Journal of clinical anesthesia and intensive care最新文献

{"title":"Inhaled Sevofluran vs Endovenous Propofol for Sedation Maintenance in Patients Submitted to Colonoscopy","authors":"L. Pérez-Díaz, Leopoldo Wulff, A. Salazar, M. Amaro, J. Álvarez","doi":"10.24966/acc-8879/100032(1)","DOIUrl":"https://doi.org/10.24966/acc-8879/100032(1)","url":null,"abstract":"Introduction: Endoscopic procedures under sedation currently occupy an important place. Sedation allows optimal conditions for the study Objective: To compare the anesthetic efficacy of the inhalation versus intravenous technique for maintenance of sedation in patients undergoing endoscopy. Materials and methods: A longitudinal, randomized clinical study of 32 patients of both sexes ASA I-III, aged 18-80 years undergoing diagnostic colonoscopy, which was randomly divided into 2 groups. In both, intravenous induction with propofol (2-2.5 mg / kg) was performed, Group A remained sedated with propofol infusion (1-2 mg / kg / min); Group B by inhalation with sevoflurane at a concentration of 2 vol% through a nasal cannula with an oxygen flow. Results: Both techniques were performed without registering complications; group A comprised of 15 patients in which only 13% required rescue bolus and a wake-up time of 12 minutes. The group B consisted of 17 patients, with a wake-up time of 7 minutes in whom 35% required salvage bolus. Conclusion: Both anesthetic techniques proved to be safe and effective; patients receiving sevoflurane shortened their stay by 50% in the recovery of the endoscopic unit. Patients who only received propofol presented greater anesthetic depth required a lower rate of rescue boluses. Both techniques evidenced a good comfort level in both the patients and gastroenterologists.","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"228 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79019564","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}

{"title":"Anesthesia with Peribulbar Block: Lidocaine-Bupivacaine vs Lidocaine-Bupivacaine-Fentanyl","authors":"Leopoldo Wulff, Caracas Centro Médico Docente La Trinidad","doi":"10.24966/acc-8879/100029","DOIUrl":"https://doi.org/10.24966/acc-8879/100029","url":null,"abstract":"","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85000768","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}

{"title":"Use of the Laryngeum Mask for Intubation (Fastrach): Initial Experience in the Specialty Hospital “Dr. Bernardo Sepulveda G”, Centro Medico Nacional Siglo XXI IMSS Mexico","authors":"Leopoldo Wulff","doi":"10.24966/ACC-8879/100028","DOIUrl":"https://doi.org/10.24966/ACC-8879/100028","url":null,"abstract":"There is unanimous agreement that if planning is done for the management of the airway, the vast majority of complications can be prevented or solved. The American Society of Anesthesiology in recent years has developed an algorithm to follow in case of presenting a difficult and unexpected airway. In this algorithm, various techniques or mechanisms other than direct laryngoscopy are mentioned, which may at a certain moment resolve a pressing situation. The laryngeal mask for intubation (Fastrach) is a device that has increased its popularity by playing an important role in the management of the anatomically difficult airway allowing adequate oxygenation. It offers advantages such as simplicity and versatility in its placement, as well as being a traumatic for the patient. We decided to carry out this project to obtain an initial experience in the management of the airway with this type of devices whose successful results in other countries have not been corroborated in our hospital. Objective: To demonstrate that the laryngeal mask for intubation (Fastrach) is a useful device for the management of the airway in patients undergoing general anesthesia. Material and method: We studied 50 patients of both genders and ages between 22 and 85 years, physical status ASA I, II or III, scheduled for elective surgery and general anesthetic technique. The number of attempts of Fastrach placement and orotracheal intubation through it, the time in seconds, the hemodynamic and SpO2 values, and finally the complications during and after the procedure (oral bleeding, impossibility to place Fastrach and/or IOT, odynophagia and/or dysphonia). Results: A success rate was obtained for the placement of Fastrach and I.O.T. 94% where 54% was the first attempt, 32% the second and 4% the third attempt. The complications presented were minimal and reached 2%. Conclusion: The use of the laryngeal mask for intubation (Fastrach) as an alternative to direct laryngoscopy for orotracheal intubation in patients with easy airway is feasible and has been shown to be useful, safe and effective.","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"434 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79601651","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}

{"title":"Comparison of Two Intubation Techniques during General Anesthesia. Laryngeal Mask for Intubation (Fastrach) vs Endotracheal Intubation","authors":"Leopoldo Wulff","doi":"10.24966/acc-8879/100031","DOIUrl":"https://doi.org/10.24966/acc-8879/100031","url":null,"abstract":"Introduction: The American Society of Anesthesiology (ASA) has developed in recent years an algorithm to follow in case of presenting a difficult or unexpected airway. In said algorithm various techniques or mechanisms different from direct laryngoscopy are mentioned that can help in a pressing situation. The laryngeal mask for intubation (Fastrach) is a device that has increased its popularity by playing an important role in the management of the airway Objective: To demonstrate that the laryngeal mask for intubation (Fastrach) is a useful device for the management of the airway and that it causes fewer complications than traditional intubation in patients undergoing general anesthesia. Materials and methods: We studied 100 patients of both sexes and ages between 20 and 90 years, physical status ASA I, II and III, scheduled for elective surgery and general anesthetic technique. The time of Fastrach intubation and endotracheal intubation in seconds, hemodynamic and oxygen saturation values and finally the complications during and at the end of the procedure (oral bleeding, mucosal laceration, and impossibility of intubation, odynophagia and dysphonia) were measured. Results: A statistically significant intubation time was obtained with p < 0.05 for the EIT with a time of 25.38 sec ± 13.68 sec and for the ML (Fastrach) of 57.04 sec ± 32.68 sec, the hemodynamic behavior remained practically the same in both cases. Groups and complications presented were more notable in the EIT mainly odynophagia and dysphonia. Conclusion: The use of the laryngeal mask for Fastrach intubation as an alternative in direct laryngoscopy for endotracheal intubation in patients with easy airway is viable, demonstrating fewer complications than traditional intubation, as well as being safe, useful and effective.","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73237093","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}

{"title":"Anaesthetic Concerns in a Child with Lesch-Nyhan Syndrome","authors":"R. Reddy","doi":"10.24966/ACC-8879/100026","DOIUrl":"https://doi.org/10.24966/ACC-8879/100026","url":null,"abstract":"Lesch-Nyhan syndrome is a rare X-linked recessive disorder caused by a deficiency of Hypoxanthine-Guanine Phosphoribosyl Transferase (HGPRT) enzyme. The patients with Lesch-Nyhan Syndrome will have spasticity due to which there could be several problems such as positioning, difficult intravenous cannulation and difficult airway. And these patients will have self-mutilating behavior and lack of pain sensation. Bradycardia, pulmonary aspiration, convulsion are the important causes of death. Anesthetic management of these patients in pediatric age group is not well described. Here, we report our anesthesia experience in a 3 years-old child who was posted for debridement of right great toe with Lesch-Nyhan syndrome. Patients with Lesch-Nyhan syndrome should be induced in titrated doses and no analgesia is required because of lack of sensation. Careful monitoring is required during perioperative and post-operative period as they are more prone for bradycardia, apnea and aspiration.","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72593727","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}

{"title":"The Role of Transnasal Sphenopalatine Ganglion Block in Post-Dural Puncture Headache Management: A Case Series and Review","authors":"M. Jackson","doi":"10.24966/ACC-8879/100024","DOIUrl":"https://doi.org/10.24966/ACC-8879/100024","url":null,"abstract":"","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90934173","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}

{"title":"Wide Spread Arterial and Venous Thrombosis in a Case of Hyperglycemic Hyperosmolar State (HHS)","authors":"A. Ganaw","doi":"10.24966/ACC-8879/100027","DOIUrl":"https://doi.org/10.24966/ACC-8879/100027","url":null,"abstract":"A case is presented with a patient in a Hyperglycemic Crisis (HC), complicated by widespread thrombo ischemia including the left upper and lower limb, and the aortic arch. Extreme hyperglycemia and dehydration added to the pro-thrombotic state of diabetes and resulted in lower limb ischemia with ultimate limb loss. Current guidelines provide for thrombo-prophylaxis against Deep Venous Thrombosis (DVT) in HHS. Further development of the guidelines is needed to cover the risk of an arterial thrombosis as well. Characteristics Clinical Parameters Normal Range Age 50 years Gender female BMI 31.1 Kg/m2 Heart rate 126 beats/min. Blood pressure 93/40 mm Hg. Temperature 38 ̊C Resp. rate 28 breaths/min. normal range Blood sugar 84.4 mmol/L 3.3-5.5 mmol/L Calculated osmolarity 348.4 mOsm/Kg 275-295mOsm/Kg Sodium 132 mmol/L 135-145 mmo/L Potassium 6.1 mmol/L 3.5-5.5mmol/L Urea 18 mmol/L 2.5-7.1 mmol/L Creatinine 312 μmol/L 50-98 μmol/L Leucocytes 23X109/L 4-10X109/L Platelets 425 x103 150-400x103 Serum Lipase 1400 IU/L 13-60 IU/L Table 1: Characteristics of the patient. Citation: Ganaw A, Shaikh N, Marcus AE, Soekarman D (2018) Wide Spread Arterial and Venous Thrombosis in a Case of Hyperglycemic Hyperosmolar State (HHS) 5: 027.","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85469639","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}

{"title":"Management of Congenital Diaphragmatic Hernia with Epidural and General Anaesthesia","authors":"Kalpana Rajendra R Kulkarni","doi":"10.24966/acc-8879/100030","DOIUrl":"https://doi.org/10.24966/acc-8879/100030","url":null,"abstract":"Surgical repair of Congenital Diaphragmatic Hernia (CDH) is one of the major neonatal emergencies that pose many challenges to the treating neonatologist, intensivist, pediatric anesthesiologist and the surgeon. Mostly these babies are premature having physiological immaturity of various organ systems and in association they may be having lung pathologies or other major congenital defects. Smooth induction/maintenance, adequate intra/post-operative analgesia and uneventful post-operative recovery are the major objectives to be achieved with the anesthetic plan. The use of Regional Anesthesia (RA) has found to be very safe and effective when combined with General Anesthesia (GA). We report a case of two days old baby for surgical repair of CDH that was managed successfully with GA along with epidural analgesia .The baby was induced and intubated under O2 + sevoflurane anesthesia and maintained with muscle relaxant atracurium. Epidural catheter was passed up to T6 through caudal route to facilitate intra and post-operative analgesia with ropivacaine. There was excellent hemodynamic stability, satisfactory perioperative pain relief and uneventful recovery.","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"238 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73133397","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}

{"title":"Enhanced recovery after thoracic surgery (ERATS): A current review","authors":"","doi":"10.46439/anesthesia.2.006","DOIUrl":"https://doi.org/10.46439/anesthesia.2.006","url":null,"abstract":"","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"133 20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88074302","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}

{"title":"Goals for pediatric inpatient pain management: Best care everywhere","authors":"","doi":"10.46439/anesthesia.2.009","DOIUrl":"https://doi.org/10.46439/anesthesia.2.009","url":null,"abstract":"","PeriodicalId":73662,"journal":{"name":"Journal of clinical anesthesia and intensive care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87486702","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}