Articles: postoperative-complications.
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Recurrent laryngeal nerve palsy (RLNP) occurs as a complication during anterior cervical spine surgery. In 2005 the authors demonstrated the high incidence of asymptomatic RLNP in a right-sided approach. ⋯ The left-sided approach in anterior cervical spine surgery reduces the incidence of postoperative and permanent RLNP significantly. Endotracheal cuff pressure reduction used additionally decreases the rate of RLNP even more. These results indicate that anterior cervical spine surgery should be performed with a left-sided approach and, if possible, with an additional reduction of the endotracheal cuff pressure while the retractors are inserted.
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Symptomatic spontaneous pneumocephalus after a spinal fusion for spondylolisthesis without injury to the dura mater is rare. There are only a few reports of tension pneumocephalus after spinal operations published in English. ⋯ CT cisternography and MRI showed no anatomical defects that could have caused the pneumocephalus. We suggest that spontaneous pneumocephalus without dural injury may occur after a spondylolisthesis operation because of increased intra-abdominal pressure, and thus may be avoided by the careful management of abdominal pressure.
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Anaesth Intensive Care · Jul 2010
Single dose dexamethasone for postoperative nausea and vomiting--a matched case-control study of postoperative infection risk.
Dexamethasone is an effective prophylaxis against postoperative nausea and vomiting but is immunosuppressive and may predispose patients to an increased postoperative infection risk. This matched case-control study examined the association between the administration of a single intraoperative anti-emetic dose of dexamethasone (4 to 8 mg) and postoperative infection in patients undergoing non-emergency surgery in a university trauma centre. Cases were defined as patients who developed infection between one day and one month following an operative procedure under general anaesthesia. ⋯ Cases were more likely to have received dexamethasone intraoperatively (25.4 vs. 11%, P = 0.006), and less likely to have received perioperative antibiotic prophylaxis (60.3 vs. 84.3%, P = 0.001). Stepwise, multivariate conditional logistic regression confirmed these associations, with adjusted odds ratios of 3.03 (1.06 to 19.3, P = 0.035) and 0.12 (0.02 to 0.7, P = 0.004) respectively for the associations between dexamethasone and perioperative antibiotic prophylaxis, with postoperative infection. We conclude that intraoperative administration of dexamethasone for anti-emetic purposes may confer an increased risk of postoperative infection.
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Anesteziol Reanimatol · Jul 2010
Case Reports[Compression cervical spine cord injury in patients with posterior cranial fossa tumors operated on in the sitting position: two cases with different outcomes].
The paper describes two cases of posterior cranial fossa pathology, operated on in the sitting position on the operating table. In one case, symptoms of cervical spine injury caused by undiagnosed preoperative cervical spine pathology emerged in a female patient in the early postoperative period. In the other case, cervical spine pathology was diagnosed before surgery and evoked potentials were monitored to prevent possible cervical spine injury in the sitting position during an operation.