Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 2003
Case ReportsFailed extubation of a double-lumen tube requiring a cricoid split.
Following a five-hour procedure, it was not possible to remove a double-lumen endobronchial tube that had been placed to facilitate the removal of a massive spleen from a 45-year-old female. The tube had been passed easily at the start of surgery, but was firmly stuck at the level of the cricoid at the end of surgery. Surgical removal of the tube by a cricoid split was required 48 hours later. Consideration of previous airway manipulations, careful choice of airway devices and regular checks of airway patency around tracheal tubes during lengthy procedures may prevent similar events in the future.
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Anaesth Intensive Care · Oct 2003
Case ReportsInadvertent subdural spread complicating cervical epidural steroid injection with local anaesthetic agent.
Although cervical epidural steroid injection with local anaesthetic is considered a safe technique and widely practiced, complications may occur. We report a patient experiencing unexpected delayed high block, moderate hypotension and unconsciousness eight to ten minutes after an apparently normal cervical epidural steroid injection. ⋯ Anatomical peculiarities of the epidural and subdural space in the cervical region increase the risk of subdural spread during cervical epidural injection. Fluoroscopic guidance is important during cervical epidural injection to increase certainty of correct needle placement, thus minimizing the risk of complications.