Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Mar 2015
Safety of pediatric continuous interscalene block catheters placed under general anesthesia: a single center's experience.
The use of interscalene catheters is an effective treatment strategy for children and adolescents undergoing shoulder surgery. Although placement of interscalene catheters in the awake child is challenging, some have cautioned against performing regional anesthesia in the patient under general anesthesia. We present a case series of 154 interscalene catheters placed in pediatric patients under general anesthesia and managed in the outpatient setting. ⋯ Interscalene catheter placement under general anesthesia and management on an outpatient basis is feasible in the pediatric population and is associated with a low rate of catheter-related complications.
-
Trauma systems have improved outcomes for injured patients, but might be challenging to implement. We assessed the implementation of a trauma system in Norway after recommendations for a national trauma system were published in 2007, with a focus on elements in acute care hospitals. ⋯ Shortcomings in requirements for lower-level trauma care hospitals correlate to hospital size and frequency with which the trauma team is activated. In order to fulfill the minimum requirements, smaller hospitals should receive more attention.
-
Acta Anaesthesiol Scand · Mar 2015
Case ReportsGlycopyrrolate-induced respiratory arrest: an unusual side effect.
A descriptive case report of a 22-year-old woman, scheduled for elective laparotomy who had a respiratory arrest after premedication with inj glycopyrrolate and ondansetron. Respiratory arrest is an uncommon side effect of glycopyrrolate with very few published reports. ⋯ This patient had tachycardia and respiratory arrest and is suggestive of glycopyrrolate-induced respiratory arrest. This case report highlights the importance of strict vigilance by the anaesthesiologist even during premedication.
-
Acta Anaesthesiol Scand · Mar 2015
Real-time ventilation and perfusion distributions by electrical impedance tomography during one-lung ventilation with capnothorax.
Carbon dioxide insufflation into the pleural cavity, capnothorax, with one-lung ventilation (OLV) may entail respiratory and hemodynamic impairments. We investigated the online physiological effects of OLV/capnothorax by electrical impedance tomography (EIT) in a porcine model mimicking the clinical setting. ⋯ EIT detected in real-time dynamic changes in pulmonary ventilation and perfusion distributions. OLV to the left lung with right-sided capnothorax caused a decrease in cardiac output, arterial oxygenation and mixed venous saturation.