Int Surg
-
To demonstrate whether reactive oxygen and free radical measuring are appropriate to evaluate short-term surgical stress after laparoscopic colectomy. The subjects consisted of 22 cases (laparoscopic surgery, 16; and laparotomy, 6) that underwent surgery for colon cancer. The reactive oxygen metabolites (ROM) value in the blood were measured perioperatively. ⋯ In the comparison of pain control 1 day following surgery, a significantly lower value was indicated in the epidural anesthesia group (n = 12) compared with the fentanyl intravenous injection group (n = 10). Moreover, no significant change was observed in the surgical stress level in a comparison of patient background items such as age, sex, and so forth, laparoscopic surgery, and laparotomy. The low-invasiveness of laparoscopic surgery was not indicated in the ROM value 1 day following surgery, probably because pain control offsets the level of surgical stress using this method.
-
We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block(+) group, n = 18) or without peripheral nerve block (Block(-) group, n = 14). ⋯ A total of 11 patients and 1 patient underwent day surgery in the Block(+) and Block(-) groups, respectively (P = 0.0012). Good postoperative pain control was more commonly observed in the Block(+) group than in the Block(-) group (P = 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery.
-
Case Reports
Fiberoptic bronchoscopy-assisted endotracheal intubation in a patient with a large tracheal tumor.
In the event of a high degree of airway obstruction, endotracheal intubation can be impossible and even dangerous, because it can cause complete airway obstruction, especially in patients with high tracheal lesions. However, a smaller endotracheal tube under the guidance of a bronchoscope can be insinuated past obstructive tumor in most noncircumferential cases. Here we report a case of successful fiberoptic bronchoscopy-assisted endotracheal intubation in a patient undergoing surgical resection of a large, high tracheal tumor causing severe tracheal stenosis. ⋯ After several failed conventional endotracheal intubation attempts, fiberoptic bronchoscopy-assisted intubation was successful. The patient received mechanical ventilation and then underwent tumor resection and a permanent tracheostomy. This case provides evidence of the usefulness of the fiberoptic bronchoscopy-assisted intubation technique in management of an anticipated difficult airway and suggests that tracheal intubation can be performed directly in patients with a tracheal tumor who can sleep in the supine position, even if they have occasional sleep deprivation and severe tracheal obstruction as revealed by imaging techniques.