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Evaluation of an anesthetic pump for postoperative care after shoulder surgery.

In theory, a prolonged, local infusion of anesthetic into a surgical field should reduce postoperative pain. Recently, disposable products have become available to implement this, but the balance between cost and benefit is controversial. This study evaluated such a device in two specific types of arthroscopic surgery of the shoulder: decompression of the subacromial space and repair of a torn labrum in the glenohumeral joint. Placement of the catheter into the glenohumeral joint resulted in problems in removing the device from some cases so that application is not recommended. When the catheter was placed in the subacromial space, the infusion pump was associated with significantly shorter stays in the recovery room, but there was no benefit over placebo with regard to pain, demand for rescue narcotic, or recovery of motion. Furthermore, use of the device presented some inconveniences to the surgical staff and the patient. It was concluded that use of this particular device in these particular applications is not justified.

Adolescent↗
PubMed1976

[Artificial respiration for the postoperative care after major surgery (author's transl)].

An analysis was made of the postoperative course of 158 cases of major surgery performed during 1971-1973. The operations comprised thoraco-abdominal resection of the oesophageal and cardia, abdominal duodenopancreatectomy, partial gastrectomy and enterectomy and partial hepatectomy. 63 per cent of the patients were given artificial respiration either prophylactically immediately after the operation (47 per cent) or at a later stage (53 per cent) on account of respiratory complications (arterial hypoxia below 55 mm Hg pO2). Postoperative mortality for the group of patients who did not have artificial respiration was 46 per cent, as compared with 32 per cent for the artifically ventilated patients - a difference of 14 per cent. The causes for this discrepancy, and especially the role of non-respiratory complications are discussed and the indications for prophylactic postoperative artificial respiration are reviewed.

Cardia↗