Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Mar 2012
ReviewReview of interscalene block for postoperative analgesia after shoulder surgery in obese patients.
In recent years, the prevalence of obesity has significantly increased in developed countries, a trend that has been just as apparent in France as elsewhere. Obesity may predispose to osteoarthritis, which may subject a high percentage of patients to shoulder surgery. Interscalene block remains one of the most efficient technique for postoperative analgesia after shoulder surgery. ⋯ In obese patients undergoing shoulder surgery, the goal of postoperative pain management is to provide comfort, early mobilization, and improved respiratory function without the worry of inadequate sedation and respiratory compromise. The ongoing debate on the relevance of obesity, for example in terms of obstructive sleep apnea syndrome, obesity hypoventilation syndrome, and other related respiratory disturbances, in relation to the choice of analgesic techniques, especially interscalene block, patient-controlled intravenous analgesia and patient monitoring, demands large-scale, well-designed studies to resolve it. Nevertheless, obesity per se should not dissuade patients from undergoing shoulder surgery under interscalene block.
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Acta Anaesthesiol Taiwan · Mar 2012
Case ReportsDevelopment of acute ischemic stroke in a patient with acute respiratory distress syndrome (ARDS) resulting from H1N1 pneumonia.
Pneumonia due to H1N1 infection is now very common. We report a case of ischemic stroke which arose subsequently to H1N1 influenza. The patient was a female who developed acute respiratory distress syndrome (ARDS) after H1N1 influenza, was ventilated as per standard protocol and started treatment with oseltamivir. ⋯ In the course of time, she had acceptable neurological recovery following treatment with aspirin and neuro-rehabilitation. This case report provides evidence that a rare, debilitating complication like stroke can occur in H1N1 infection. A high index of suspicion of the probability of a cerebrovascular event should be borne in mind and regular neurological assessment should be done in such cases.