Articles: postoperative.
-
Orogastric and nasogastric tubes are routinely inserted in anesthetized patients to both reduce the volume of stomach contents and decrease the incidence of postoperative nausea. We present a case of esophageal perforation and subsequent pneumothorax after insertion of an orogastric tube in a patient undergoing routine shoulder arthroscopy.
-
The use of regional anesthesia including paravertebral blocks has been advocated for the treatment of pain from rib fractures in adults. Although paravertebral nerve blocks have been used in pediatric patients to manage postoperative pain for surgeries to the thorax and abdomen, their use for analgesia after rib fractures and thoracic trauma has not been reported. We report the use of a T7 continuous paravertebral nerve block for pain relief in a 5-week-old, 5-kg infant who suffered T7 and T8 rib fractures and a pulmonary contusion to the left chest secondary to a gunshot wound.
-
Acta Anaesthesiol Scand · May 2014
Randomized Controlled Trial Comparative StudyKetamine and magnesium association reduces morphine consumption after scoliosis surgery: prospective randomised double-blind study.
Intraoperative ketamine and magnesium improves post-operative analgesia after scoliosis surgery when compared to ketamine alone.
pearl -
Anesthesia and analgesia · May 2014
Randomized Controlled TrialDexmedetomidine Reduces Propofol and Remifentanil Requirements During Bispectral Index-Guided Closed-Loop Anesthesia: A Double-Blind, Placebo-Controlled Trial.
The α2-adrenergic agonist dexmedetomidine is a sedative and can be used as an adjunct to anesthetics. Our primary goal was thus to determine the extent to which dexmedetomidine reduces the requirement for propofol and remifentanil. ⋯ Dexmedetomidine administration significantly reduced the requirement for both propofol and remifentanil during anesthetic induction and reduced propofol use during maintenance of anesthesia. Dexmedetomidine also delayed postoperative analgesic use. Dexmedetomidine is a useful adjuvant that reduces anesthetic requirement and provides postoperative analgesia.
-
Anesthesia and analgesia · May 2014
Cognitive dysfunction after fast-track hip and knee replacement.
Postoperative cognitive dysfunction (POCD) is reported to occur after major surgery in as many as 20% of patients, elderly patients may especially experience problems in the weeks and months after surgery. Recent studies vary greatly in methods of evaluation and diagnosis of POCD, and the pathogenic mechanisms are still unclear. We evaluated a large uniform cohort of elderly patients in a standardized approach, after major joint replacement surgery (total hip and knee replacement). Patients were in an optimized perioperative approach (fast track) with multimodal opioid-sparing analgesia, early mobilization, and short length of stay (LOS ≤3 days) and discharged to home. ⋯ The incidence of POCD early after total hip and knee replacement seems to be lower after a fast-track approach than rates previously reported for these procedures, but late POCD occurred with an incidence similar to that in previous studies of major noncardiac elective surgery. No association between early and late POCD could be verified.