Anesthesia and analgesia
-
Anesthesia and analgesia · Apr 2008
Case ReportsSealing of a tracheoesophageal fistula using a Sengstaken-Blakemore tube for mechanical ventilation during general anesthesia.
A 78-yr-old man was admitted to our hospital because of repeated episodes of pneumonia. Both fiberoptic bronchoscopy and esophagoscopy revealed a large tracheoesophageal fistula and protrusion of the metal stent from the esophagus into the trachea. ⋯ Anesthetic management is difficult because of the care needed to prevent aspiration of esophageal contents and diversion of oxygen through the fistula into the stomach from the trachea when patients are under mechanical ventilation. Our method of sealing a large tracheoesophageal fistula with a Sengstaken-Blakemore tube was performed successfully.
-
Anesthesia and analgesia · Apr 2008
A new single use supraglottic airway device with a noninflatable cuff and an esophageal vent: an observational study of the i-gel.
The i-gel is a new single-use supraglottic airway device with a noninflatable cuff and an esophageal vent. ⋯ The i-gel is a reliable, easily inserted airway device that provides an adequate seal with a low morbidity rate.
-
Anesthesia and analgesia · Apr 2008
Meta AnalysisDoes tight heart rate control improve beta-blocker efficacy? An updated analysis of the noncardiac surgical randomized trials.
Recent meta-analyses assessing the efficacy of perioperative beta-blockade trials have failed to show a reduction in postoperative morbidity and mortality. Tight control of heart rate (HR) has been suggested to improve these outcomes. Meta-analyses have not considered the influence of tight HR control on the efficacy of perioperative beta-blockade. ⋯ The trials that achieve the most effective control of HR are associated with a reduced incidence of postoperative MI, suggesting that effective control of HR is important for achieving cardioprotection. Second, this analysis demonstrates that administration of beta-blockers does not reliably decrease HRs in all patients, and may be associated with increased side effects. Judicious use of combination therapy with other drugs may be necessary to achieve effective postoperative control of HR.
-
Anesthesia and analgesia · Apr 2008
Randomized Controlled TrialStimulating catheters for continuous femoral nerve blockade after total knee arthroplasty: a randomized, controlled, double-blinded trial.
Continuous femoral nerve blockade (CFNB) is often used for postoperative analgesia after total knee arthroplasty (TKA). CFNB can be instituted using a variety of techniques. Stimulating catheters (SC) have the advantage of confirming placement of the catheter close to the nerve during advancement. ⋯ In this study, blind catheter advancement was as reliable as a SC technique for establishing and maintaining CFNB for postoperative analgesia as a part of multimodal analgesia technique after TKA.