Minerva anestesiologica
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Minerva anestesiologica · Dec 2006
Case ReportsTracheal rupture after tracheal intubation: effectiveness of conservative treatment.
A tracheal rupture is a rare complication of tracheal intubation. Risk factors include advanced age, COBP and corticosteroid therapy. The direct causes of the rupture are difficult tracheal intubation, particularly with a stylet inside the tube and overdistension of the cuff of the tracheal tube. ⋯ We adopted a conservative treatment, consisting of a tracheal intubation and chest drain, which resulted in a full recovery after 5 days of mechanical ventilation. The causes that could have provoked a tracheal laceration in our patient and the suggested therapies with preference for conservative treatment, are discussed. We recommend a tracheal tube cuff monitoring during surgery, to prevent fatal overinflation of the cuff, which is permeable to nitrous oxide.
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Minerva anestesiologica · Dec 2006
Case ReportsAirway obstruction during arthroscopic shoulder surgery: anesthesia for the patient or for the surgeon?
Two cases of airway obstruction as a result of oedema of laryngeal structures which arose during protracted arthroscopic shoulder surgery, in which single-shot interscalene blocks had been performed, are reported. In these 2 cases, the complexity of the pathologies and the fact that the surgeons were at the beginning of their surgical experience are the most likely causes of the conditions which led to tracheal compression from extra-articular leakage of fluid. Therefore, we recommend a combined peripheral block and general anaesthesia with tracheal intubation for procedures performed by surgeons without an adequate experience and on obese patients, patients placed in a lateral decubitus, or procedures in which difficulties are expected. The advantages of regional anaesthesia with a constant control of the airways are underlined.