British journal of anaesthesia
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Poor positioning of an endobronchial double lumen tube (DLT) could affect oxygenation during one lung ventilation (OLV). We set out to relate DLT position to hypoxaemia and DLT misplacement during OLV. ⋯ Patients who have DLT malposition after placing the patient in the lateral position had more DLT malposition during OLV and hypoxaemia during OLV.
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Case Reports
Acute motor axonal polyneuropathy after a cisatracurium infusion and concomitant corticosteroid therapy.
A 40-yr-old male was admitted to the intensive care unit following blunt chest trauma. He had multiple rib fractures, bilateral pneumothoraces, and acute respiratory failure requiring mechanical ventilation. Sedation was achieved with midazolam and morphine, and later with propofol. ⋯ No sensory deficits were observed. Electromyography (EMG), repetitive nerve stimulation testing, and single fibre EMG (SFEMG) were performed at regular intervals after stopping cisatracurium. Clinical symptoms and electrophysiological examinations supported the diagnosis of acute motor axonal polyneuropathy related to concomitant administration of cisatracurium and corticosteroid therapy.
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We report a case of acute upper airway obstruction caused by a rapidly expanding blood-filled bulla in the oropharynx (angina bullosa haemorrhagica), requiring tracheal intubation. The larynx could not be visualized by either awake fibreoptic laryngoscopy or direct laryngoscopy under anaesthesia. Surgical tracheostomy was therefore performed under general anaesthesia.
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Little attention has been paid to pain on medical wards, with publications limited to the management of surgical patients. We wanted to establish the prevalence and severity of pain in the general medical setting, and how this compared with other clinical specialties. ⋯ Patients in all hospital specialities experience pain. Until the issue of pain management in medical patients is fully addressed the situation will not improve.