Dexmedetomidine Infusion an Effective Intra-Operative Medication for Patients Undergoing Laparoscopic Cholecystectomy
Summaira Jan, Tawheed Ahmad and Saima Rashid
Article Type: Research Article | First Published: December 20, 2018
Laparoscopic surgeries involves creation of pneumo-peritoneum with insufflation of gas usually CO2 thereby increasing intra-abdominal pressure. The Intra-abdominal pressure above 10 mmHg causes adverse hemodynamic changes. Various agents have been used to attenuate these adverse effects. Dexmedetomidine alpha-2 agonist has sedative, sympatholytic, analgesic and anxiolytic properties and used in laparoscopic cholecystectomies for attenuation of adverse hemodynamic changes and to maintain hemodyna...
Apneic Oxygenation and High Flow
Ayten Saracoglu, Halime Hanim Pence, Mehmet Yilmaz and Kemal Tolga Saracoglu
Article Type: Review Article | First Published: November 16, 2018
Prevention and minimizing serious complications during difficult airway management is an important goal for anesthesia providers. Using the high flow cannula oxygenation systems it is possible to improve the clinical outcomes, increase patient safety and reduce the rate of complications. A possible mechanism of this method can be explain by 'Aventilatory Mass Flow' which is a physilogical phenomenon. Several methods can be used to implement apneic oxygenation such as nasopharyngeal catheter, nas...
Hemostatic Coagulation Management in Trauma
Ayten Saracoglu and Sermin Tetik
Article Type: Review Article | First Published: November 15, 2018
Trauma is still a leading cause of death in the 21st Century mainly due to uncontrolled hemorrhage. Trauma has also an increasing cost of treatment in patients. Recently we have been aware of the importance of complex hemostatic and immunoinflammatory responses in pathogenesis of "Trauma Induced Coagulopathy". As a result of understanding of changes on coagulation pathway in trauma, different hypotheses put forward explaining the trauma induced coagulopathy. New treatment algorithms also take pl...
A Rare Case of an Adult Congenital Diaphragmatic Hernia becoming Symptomatic after an Elective Procedure
Stylianos Voulgarelis and Sylvia Y Dolinski
Article Type: Case Report | First Published: November 03, 2018
Congenital diaphragmatic hernias may run undiagnosed for years before a change in symptomatology may lead to the diagnosis and treatment. We present a 63-year-old previously asymptomatic patient that developed progressive symptomatology after a laparoscopic procedure. The increased intraabdominal pressure related to the peritoneal insufflation and Trendelenburg intraoperative positioning in combination with the failure of the surgeon to perform the initial laparoscopic exploration of the whole a...
Iatrogenic Nerve Injury Resulting in Respiratory Failure after Mediastinoscopy
Dustin Hang, Herodotos Ellinas and Sylvia Y Dolinski
Article Type: Case Report | First Published: November 01, 2018
Acute respiratory failure is divided into four categories: hypoxemic (type I), hypercarbic (type II), perioperative (type III) and shock (type IV). We present a case of perioperative respiratory failure in a patient with iatrogenic phrenic nerve injury after mediastinoscopy and the implications for a high index of suspicion as well as appropriate diagnostics. Of the four types of respiratory failure, perioperative (Type III) respiratory failure is often due to hypoxemia or hypercarbia (i.e. Type...
Quality of Life and Anxiety Status following Donor Liver Transplantation
Ayten Saracoglu, Fisun Bulutcu, Levent Oklu, Ercument Yentur, Yaman Tokat and Yildiray Yuzer
Article Type: Original Article | First Published: October 31, 2018
Anxiety disorder, which is encountered in surgical patients receiving general anesthesia is a psychological and physical condition, characterized by sudden onset of hazard perception and extensive fear, and may lead to panic disorder. In this study, we aimed to determine anxiety levels of liver transplantation donors via a questionnaire and reveal their quality of life and anxiety status during the 1st postoperative day and month....
Outcome of Self- and Planned Extubation in Organophosphate-Poisoned Patients
Abbas Aghabiklooei, Omid Mehrpour, Hossein Hassanian-Moghaddam, Shahin Shadnia and Nasim Zamani
Article Type: Original Article | First Published: October 24, 2018
Respiratory failure is the most common cause of morbidity and mortality in organophosphate (OP)-intoxicated patients. We aimed to assess and compare the need for re-intubation and outcome between patients with self-extubation (SE) and planned extubation (PE). All OP-poisoned endotracheally intubated patients admitted to poisoning ICU were included. The frequency and time of SE, need for re-intubation, and its impact on hospital stay and outcome were assessed....
Accidental Perforation of Subarachnoid Space with Spinal Introducer
Luiz Eduardo Imbelloni and Micaela Barbosa L Sales
Article Type: Case Report | First Published: October 17, 2018
The existence of fine gauge needles with a traumatic bevel, pencil tip type; it is possible to increase the indication of spinal anesthesia in young people and to reduce the incidence of post-puncture headache. We present a case of a post-dural puncture headache occurring after perforation dura mater using a 20-gauge needle introducer for spinal anesthesia with Whitacre needle....
Menstrual Cycle Phase May Effect the Thermoregulation during Anesthesia
Veysel Erden, Cihan Guler, Hasan Bulut, Naile Ozsoy Toprak and Nedret Uslu
Article Type: Original Article | First Published: October 12, 2018
This study was registered to Australian New Zealand Clinical Trial Registry with serial number ACTRN12614000286640. After institutional review, board approval and informed consent 50 female patients; ASA (American Society of Anesthesiologists) class 1, ages between 18-45 years old were enrolled in this study. The surgeries performed were septorhinoplasty and tympanoplasty. 25 patients with menstrual cycle days from 1 to 10 (follicular group), 25 patients with menstrual cycle days from 18 to 24 (...
When Equipment Misbehaves: Severe Respiratory Acidosis Resulting from a Compromised Coaxial Circuit
Anh Q Dang, Marc Rozner, Nicole Luongo and Shital Vachhani
Article Type: CASE REPORT | First Published: September 07, 2018
The construction of a coaxial circle breathing circuit encloses the inspiratory limb within the expiratory limb to preserve heat, humidity, anesthetic gas, and oxygen. However, the construction also makes kinks or breaks in the enclosed inspiratory limb difficult to detect. With kinking or disconnection of the central inspiratory limb, the patient may rebreathe expiratory gases, leading to a significant increase in dead space and concomitant respiratory acidosis. We describe a clinical case in w...
Uncommon Complication for Commonly Used Drugs: Cardiac Arrest after Administration of Succinylcholine
Mohd Nazri A, Nor Hidayah ZA, Suryati MP, Wan Nasrudin WI, Azhar M, Mazelan O, Nurul Ashikin H, Fazilawati Z, Maziah M, Khairul Has H and Puzizer S
Article Type: Case Report | First Published: August 04, 2018
Succinylcholine is a depolarizing, muscle relaxant, that commonly used to facilitate endotracheal intubation, especially in emergency surgery or patient with difficult intubation. However succinylcholine is associated with severe hyperkalaemia, arrhythmia and cardiac arrest especially in severe burn and neuromuscular disease and renal failure. We report a case of young boy with underlying Obstructive Sleep Apnoea (OSA) presented for bleeding post tonsillectomy, who developed cardiac arrest follo...
An Accidental Arterial Puncture and Anticoagulation after Internal Jugular Vein Catheterization Resulting in Massive Hematoma and Airway Compromise
Kurt Ruetzler, Till Hauffe, Tobias Piegeler, Alkadhi Hatem and Donat R Spahn
Article Type: Case Report | First Published: July 05, 2018
Central Venous Catheterization is a common procedure in daily clinical practice. The internal jugular, subclavian and the femoral veins are the most frequently catheterized central veins. Pneumothorax, hematothorax, arterial puncture, hematoma, nerve lesions, damage to the left thoracic duct, and air embolism are among the main mechanical complications. Nowadays, there are two techniques in daily clinical use: the traditional technique and the ultrasound guided technique. ...