Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsA novel method of intubation and orogastric tube insertion using a C-MAC-D-blade videolaryngoscope-bougie technique.
Expertise in airway management is a fundamental aspect of anesthesia practice. Fortunately 'can't intubate, can't ventilate' scenarios are extremely rare. In particular, patients with tumors on the right side of the oropharynx and larynx can be very problematic to intubate. ⋯ The C-MAC D-Blade videolaryngoscope-bougie technique provides an alternative method to intubate patients with difficult airways, even in exceptional situations such as in patients with a large right-sided oropharynx-larynx tumor.
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsPhrenic nerve palsy following interscalene brachial plexus block; a long lasting serious complication.
Interscalene brachial plexus block (ISBPB) offers good analgesia for painful surgical procedures on the shoulder. We here describe two cases of long-term phrenic palsy following ISBPB that occurred in our practice in a relative short time period and both clearly illustrate the devastating impact of this complication for the patient. ⋯ When ISPBP is considered, the fact that the incidence of prolonged phrenic nerve palsy may be higher than previously expected should be taken into account carefully. A reevaluation on the indication and patient selection of ISBPB may even be warranted.
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Acta Anaesthesiol Belg · Jan 2015
ReviewAnesthesia and neurotoxicity in the developing brain: A non-systematic review.
In recent years, increasing experimental evidence has suggested an association between exposure to anesthesia in early life and subsequent poor neurodevelopmental outcome. Retrospective and follow-up studies have also suggested anesthesia-related neurotoxicity in the developing human brain. The present non-systematic review summarizes the available evidence, depicts the current knowledge on the potentially harmful effects of anesthesia and will discuss whether this knowledge urges us to implement changes in clinical practice.
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsIntermediate cervical plexus block for cervical esophagus diverticulectomy.
We report the case of a 97 year old woman suffering from a voluminous diverticle of the cervical esophagus with important comorbidities and a very poor quality of life. A diverticulectomy under general anesthesia implied a high level of risk. Regional anesthesia was chosen, i.e. an intermediate cervical plexus block, with mild sedation allowing to maintain contact with the patient. The procedure was carried out without complications and the patient's and surgical staff satisfaction were optimal.
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Acta Anaesthesiol Belg · Jan 2015
Cerebral tissue oxygen saturation during arthroscopic shoulder surgery in the beach chair and lateral decubitus position.
Arthroscopic shoulder surgery is a common procedure and can be performed with the patient in the lateral decubitus position (LDP) or beach chair position (BCP). Although the BCP is associated with better visualization and less bleeding, it has also been associated with hemodynamic changes and consequently cerebral hypoperfusion. Devastating events reported after surgery in the BCP were attributed to a combination of the upright position and hypotension. ⋯ Near infrared spectroscopy might be able to provide an early warning sign of cerebral hypoperfusion during shoulder surgery in the BCP. It was therefore recommended to continuously monitor cerebral oxygenation in patients undergoing shoulder surgery in the BCP, to potentially prevent devastating outcomes. However, more clinical research on the safe lower limits of cerebral tissue oxygen saturation is needed for this recommendation to gain broad acceptance.