Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 2000
Case ReportsTracheal foreign body following tube change during percutaneous dilational tracheostomy: a cautionary tale.
Although studies have shown percutaneous dilational tracheostomy to be a safe and cost-effective alternative to conventional surgical tracheostomy, there are inherent risks and complications. We report an incident occurring during percutaneous dilational tracheostomy using the Portex technique, in which a significant cuff leak occurring on insertion of the tracheostomy tube necessitated an immediate tube change. During this latter procedure, using a fresh Portex kit and guidewire, the guidewire introducer became dislodged from the guidewire assembly and inadvertently impacted in the trachea. Routine bronchoscopy identified the hazard and the foreign body was successfully removed via the bronchoscope with no adverse sequelae.
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Anaesth Intensive Care · Aug 2000
Prediction of the mediastinal drainage after coronary artery bypass surgery.
Using multiple correlation and linear regression approaches, we investigated the association between the amount of mediastinal drainage for the first 24 postoperative hours and clinical variables as well as multiple haematological tests performed at three time points: before anaesthesia induction, 10 minutes after protamine administration and just after skin closure, on 46 patients undergoing primary coronary artery bypass grafting. Three models from the three times were then developed to predict mediastinal drainage. ⋯ Each regression model explained approximately 60% of the variation in postoperative mediastinal drainage. The information obtained from these predictive models is useful in defining high-risk populations.
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Anaesth Intensive Care · Aug 2000
Case ReportsSwelling and cyanosis of the tongue associated with use of a laryngeal mask airway.
We present a case report of a patient who developed acute swelling of the tongue during anaesthesia using the laryngeal mask airway. The swelling was thought to be due to obstruction of the venous drainage of the tongue. ⋯ The swelling and cyanosis of the tongue resolved rapidly after removal of the laryngeal mask airway. The patient suffered paraesthesia of the tip of the tongue that lasted for two weeks.
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Anaesth Intensive Care · Aug 2000
Letter Biography Historical ArticleAlexander Wood's observations on the action of opiates.
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A young patient had unexpected and prolonged postoperative delirium apparently associated with morphine-induced biliary colic. Naloxone had no therapeutic effect, but a small dose of pethidine produced a dramatic return to lucidity. Unrecognized biliary spasm should be considered as a cause of agitation in the recovery room in postoperative patients who have received morphine.