Articles: postoperative.
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Anesthesia and analgesia · Dec 2013
Airway exchange failure and complications with the use of the cook airway exchange catheter®: a single center cohort study of 1177 patients.
There are limited data on rates of failure and airway injury with the use of airway exchange catheters. We performed a single-center retrospective analysis of airway exchange catheters to determine the incidence and associated factors for tube exchange failure and airway injury. ⋯ Pneumothorax was noted after 1.5% of attempted tube exchanges. Difficult tube exchange was encountered in 6 of 8 patients with pneumothorax.
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Randomized Controlled Trial
Effect of ultrasound-guided intercostal nerve block on postoperative pain after percutaneous nephrolithotomy : Prospective randomized controlled study.
The aim of the study was to investigate the effect of preoperative ultrasound-guided (US) intercostal nerve block (ICNB) in the 11th and 12th intercostal spaces on postoperative pain control and tramadol consumption in patients undergoing percutaneous nephrolithotomy (PCNL). ⋯ In PCNL with nephrostomy tube placement US-guided ICNB performed at the 11th and 12th intercostal spaces provided effective analgesia.
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Randomized Controlled Trial Comparative Study
A randomised controlled trial comparing the GlideScope(®) and the Macintosh laryngoscope for double-lumen endobronchial intubation.
Double-lumen endobronchial tubes are the most common method of achieving lung isolation and one-lung ventilation during thoracic anaesthesia and surgery. We compared the clinical performance of the Macintosh laryngoscope and the GlideScope(®) during endobronchial intubation with a double-lumen tube. Seventy patients with no predictors for difficult laryngoscopy were allocated randomly to the Macintosh laryngoscope or GlideScope. ⋯ On a numerical rating scale (scored from 0 to 10), the 30 anaesthetists who took part in the study rated endobronchial intubation overall as easier using the Macintosh compared with the GlideScope, 2 (1-3 [0-8]) vs 3 (2-6 [0-10]), respectively, p = 0.003. Postoperative voice changes were also less common in the Macintosh group (8 (22%) vs 17 (58%), p = 0.045). Anaesthetists found the GlideScope more difficult to use than the Macintosh laryngoscope and endobronchial intubation took longer; therefore, we cannot recommend its routine use with double-lumen tubes in patients who are predicted to have a normal airway.
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Chylothorax is a pathologic condition defined by an accumulation of lymphatic fluid, the chyle, in the thorax. Postoperative chylothorax is a potentially lethal complication, with a reported mortality rate of 15.4%-25%. ⋯ The 2-wk regimen reduced the requirement for TDL and the overall morbidity and mortality rates compared with the 48-h regimen. Importantly, this regimen does not increase the risk of chylothorax recurrence.