Anesthesia and analgesia
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Anesthesia and analgesia · Oct 2010
Randomized Controlled Trial Comparative StudyEffect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine.
Postoperative sore throat (POST) is a common complication after endotracheal intubation. We compared the effectiveness on POST of spraying the endotracheal tube (ETT) cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. ⋯ Spraying benzydamine hydrochloride on the ETT cuff is a simple and effective method to reduce the incidence and severity of POST.
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Anesthesia and analgesia · Oct 2010
Review Case ReportsCase report: epidural hematoma nine days after removal of a labor epidural catheter.
Timely recognition and surgical decompression are crucial to minimize risk of permanent neurologic deficit from epidural hematoma. We present the case of a patient who developed acute back pain, sensory deficit, and ascending weakness 9 days after removal of a labor epidural catheter. Magnetic resonance imaging revealed a heterogeneous fluid collection extending from C6-7 through the lumbar region, with cord deformity at T9-11. ⋯ Twelve hours later, her motor function had fully recovered. Subsequent anatomic and hematologic workup was inconclusive. This presentation is atypical given the delayed presentation of symptoms after epidural placement.
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Anesthesia and analgesia · Oct 2010
Comparative StudyTwo serial check valves can prevent cross-contamination through intravenous tubing during total intravenous anesthesia.
Nonsterile handling of propofol for anesthesia has been linked with severe sepsis and death. Placing a single check valve in the IV tubing does not prevent retrograde ascension of pathogens into propofol-filled syringes, so we designed an IV tubing set with multiple check valves. To estimate the efficacy of this design, we measured the concentration of pathogens detected upstream in the IV tubing in relation to the pathogen concentration in a model of a contaminated patient. ⋯ The data from this experimental setting suggest that the design with multiple check valves in paired configuration prevents retrograde contamination. Of note, this does not permit the reuse of propofol syringes because reusing is against the manufacturer's recommendations.
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Anesthesia and analgesia · Oct 2010
Comparative StudyRobot-assisted airway support: a simulated case.
Recent advances in telemedicine and robotically assisted telesurgery may offer advanced surgical care for the geographically remote patient. Similar advances in tele-anesthesia will be necessary to optimize perioperative care for these patients. ⋯ Both oral and nasal approaches to fiberoptic intubation were successful, but presented unique opportunities and challenges inherent to the robot's design. Robotically assisted airway management is feasible using multipurpose surgical robotic systems.
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Anesthesia and analgesia · Oct 2010
Comparative StudyRepinotan, a selective 5-HT1A-R-agonist, antagonizes morphine-induced ventilatory depression in anesthetized rats.
Spontaneous breathing during mechanical ventilation improves arterial oxygenation and cardiovascular function, but is depressed by opioids during critical care. Opioid-induced ventilatory depression was shown to be counteracted in anesthetized rats by serotonin(1A)-receptor (5-HT(1A)-R)-agonist 8-OH-DPAT, which cannot be applied to humans. Repinotan hydrochloride is a selective 5-HT(1A)-R-agonist already investigated in humans, but the effects on ventilation and nociception are unknown. In this study, we sought to establish (a) the effects of repinotan on spontaneous breathing and nociception, and (b) the interaction with the standard opiate morphine. ⋯ The 5-HT(1A)-R-agonist repinotan activates spontaneous breathing in anesthetized rats even in morphine-induced ventilatory depression. The potency of 5-HT(1A)-R-agonists to stimulate spontaneous breathing and their antinociceptive effects should be researched further.