Journal of clinical anesthesia
-
Review Meta Analysis
Postoperative complications in patients with obstructive sleep apnea: a meta-analysis.
To determine whether a diagnosis of obstructive sleep apnea (OSA) imparts an increased risk of postoperative respiratory failure, cardiac events, and intensive care unit (ICU) transfer than patients with no OSA diagnosis. ⋯ Surgical patients with OSA are at increased risk of postoperative respiratory failure, cardiac events, and ICU transfer.
-
A 52-year-old man underwent tracheal resection during regional anesthesia with sedation. The patient had a prior history of tracheostomy resulting in tracheal stenosis and expiratory wheezing. Awake tracheal resection with spontaneous ventilation was performed. Patient cooperation was essential to identify the lesion and perform the resection safely.
-
To identify risk factors for coagulopathy in patients undergoing liver resection. ⋯ Epidural anesthesia is feasible in patients scheduled for liver resection. Caution should be observed for patients with extended resection (≥3 segments) and increased postoperative lactate. In patients with preexisting liver disease, epidural catheters should be avoided.
-
Two cases of vocal cord closure, which was responsible for acute intraoperative impairment of mechanical ventilation in two patients with entropy-controlled depth of anesthesia, are reported. Administration of low-dose neuromuscular blocking drug was associated with immediate vocal cord relaxation and restoration of efficient mechanical ventilation.
-
Lumbar chemical sympathectomy has been performed using fluoroscopic guidance for needle positioning. An 84 year old woman with atherosclerosis obliterans was referred to the pain clinic for intractable cold allodynia of her right foot. A thermogram showed decreased temperature of both feet compared with temperatures above both ankles. ⋯ Her blood pressure was 80/50 mmHg, and flank tenderness was noted. Retroperitoneal hemorrhage from the second right lumbar segmental artery was shown on computed tomography and angiography. Vital signs were stabilized immediately after embolization into the right lumbar segmental artery.