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Complications of Equine Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
There are two factors known to impact the likelihood of postanesthetic myopathy (a potentially life-threatening complication of general anesthesia) in the horse: Hypotension.Duration of general anesthesia.
Uterine Rupture
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
The early diagnosis and treatment of uterine rupture are pivotal to a successful outcome. The early involvement of a senior obstetrician, an anaesthesiologist, a neonatologist and a transfusion medicine specialist forms an essential part of management. The aims of management are resuscitation (discussed in Chapter 14) and laparotomy followed by repair of the uterine tear (with or without tubal ligation) or hysterectomy. Verbal consent for either of the surgical interventions should be obtained from the woman. The urgency of the situation necessitates general anaesthesia to be administered.
Critical care, neurology and analgesia
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
General anaesthesia is a medically controlled state of unconsciousness accompanied by: the inability of the patient to respond purposefully to physical stimulation or verbal command, corresponding to a GCS or CGCS of 3–9andloss of airway protective reflexes, including loss of the patient’s ability to maintain a patent airway independently.
The bleeding risk and safety of multiple treatments by bronchoscopy in patients with central airway stenosis
Published in Expert Review of Respiratory Medicine, 2023
Congcong Li, Yanyan Li, Faguang Jin, Liyan Bo
We also explored the operation method, stenosis location, anesthesia type, and etiology on the incidence of hemorrhage. As shown in Table S1, the hemorrhage rate of every type of operation method varied in both the first treatment group (p = 0.048) and the retreatment group (p < 0.01), and electric snare ligating had the highest incidence of hemorrhage in the first treatment group, whereas balloon dilatation had the highest incidence of hemorrhage in the retreatment group. As shown in Table S2, the hemorrhage incidences of different stenosis locations were not similar. In the first treatment group, the carina had the highest incidence of hemorrhage. In the retreatment group, the bronchus intermedius had the highest incidence of hemorrhage. As shown in Table S3, anesthesia type also influenced the incidence of hemorrhage. The results showed that general anesthesia was related to a lower rate of bleeding than local anesthesia, although the severe bleeding rates were similar. As shown in Table S4, bronchial tuberculosis and tumors comprised most of the causes of CAO, and their incidence of hemorrhage was also significantly higher than that of other causes.
Rib osteochondral graft for scaphoid proximal pole reconstruction
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Tomoyuki Koike, Naoki Kato, Kenta Saito, Kenichi Kokubo, Jiro Maegawa
The disadvantages of this technique are the risk of pneumothorax and the possibility of ossification of the rib cartilage in patients over 40 years of age. Previous reports included major complications affecting vital signs such as pneumothorax and hemothorax. However, these were technical errors due to rib cartilage harvesting. Rib cartilage harvesting is a common technique that is performed traditionally, and these complications are likely to decrease with the improvement of skills. Our average operating time under general anesthesia was 191 min, and it may be possible to perform this as day surgery in some hospitals. However, due to the possibility of complications at the donor site, we hospitalize the patient, and monitor vital signs until the next day. Another disadvantage is the problem of calcification. Calcification of the rib cartilage varies by sex and individual, and calcification is seen even in young people [13]. In people over 50 years of age, calcification is clearly depicted on X-rays [14]. Above 40 years of age, accurate assessment of ossification within a rib osteochondral graft is difficult before harvesting. However, fluoroscopy can be used to identify areas with rich cartilage content, which can be used for reconstruction. It is also not indicated for Kalainov [15] type 1 lesions involving the entire scaphoid bone. In addition, it is difficult to assess is the time of bone union using X-rays. Therefore, we assessed the bone union with CT scans when considering wire removal.
Prospective audit on fasting status of elective ambulatory surgery patients, correlated to gastric ultrasound
Published in Acta Chirurgica Belgica, 2023
Thibo Degeeter, Birgit Demey, Els Van Caelenberg, Luc De Baerdemaeker, Marc Coppens
The most recent guidelines from the European Society of Anesthesiology (ESA) suggest that for surgical procedures under general anesthesia, it is safe to allow solid foods until 6 h before induction, and even stimulate to drink clear fluids until 2 h before induction of anesthesia [1,7–10]. Solid foods are described as a light meal, for example toast or bread. In case of fried foods, meals high on fat and meat an 8-h interval before fasting should be respected. Clear fluids are water, black coffee or tea (with milk to a maximum of up to 1/5th of the total volume), carbonated drinks, sugared drinks and pulp-free juices. Commercial preoperative beverages became available recently. Studies advise to drink carbohydrated fluids until 2 h before induction. Most recent practice even allows a 1 h interval. Non-human milk is thought to behave as solid food in the stomach [10–12]. Infants can drink breast milk up 4 h before induction. [1,9,10,12,13]. Modern guidelines do not have a scientific basis to support them [8,10,14]. Despite the guidelines, a lot of studies have proven it is safe to drink up to 1 h before induction [5,12,13,15]. However, mean fasting periods found in literature are [6,25h; 9,36 h] for fluids and [9,6h; 13,5 h] for solid foods [8,16,17]. Gastric ultrasound preoperatively has proven to be reliable at determining gastric volume.