycle on sedation level and propofol requirement with preoperative intravenous dexmedetomidine. Sixty-four adult fertile women receiving general anesthesia for elective gynecologic surgery were included in the study. ⋯ From propofol administered to loss of eyelash reflex and BIS values reach to 50, propofol requirements were significantly least and duration were shortest in the LD group among the four groups. Menstrual cycle phases affect the sedation of propofol induction with preoperative intravenous dexmedetomidine, which is deeper in the luteal phase. We should cautious of excessive sedation by propofol anesthesia with preoperative dexmedetomidine in the luteal phase.
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Case Reports
Life-threatening anaphylactic shock due to chlorhexidine on the central venous catheter: a case series.
In this article, we report two life-threatening anaphylactic shocks by an antiseptic coated central venous catheter (CVC) within a 6-month period in our cancer center. Anaphylactic shock was preceded immediately after insertion of a central venous catheter (CVC) coated with silver sulphadiazine and chlorhexidine acetate (Blue FlexTip(®) ARROWg(+)ard Blue(®), 14Ga, Arrow International, Inc. ⋯ Though antiseptic coated CVC anaphylaxis has been reported in Japan, Europe and America, to our knowledge, this is first reported in China. We present these rare cases to remind clinicians about hypersensitivity to chlorhexidine that could potentially be life-threatening.