[Ear suction device with simple self-cleaning mechanism].
The obturation of ear suction tubes is a frequent problem. A very simple change in tube can avoid this problem. This article describes a new tube design.
Cerumen↗
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Physiologic changes induced by endotracheal instillation and suctioning in critically ill preterm infants with and without sedation.
Endotracheal instillation and subsequent suctioning produces fluctuations of intracranial pressure (ICP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) in sick preterm infants. In an attempt to observe if these fluctuations could be minimized using sedation, we studied a group of seven sick mechanically ventilated preterm infants with and without sedation. Continuous monitoring of ICP, MAP, heart rate, CPP, and arterial oxygen tension (PaO2) were obtained. The statistical analysis of the data revealed significant blunting of fluctuations of MAP, ICP, and CPP with sedation.
Blood Pressure↗
[Preoperative use of suction cup oculopression in comparison with Vörösmarthy oculopression].
In contrast to Vörösmarthy oculopression (VOP), suction-cup oculopression (SOP) is "pure" oculopression without compression of orbital tissue. Prior to 44 cataract operations with posterior chamber lens implantation, the authors performed SOP (negative pressure - 110 mm Hg) or VOP (level of oculopression 30 mm Hg) of the same duration (average 26 min). Before oculopression, a retrobulbar injection (RBI) was performed for local anesthesia. The intraocular pressure (IOP) was decreased by 14 mm Hg to 3.9 and 4.9 mm Hg after SOP and VOP, respectively. After VOP, the iris-vitreous diaphragm was more frequently judged to be concave, i.e., vaulted against the retina, than after SOP (standardized questionnaire). After RBI + SOP, a post-injection of anesthetic was necessary in three cases; no additional injection was required after RBI + VOP. In conclusion, identical preoperative reductions in IOP can be achieved with SOP and VOP. Regarding the form of the iris-vitreous diaphragm and the frequency of post-injection, the differences between the two methods may be related to the lack of orbital compression during SOP.
Aged↗
A malleable endoscopic suction instrument: technical note.
Flexible endoscopes are being employed for a variety of neurosurgical procedures. These instruments have drawbacks, especially in their ability to evacuate clotted blood. We have attempted to rethink the design of these instruments and have developed a malleable endoscopic suction instrument. This has proved to be helpful in a variety of intracranial and intraspinal procedures.
Endoscopes↗
No need for routine closed suction drainage in elective arthroplasty of the hip: a prospective randomized trial in 104 operations.
BACKGROUND: The purpose of this study was to determine the utility of closed suction drainage (CSD) in elective total hip arthroplasty (THA). PATIENTS AND METHODS: We randomized 104 elective, consecutive THAs to receive drainage (53) or no drainage (51). 60 arthroplasties were cemented and 44 hybrid. RESULTS: In the drainage group, 2 hematomas and 2 superficial wound infections occurred; there were no wound complications in the undrained group (p = 0.04). Patients receiving drainage had a greater reduction in hematocrit (10.4 vs 7.4) (p = 0.03), and longer hospital stay (5.1 days vs 4.7) (p = 0.01). At the 3-month follow-up, we found no deep wound infections in either group. INTERPRETATION: We no longer use CSD in elective, primary, routine THA.
Adult↗
Subgaleal suction drain leading to fatal sagittal sinus haemorrhage.
The use of wound drains in surgical practice, very often falls into the realm of habit, rather than science. The utility of a prophylactic drain in surgical wounds may be questionable, but this practice is not uncommon, despite complications. We report a case of fatal haemorrhage from the superior sagittal sinus, due to a closed negative suction drain of the craniotomy wound in an infant operated upon for a growing fracture skull.
Cerebral Hemorrhage↗
Unusual development of acute compartment syndrome caused by a suction injury: a case report.
There have been recent reports of acute compartment syndrome secondary to suction injuries of the hands of children. We report the case of a 68-year-old patient who developed an acute compartment syndrome of the forearm after his arm had been sucked into an exhaust port. He was treated by emergency fasciotomies and the wound was closed five days later with a small skin graft. His recovery was uneventful.
Acute Disease↗
A prospective evaluation of an endometrial suction curette.
The object of this study was to assess the reliability of a technique using an endometrial suction curette to obtain tissue for diagnosis. A prospective study was performed. One hundred sequential outpatient biopsies using the Z-Sampler were studied. All samples were reviewed a second time by a single pathologist for adequacy. In 75% of samples, a histologic diagnosis could be determined. The remaining 25% were inadequate for diagnosis--4 identified at the time of sampling and completed with a Novak curette and 21 in which the sample would not support the histologic diagnosis. Analysis of the inadequate samples found that 12 of the 25 (48%) inadequate samples came from patients with the clinical diagnosis of postmenopausal or climacteric bleeding. This diagnosis was represented in only 18 of the 75 successful biopsies (24%, p less than 0.001). The findings suggest that endometrial sampling using disposable endometrial curettes provides adequate tissue for histologic interpretation in most patients. Although patients with postmenopausal or climacteric bleeding made up one half of all patients with an inadequate sample, 60% of these patients did have interpretable tissue obtained. In these patients, use of other or adjunctive sampling methods should be entertained based on clinical or other considerations.
Adult↗
A randomized, double blind, placebo-controlled study to investigate the use of conscious sedation in conjunction with paracervical block for reducing pain in termination of first trimester pregnancy by suction evacuation.
BACKGROUND: This study evaluated the role of conscious sedation in pain relief during termination of first trimester pregnancy by suction evacuation (SE) under local anaesthesia. METHODS: A hundred women undergoing SE before 12 weeks gestation were randomized by computer using the sealed envelope method to receive placebo (saline) or conscious sedation (2 mg midazolam and 25 microg fentanyl) i.v. 5 min before cervical dilatation. Paracervical block was given to all patients, 2 min later. Pain scores during and after SE, post-operative side-effects and satisfaction level were compared. RESULTS: No statistically significant differences in pain scores were found between the two groups. Post-operative side-effects such as dizziness (P = 0.015) and drowsiness (P < 0.001) were significantly more severe in the conscious sedation group. However, patients in the conscious sedation group reported better satisfaction levels than the control group (P = 0.003). CONCLUSION: The use of conscious sedation significantly improved patient satisfaction during termination of first trimester pregnancy by SE under local anaesthesia, despite a lack of improvement in pain relief and the presence of increased severe dizziness/drowsiness in the post-operative period.
Abortion, Induced↗
Antibiotic concentration in suction skin blister fluid and saliva after repeated dosage of erythromycin acistrate and erythromycin base.
The drug concentration in plasma, suction skin blister fluid (SBF), urine and saliva after repeated dosage of either erythromycin acistrate (EA) or enterocoated pellets of erythromycin base (EB) was studied in young healthy volunteers with a cross-over design in two separate studies. In Study I, the total drug concentration (erythromycin + 2'-acetyl erythromycin) after EA (400 mg tid) was slightly higher than the erythromycin concentration after EB (500 mg tid). The concentration of erythromycin after EA was about half of that after EB. In SBF the total antibiotic concentration after EA and erythromycin concentration after EB were 49 and 46% of the corresponding plasma concentrations, respectively. The degree of hydrolysis of 2'-acetyl erythromycin was higher in SBF (44%) than in plasma (39%). An equal proportion (7.3-7.5%) of the dose was excreted in urine after administration of both drugs. The degree of hydrolysis of 2'-acetyl erythromycin in urine was 58%. In Study II, the plasma/saliva concentration ratio ranged from 0.11 to 0.17 after EA 400 mg tid, 0.12 to 0.20 after EA 500 mg tid and 0.17 to 0.22 after EB 500 mg tid. The degree of hydrolysis of 2'-acetyl erythromycin was considerably higher in saliva (61-78%) than in plasma (27-41%). In plasma, the percentage of hydrolysis of 2'-acetyl erythromycin was inversely correlated with the concentration of acid-alpha 1-glycoprotein. The penetration of 2'-acetyl erythromycin and erythromycin into the extravascular space as evaluated from SBF and saliva levels was equal, and adequate concentrations of erythromycin were obtained for the treatment of bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
A randomized controlled trial comparing the ProSeal Laryngeal Mask Airway with the Laryngeal Tube Suction in mechanically ventilated patients.
BACKGROUND: The ProSeal Laryngeal Mask Airway (PLMA) (Laryngeal Mask Company, Henley-on-Thames, United Kingdom) is a new laryngeal mask with a modified cuff designed to improve its seal and a drain tube for gastric tube placement. Similarly, the Laryngeal Tube Suction (LTS) (VBM Medizintechnik Gmbh, Sulz a.N, Germany) is a new laryngeal tube that also has an additional channel for gastric tube placement. This study compared the placement and functions of these two devices. METHODS: One hundred fifty patients undergoing general anesthesia for elective surgery were randomly allocated to the PLMA (n = 75) or LTS (n = 75). Oxygenation and ventilation, ease of insertion, fiberoptic view, oropharyngeal leak pressure, ventilatory data, ease of gastric tube insertion, and postoperative airway morbidity were determined. RESULTS: After successful insertion of the devices in 96% of patients with the PLMA and in 94.4% with the LTS it was possible to maintain oxygenation, ventilation, and respiratory mechanics during the entire duration of surgery. Successful first and second attempt insertion rates were 57 patients (76%) and 15 patients (20%), respectively, for the PLMA and 60 patients (80%) and 11 patients (14.6%), respectively, for the LTS. Airway placement was unsuccessful with the PLMA in three patients and with the LTS in four patients. Time to achieve an effective airway was 36 +/- 24 s with the PLMA versus 34 +/- 25 s with the LTS. Gastric tube insertion was possible in 97.3% of patients with the PLMA and in 96% with the LTS. CONCLUSIONS: With respect to both physiologic and clinical function, the PLMA and LTS are similar and either device can be used to establish a safe and effective airway in mechanically ventilated anesthetized adult patients.
Adult↗
A new device for suction-assisted lipectomy: a flexible cannula.
A new type of cannula, "Flex," has been designed for suction-assisted lipectomy. It is flexible, permitting easy access to areas distant from the skin incision. Flex is best characterized by one word: Bend.
Adipose Tissue↗
Suction extraction of lipomas.
With the use of suction-assisted lipectomy techniques in treatment of lipomas, the length and number of surgical scars may be minimized. The procedure is reviewed and several clinical applications are presented. Because no long-term recurrence rates are known, caution must be exercised in recommending this procedure to the patient.
Adipose Tissue↗
Simple suction drainage: an adjunct to septal surgery.
Postoperative hematoma is a complication of septal surgery that can be associated with significant morbidity and possibly even mortality in some cases. A simple suction drainage technique using a scalp vein cannula and vacuum tube can prevent a septal hematoma without the need for bulky nasal packing (with its attendant nasal obstruction and risk of bleeding on removal). The technique is also useful for postoperative drainage of an established septal hematoma or abscess secondary to trauma.
Hematoma↗
Endoscopic extraction of lipomas using an ultrasonic suction scalpel.
Lipomas were extracted with an ultrasonic suction scalpel, assisted by an endoscope, with good results. The combined surgical technique is described in this paper. Preoperative clinical findings and diagnostic imaging of the patients provided a preoperative diagnosis of lipomas. For the procedure, the endoscope was inserted through a small incision immediately above the tumor. The tumor was endoscopically confirmed and then extracted with an ultrasonic scalpel. Complete lipoma extraction was achieved in all patients without recurrence. The patients had good cosmetic results with only minimal postoperative scarring. The endoscopic extraction of lipomas with an ultrasonic scalpel is proven to be highly useful, especially for large tumors, and permits a less invasive and more reliable surgical operation.
Adult↗
Superiority of closed suction drainage for pancreatic trauma. A randomized, prospective study.
During a 42-month period, 65 patients sustaining pancreatic injuries were treated. They were randomized on alternate days (two separate trauma teams) to receive sump (S) or closed suction (CS) drainage. Twenty-eight patients were randomized to S and 37 to CS; there were six early deaths, which precluded drainage analysis, leaving 24 evaluable S patients and 35 CS patients. Penetrating wounds occurred in 71% and blunt in 29%. No significant differences appeared between the groups with respect to age, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), or grade of pancreatic injury. Twelve patients in each group required resection and drainage for grade III injuries, with the remaining patients receiving external drainage alone. Five of twenty-four S patients versus one of thirty-five CS patients developed intra-abdominal abscesses (p less than 0.04). We conclude that septic complications after pancreatic injury are significantly reduced by CS drainage. Bacterial contamination via sump catheters is a major source for intra-abdominal infections after pancreatic trauma.
Abscess↗
Suctioning of the left bronchial tree in critically ill patients.
When suctioning patients with either a tracheostomy or endotracheal tube, the incidence of entry into the left main stem bronchus was recored at the time of routine AP chest examinations in an ICU. The success rate was 8% with an endotracheal tube and 25% when a tracheostomy tube was present; this was lower than has been reported by others. It could reflect the small size of the series or a more accurate picture.
Bronchi↗
Inline closed-system suctioning: a research analysis.
Numerous studies on closed-system suctioning have been conducted including projects evaluating hyperoxygenation, influence of airway pressures and ventilation mode, efficiency in secretion removal, and autocontamination. These authors critique past research projects and propose directions for nursing practice and future research. By analyzing these projects, you can develop current practice standards to improve patient outcomes.
Clinical Nursing Research↗