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At least 343 records · Page 19Linked to original sources
PubMed1991

[Incidence and etiology of cardiac arrest occurring during the peroperative period and in the recovery room. Apropos of 102,468 anesthesia cases].

This study reviewed retrospectively 186 cardiac arrests (CA) observed in a series of 102,468 anaesthetics, carried out in a University Hospital between 1983 and 1987. Among them 29 were partly or totally related to anaesthesia and 11 had a fatal outcome. On the other hand, 157 CA (144 deaths) were not related to anaesthesia. Mortality rate due to anaesthesia was therefore 1.1 per 10,000. The main causes of anaesthesia related CA were overdosage, with or without hypovolaemia (9 CA, 6 of which occurred under regional anaesthesia); hypoxaemia (6 CA, 5 of which occurred under regional anaesthesia) and multifactorial sudden cardiac arrest (n = 8). The other aetiologies were: myocardial ischaemia (n = 3); anaphylactic shock due to propanidid (n = 1); protamine accident (n = 1); ventricular arrhythmia due to hypokalemia (n = 1). Fourteen CA occurred during induction (2 deaths), 14 during maintenance (8 deaths), and one during recovery. Risk factors for CA included a high ASA class, and the type of anaesthesia: there were 8 CA for 12,981 regional anaesthetics, and 21 for 89,487 general anaesthetics (p = 0.017). Emergency and paediatric anaesthesia were not risk factors. Outcome was independent of ASA class, but was related to aetiology: hypoxaemia (5 out of 6 recovered) and overdose with or without hypovolaemia (7 out of 8 recovered) had favourable outcomes. Furthermore, outcome of CA due to regional anaesthesia was satisfactory (7/8 recovered) (p = 0.08, NS). Such an analysis of the causes of anaesthetic disasters and their rate of occurrence can lead to more effective prevention.

Adolescent↗
PubMed2004

Risk factors associated with postoperative sore throat after tracheal intubation: an evaluation in the postanesthetic recovery room.

BACKGROUND: Postoperative sore throat after tracheal intubation is an unpleasant and distressing experience to patients. The aim of the study was to carry out a large-scale search for the risk factors of postoperative sore throat in patients undergoing endotracheal general anesthesia. METHODS: During a 6-month study period, patients (> or = 10 years old) who consecutively underwent endotracheal general anesthesia for all kinds of surgical procedures were included. A total of 7541 patients were recruited in our study. RESULTS: Five risk factors associated with postoperative sore throat were identified. They were female gender, age between 30-39, surgical sites within the oral or nasal cavity, or around the neck, use of nitrous oxide during anesthesia, and duration of anesthesia longer than 2 hours. CONCLUSIONS: Five risk factors related to postoperative sore throat were identified in our study.

Adolescent↗
PubMed1996

Paradoxical vocal cord motion in the recovery room: a masquerader of pulmonary dysfunction.

PURPOSE: We report a case of paradoxical vocal cord motion as an unusual cause of postoperative stridor and wheezing. A means of diagnosis and management is discussed. CLINICAL FINDINGS: A 71-yr-old man developed paradoxical vocal cord motion following uncomplicated hip replacement. He was treated with standard therapy for postoperative stridor and wheezing. After extensive evaluation, a flexible fibreoptic laryngoscope was used and the vocal cords noted to move paradoxically. This was the cause of his postoperative stridor and wheezing. Paradoxical vocal cord motion should be suspected as a cause of postoperative stridor and wheezing when the airway is easily maintained by a bag and mask, there is previous history of psychological problems, and there exists an unexplained history of previous postoperative airway distress. The definitive diagnosis may be made using a fibreoptic laryngoscope. In this patient, intubation was deferred and a plan of conservative therapy pursued. CONCLUSION: Paradoxical vocal cord motion is an unusual cause of postoperative respiratory distress. A definitive diagnosis may be made by the use of a flexible fibreoptic laryngo-scope using topical anaesthesia.

Aged↗
PubMed2006

Tongue swelling in the recovery room: a case report and discussion of postoperative angioedema.

We present a case of potentially life-threatening postoperative swelling of the tongue and oropharynx that developed in the postanesthesia care unit in a patient taking lisinopril. The principal treatment of angioedema is the discontinuation of the precipitating agent and airway management. Patients with swelling limited to the face and oral cavity may only require monitoring. However, those with swelling in the floor of the mouth, tongue, and supraglottic or glottic areas should have their airway secured by tracheal intubation immediately. Early intubation in patients displaying these characteristics may decrease the incidence of emergent surgical airways. Angioedema is self-limiting, and the swelling usually resolves spontaneously in two to 3 days. Proper identification of angiotensin-converting enzyme inhibitor-associated angioedema requiring a timely airway intervention may reduce mortality, and recognition of its self-limiting course can prevent unnecessary tracheostomy.

Angioedema↗