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The Open Anesthesiology Journal最新文献

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The use of “High Dose” Dexmedetomidine in a Patient with CriticalTracheal Stenosis and Anterior Mediastinal Mass “大剂量”右美托咪定在气管严重狭窄和前纵隔肿块患者中的应用
The Open Anesthesiology Journal Pub Date : 2011-11-30 DOI: 10.2174/1874321801105010042
C. Voscopoulos, F. L. Kirk, M. Lovrincevic, M. Lema
{"title":"The use of “High Dose” Dexmedetomidine in a Patient with CriticalTracheal Stenosis and Anterior Mediastinal Mass","authors":"C. Voscopoulos, F. L. Kirk, M. Lovrincevic, M. Lema","doi":"10.2174/1874321801105010042","DOIUrl":"https://doi.org/10.2174/1874321801105010042","url":null,"abstract":"The anterior medial mass patient continues to offer great challenges for the anesthesiologist. As such, newer and safer methods of providing anesthetic care are continually being sought. To this end, there is a growing body of evidence that may suggest that higher than Food and Drug Administration approved dosages of dexmedetomidine may offer another option in the arsenal of the anesthesiologist in this patient population. We recently cared for a middle aged male who presented with a large mediastinal mass, extrinsic compression critical tracheal stenosis, superior vena cava syndrome, and massive supraclavicular lymphadenopathy, scheduled for tracheal stent placement, biopsy, and diagnostic evaluation of the esophagus. After reviewing anesthetic options, we deemed the safest technique available to us to be the use of a high dose dexmedetomidine based technique with continuous infusion rate of 2mcg/kg/hr. Spontaneous respirations were maintained throughout the case, with a stable heart rate and blood pressure, and our patient tolerated the procedure without complications.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128285846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
A Rare Chondrosarcoma of the Larynx Presenting as Difficult Intubation: Report of a Case and Literature Review 罕见喉部软骨肉瘤以插管困难为表现:1例报告及文献复习
The Open Anesthesiology Journal Pub Date : 2011-11-25 DOI: 10.2174/1874321801105010037
J. Sarma, Srinivas M Susarla, W. Faquin, P. Song
{"title":"A Rare Chondrosarcoma of the Larynx Presenting as Difficult Intubation: Report of a Case and Literature Review","authors":"J. Sarma, Srinivas M Susarla, W. Faquin, P. Song","doi":"10.2174/1874321801105010037","DOIUrl":"https://doi.org/10.2174/1874321801105010037","url":null,"abstract":"Chondrosarcomas of the larynx are rare tumors, representing less than 0.2% of all head and neck malignancies (1). In this report, we present an unusual case of an undiagnosed chrondrosarcoma of the larynx presenting as difficult intubation in an otherwise asymptomatic patient. Difficult intubation in an otherwise asymptomatic patient has not been reported as an initial presentation of this tumor. Men are more commonly affected than women (3.6: 1), and the tumors typically present in the fifth or sixth decade of life. Patients may present with dyspnea, dysphagia, hoarseness of the voice, airway obstruction and some may have pain as a result of expansion of this tumor. The tumors almost always arise from hyaline cartilage, with the most common site of involvement the cricoid cartilage (75%), specifically the posterior lamina, with the thyroid cartilage and arytenoid cartilage less frequently involved. Though locally invasive, these tumors are characterized by a low tendency for distant metastasis and the overall prognosis following excision is excellent (2).","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125163466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Bi Lateral Vocal Cord Paralysis Post Thyroidectomy Causing Total Airway Obstruction: Case Report 甲状腺切除术后双侧声带麻痹引起全气道阻塞1例
The Open Anesthesiology Journal Pub Date : 2011-08-26 DOI: 10.2174/1874321801105010035
S. Mundada, K. Gosavi, Naveed Khan
{"title":"Bi Lateral Vocal Cord Paralysis Post Thyroidectomy Causing Total Airway Obstruction: Case Report","authors":"S. Mundada, K. Gosavi, Naveed Khan","doi":"10.2174/1874321801105010035","DOIUrl":"https://doi.org/10.2174/1874321801105010035","url":null,"abstract":"Thyroid surgery in recent years is generally considered quite safe. Better preoperative preparation and proper surgical techniques of thyroidectomy have minimized complications to less than 2-3%. Bilateral recurrent nerve palsy is the rarest of all complications, with a reported incidence varying between 0.4% to 14 %, but can be potentially fatal if missed (1, 2). We report a case in which the patient experienced life threatening stridor and severe dyspnoea requiring re-intubation few minutes after extubation.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131914814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perioperative Implementation of Continuous Positive Airway Pressure: A Review of the Considerations 持续气道正压的围手术期实施:考虑因素的回顾
The Open Anesthesiology Journal Pub Date : 2011-07-22 DOI: 10.2174/1874321801105010014
S. Karan, S. Black, F. Mouton
{"title":"Perioperative Implementation of Continuous Positive Airway Pressure: A Review of the Considerations","authors":"S. Karan, S. Black, F. Mouton","doi":"10.2174/1874321801105010014","DOIUrl":"https://doi.org/10.2174/1874321801105010014","url":null,"abstract":"OSA patients present unique challenges in the peri-operative period. They routinely require more monitoring, oxygen therapy, unplanned ICU admissions, longer hospital stays, and have more adverse events than healthy counter- parts. Some data suggest that perioperative CPAP use is associated with reduced morbidity and mortality of patients with OSA, and yet its application remains inconsistent. This review aims to summarize existing literature on the peri-operative use of CPAP, identify barriers to its implementation, and begin defining an algorithm for the practical application of peri-operative CPAP.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115475796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Morbid Obesity and Obstructive Sleep Apnea: The Challenging Link 病态肥胖和阻塞性睡眠呼吸暂停:具有挑战性的联系
The Open Anesthesiology Journal Pub Date : 2011-07-22 DOI: 10.2174/1874321801105010019
T. Ebert, J. Novalija
{"title":"Morbid Obesity and Obstructive Sleep Apnea: The Challenging Link","authors":"T. Ebert, J. Novalija","doi":"10.2174/1874321801105010019","DOIUrl":"https://doi.org/10.2174/1874321801105010019","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common medical condition that is increasing in prevalence and is associ- ated with substantial morbidity and a 40% eight-year mortality rate if left untreated. Morbidly obese patients have a greater incidence of co-morbid disease, including OSA. OSA is characterized by repeated upper airway obstruction and arousal during sleep, sympathetic activation, hypertension and daytime somnolence. In morbidly obese OSA patients undergoing surgical procedures, the perioperative period is more challenging than in non obese OSA patients. Their airway anatomy is often abnormal with excess pharyngeal tissue and tongue size making it difficult to ventilate thru a facemask and to establish tracheal intubation. Several suggestions for optimizing the anesthetic induction, emergence, and early recovery periods in these patients are offered. Most important are positioning of the patient (both during and post surgery), pre-oxygenation prior to intubation, proper dosing of anesthetic maintenance drugs to ideal body weight, alveolar recruitment maneuvers, full reversal of paralysis at the end of surgery, and careful drug titration in recovery to improve pulmonary mechanics. With proper preparation and precautions it is possible to avoid the significant high frequency of respiratory and cardiac complications observed in these patients and to avoid or better manage length of hospital stay, unplanned ICU admission and/or reintubation.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131401211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Respiratory Effects of Opioids in Perioperative Medicine 阿片类药物在围手术期医学中的呼吸作用
The Open Anesthesiology Journal Pub Date : 2011-07-22 DOI: 10.2174/1874321801105010023
C. Koo, M. Eikermann
{"title":"Respiratory Effects of Opioids in Perioperative Medicine","authors":"C. Koo, M. Eikermann","doi":"10.2174/1874321801105010023","DOIUrl":"https://doi.org/10.2174/1874321801105010023","url":null,"abstract":"Opioids are widely used to treat acute and chronic pain as well as respiratory distress. There is great variability in opioid-induced side effects due to individual biological factors, patient co-morbidities and drug interactions. Normal respiratory rhythm generation is decreased primarily via inhibititory effects within the pre-Botzinger complex. Central chemosensitivity to hypercapnia and hypoxia are blunted by opioids at the levels of the retrotrapezoid nucleus, medullary raphe nucles and nucleus tractus solitarius. Opioids also decrease central drive to both respiratory pump muscles and the upper airway dilator muscles. Opioid-induced respiratory depression can be reversed by naloxone, and recent data suggest that 5-HT4(a) agonists and ampakines are effective to reverse some of the opioid-induced respiratory depressant effects. The potentially fatal side effects of respiratory depression within the acute peri-operative setting necessitates effective monitoring of respiratory function in all patients receiving opioid therapy. Each institution needs to develop an optimal organization structure locally to define appropriate methods for avoiding medication errors, titrating opioids to target effect, and monitoring for respiratory side effects.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127491965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 31
Editorial:- Sleep and Anesthesia 社论:-睡眠和麻醉
The Open Anesthesiology Journal Pub Date : 2011-07-22 DOI: 10.2174/1874321801105010005
M. Eikermann
{"title":"Editorial:- Sleep and Anesthesia","authors":"M. Eikermann","doi":"10.2174/1874321801105010005","DOIUrl":"https://doi.org/10.2174/1874321801105010005","url":null,"abstract":"","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129471047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening for Obstructive Sleep Apnea Syndrome in the PreoperativePatients 术前阻塞性睡眠呼吸暂停综合征的筛查
The Open Anesthesiology Journal Pub Date : 2011-07-22 DOI: 10.2174/1874321801105010007
F. Chung
{"title":"Screening for Obstructive Sleep Apnea Syndrome in the PreoperativePatients","authors":"F. Chung","doi":"10.2174/1874321801105010007","DOIUrl":"https://doi.org/10.2174/1874321801105010007","url":null,"abstract":"Obstructive sleep apnea (OSA) is caused by repetitive partial or complete obstruction of the upper airway, characterized by episodes of breathing cessation during sleep, which last 10 or more seconds. The prevalence of OSA var- ies widely depending on the demographics of the population studied, the definition of the disorder and the methods of di- agnosis. Patients with obstructive sleep apnea can be a potential management challenge for the anesthesiologists during the perioperative period. Therefore anesthesiologists need a thorough understanding of the diagnosis of OSA, prevalence of OSA and the available screening tools.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124721269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Unilateral Periorbital and Cervical Subcutaneous Emphysema Following Extraperitoneal Laparoscopic Radical Prostatectomy 腹腔镜下根治性前列腺切除术后单侧眶周及颈部皮下肺气肿
The Open Anesthesiology Journal Pub Date : 2011-03-29 DOI: 10.2174/1874321801105010001
J. Sarma
{"title":"Unilateral Periorbital and Cervical Subcutaneous Emphysema Following Extraperitoneal Laparoscopic Radical Prostatectomy","authors":"J. Sarma","doi":"10.2174/1874321801105010001","DOIUrl":"https://doi.org/10.2174/1874321801105010001","url":null,"abstract":"A patient undergoing laparoscopic radical prostatectomy developed unilateral periorbital edema and cervical subcutaneous emphysema following carbon dioxide insufflation into the retropubic and retroperitoneal space. He had hypercarbia and acidosis during and after the end of the case and he required hyperventilation in the recovery room for two hours before the hypercarbia subsided and the arterial blood gases returned to normal levels. Despite massive surgical emphysema reaching up to his face, there was no evidence of a pneumothorax or pneumomediastinum in this patient. He had no respiratory distress and his visual examination was normal and the periorbital surgical emphysema subsided gradually within two days. The management of this complication and a review of the literature is presented.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131327458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
LETTER TO THE EDITOR-Potential Hazards of Neuromuscular Blocking Agents in the Treatmentof Acute Respiratory Distress Syndrome. Comment on: “NeuromuscularBlockers in Early Acute Respiratory Distress Syndrome” 致编辑:神经肌肉阻滞剂治疗急性呼吸窘迫综合征的潜在危害。评论:“神经肌肉阻滞剂在早期急性呼吸窘迫综合征中的应用”
The Open Anesthesiology Journal Pub Date : 2010-12-23 DOI: 10.2174/1874321801004010025
P. Fagenholz
{"title":"LETTER TO THE EDITOR-Potential Hazards of Neuromuscular Blocking Agents in the Treatmentof Acute Respiratory Distress Syndrome. Comment on: “NeuromuscularBlockers in Early Acute Respiratory Distress Syndrome”","authors":"P. Fagenholz","doi":"10.2174/1874321801004010025","DOIUrl":"https://doi.org/10.2174/1874321801004010025","url":null,"abstract":"While the mechanisms responsible for the adjusted mortality benefit reported by Papazian et al. remain speculative, it is highly likely that lower transpulmonary pressures (TPPs) in the cisatracurium group were responsible for some portion of the reported benefit. This is suggested by the three-fold incidence of pneumothorax in the placebo group compared to the cisatracurium group despite no difference in plateau pressures between the groups. This complication is significant in its own right, and probably serves as a marker for less obvious barotrauma at the alveolar level.","PeriodicalId":272376,"journal":{"name":"The Open Anesthesiology Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126843833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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