Articles: postoperative.
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Pediatr Crit Care Me · Jan 2014
Early Postoperative Outcomes Following Surgical Repair of Complete Atrioventricular Septal Defects: Is Down Syndrome a Risk Factor?
To evaluate the impact of Down syndrome on the early postoperative outcomes of children undergoing complete atrioventricular septal defect repair. ⋯ In our study, we found no difference in the prevalence of atrioventricular valve dysplasia between children with and without Down syndrome undergoing complete atrioventricular septal defect repair. This finding contrasts with previously published data, and further confirmatory studies are required. Although clinical outcomes were similar, children with Down syndrome had a significantly higher prevalence of noncardiac complications in the early postoperative period than children without Down syndrome.
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The postoperative PCIA effects of dezocine in elderly patients were determined using a large multicenter randomized double-blind prospective study. ⋯ Dezocine combining with sufentanil is a complement drug for sufentanil in PCIA. Considering the side effects and overall satisfaction index, 0.1 mg/kg seems to be an ideal dosage for Dezocine using in the postoperative PCIA in elderly patients.
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Epidural analgesia (EDA) is used widely for postoperative pain treatment. However, studies have reported a failure rate of EDA of up to 30%. We aimed to evaluate the quality of postoperative EDA in patients undergoing a laparotomy in five Norwegian hospitals. ⋯ EDA was an effective method for postoperative pain relief at rest but did not give sufficient pain relief during mobilization. The use of cold stimulation to assess the spread of EDA had limited value as a clinical indicator of the efficacy of postoperative pain control. Validated tools for the control of EDA quality are needed.
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Surgical treatment of the lumbar spine is a standard procedure in orthopedic and neurosurgery. After endoscopic discectomy an otherwise healthy patient developed massive dyspnea in combination with severe abdominal pain. ⋯ After insertion of a drainage channel fluid could be removed and the patient was transferred to a peripheral ward after a 24 h monitoring period. This review reports on the complications and anesthetic characteristics of percutaneous spinal interventions and presents differential diagnoses of postoperative dyspnea.
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During a posterior segmental spinal fusion procedure, a 71-year-old woman developed cardiac and pulmonary embolism characterized by nonsustained ventricular tachycardia during cement injection, rapid and severe hypoxemia, and hemodynamic instability. Management included exploratory cardiotomy under cardiopulmonary bypass and removal of the emboli from the pulmonary vessels. Postoperative recovery was successful, and the patient was discharged without sequelae. We discuss the pathophysiology of bone cement implantation syndrome during spinal fusion, possible causative factors, and treatment alternatives.