Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
We present a case of 100% pneumothorax in a 41-yr-old man with a history of gastritis and gastroesophageal reflux scheduled for Nissen fundoplication. The patient was anaesthetized, and insufflation of the abdominal cavity with carbon dioxide was performed uneventfully. There was an increase in the peak inspiratory pressure and wheezing was noted with a decrease in the arterial oxygen saturation to 91%. ⋯ A chest roentgenogram showed a 100% left pneumothorax. A left chest tube was placed with immediate improvement of the arterial oxygen saturation to 100%. We recommend monitoring of arterial oxygen saturation, peak inspiratory pressures, and excursion of the chest for early diagnosis and prompt treatment of pneumothorax during laparoscopic procedures.
-
Several brands of laryngoscopes and commonly used blades are evaluated for differences in direct light intensity and area of illumination. The purpose of this study was to determine which laryngoscope/blade combination provided the best lighting conditions for tracheal intubation. The direct light intensity was assessed by directing various laryngoscope/blade combinations towards a multifunction exposure meter (Flash Meter III, Minolta Corp.). ⋯ When fitted on regular size handles, blades with incandescent bulbs provided more intense light than blades using fibreoptic light sources (P = 0.0078). For blades using incandescent light, the use of a short handle laryngoscope resulted in a decrease in light intensity (P = 0.0117). The results of this study suggest that blades using incandescent light provide greater light intensity than blades using fibreoptics.
-
This case report demonstrates embolization of echogenic material detected by transoesophageal echocardiography during a cemented total hip arthroplasty in a 76-yr-old woman without patent foramen ovale. During the placement of the acetabular and femoral components, and during relocation of the hip joint, a "snow flurry" appearing in the right atrium was followed by several highly echogenic and mobile emboli of various sizes, some of them with a vermiform shape 1 to 5 cm long. ⋯ Also, no desaturation was detected by pulse oximetry and blood gases at the time of embolism and there was no decrease in PETCO2. This case report is in line with other studies which failed to show a haemodynamic impact of TEE detected emboli during THA.