Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2019
Case ReportsAcute primary abdominal compartment syndrome due to Clostridium difficile induced toxic megacolon: a case report and review of the literature.
Without timely diagnosis, acute primary abdominal compartment syndrome (ACS) is a potentially fatal syndrome and often goes unrecognized until severe symptoms appear. Early diagnosis may significantly improve the prognosis of these patients. ⋯ Monitoring of intra-abdominal pressure allows early detection of abdominal compartment syndrome and is warranted in patients with C. difficile infection and/or toxic megacolon. Early decompression can lead to improved outcomes in patients with severe shock and organ failure.
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Anaesthesiol Intensive Ther · Jan 2019
Randomized Controlled Trial Comparative StudyComparison of propofol-ketamine versuspropofol-remifentanil in children anaesthetized for gastroscopy.
The search for ideal anaesthesia is still an open research issue. The aim of the study was to evaluate and compare two methods of general anaesthesia with preserved own breath - propofol with ketamine and propofol with remifentanil - in children anaesthetized for gastroscopy. ⋯ Both methods of anaesthesia presented in the paper are safe and can be used in children to perform endoscopy. Combining propofol with ketamine allows fast induction of anaesthesia and creates very good conditions for the examination. Combining propofol with remifentanil allows fast and full return of consciousness after anaesthesia.
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Anaesthesiol Intensive Ther · Jan 2019
Randomized Controlled Trial Comparative StudyImpact of spinal needle design and approach to postdural puncture headache and spinal anesthesia failure in obstetrics.
Concern has been raised that Sprotte needles predispose to spinal anes-thesia failure. Nevertheless, these needles are associated with a low incidence of postdural puncture headache. The impact of the paramedian approach to postdural puncture headache remains controversial. The objective of this prospective randomized study was to compare Sprotte, Quincke and Atraucan needles as well as the midline and the paramedian approach in terms of postdural puncture headache and spinal anesthesia failure in patients undergoing Caesarean section. ⋯ Sprotte but not Atraucan needle design correlates with lower incidence of postdural puncture headache compared to Quincke design. Sprotte needles are not associated with a higher spinal anesthesia failure compared to Quincke needles. The incidence of postdural puncture headache by the paramedian approach is not significantly reduced whereas the spinal anesthesia failure rate is increased in comparison to the midline approach.
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Anaesthesiol Intensive Ther · Jan 2019
Complications associated with nasotracheal intubation and proposal of simple countermeasure.
To the Editor, Nasotracheal intubation is a widely used technique in anaesthesia management for procedures including oropharyngeal, dental, and maxillofacial surgeries[1-3]. It provides an uninhibited access to the mouth and plays an important role when dealing with difficult airways[4-6]. It is also used in patients with cervical spine instability owing to injury[7] or in patients with a cervical spine fixation owing to a disease or previous operation[8]. ⋯ In conclusion, we suggest a simple countermeasure to avoid possible complications of nasotracheal intubation. It involves movement of a cleaned tracheal tube into the trachea of patient. Moreover, we suggest a possible ventilation technique in case the SpO2 falls beyond the permissible range during the nasotracheal intubation.
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Anaesthesiol Intensive Ther · Jan 2019
Randomized Controlled Trial Comparative StudyPerformance of first and second generation supraglottic airway devices in patients with simulated difficult airway: a randomised controlled trial.
Guidelines for management of unanticipated difficult intubation recommend the use of supraglottic airway devices (SADs) in cases of failed intubation. How-ever, there is a lack of comparative studies for different type of devices. In this randomised controlled trial, the performance of 1st and 2nd generation supraglottic airway devices was compared in patients with a simulated difficult airway. ⋯ First and second generation of supraglottic airway devices provided similar clinical performance for patients with difficult airway and trauma due to limited cervical motion.