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Acta Anaesthesiologica Belgica

A Stouffs, J L Scholtes
Tracheal rupture is a rare complication of endotracheal intubation and surgery of thyroid gland. We present a case of tracheal rupture diagnosed and repaired intraoperatively. A 76-year-old female patient with a recurrent parathyroid adenoma and cold thyroid nodule was scheduled for a bilateral exploration of the parathyroid glands associated to thyroid lobectomy. Induction of anesthesia was uncomplicated. Orotracheal intubation was easy and atraumatic using a 6.5mm EMG endotracheal tube (ETT) with low pressure cuff...
2016: Acta Anaesthesiologica Belgica
E A Salviz, O Aksoy, E Bayazit, O Berkoz, S A Evis, K M Tugrul
Epidermolysis bullosa (EB) is a rare genetic disease characterized by recurrent blister formation following injuries or traumas. In patients with EB, general anaesthesia may result in potential airway obstruction, aspiration and prolonged hospital stay due to airway instrumentation-associated new bullae formation and scarring. On the other hand, regional anaesthesia has been shown to be efficient and safe. Ultrasound (US)- guidance particularly provides additional benefits to this clinical situation by minimizing skin contacts, improving block success and preventing complications...
2016: Acta Anaesthesiologica Belgica
S Hontoir, S Saxena, P Gatto, M Khalife, A M Ben Aziz, M Paesmans, M Sosnowski
BACKGROUND: We investigated the effect of a pern-operative opioid-free approach on postoperative patient comfort in patients undergoing breast cancer surgery. SUBJECTS AND METHODS: From September 2014 to July 2015, 66 female patients of the Belgian Oncology Institut Jules Bordet were recruited. They were randomized into two groups: the first group received anesthesia with opioids for their breast cancer surgery, and the second group received opioid-free anesthesia...
2016: Acta Anaesthesiologica Belgica
A Teunkens, K Cootjans, K Vermeulen, M Peters, M Van de Velde, S Rex
PURPOSE: Adenotonsillectomy is a frequently performed procedure in pediatric day-case surgery causing significant pain for which adequate analgesia is required. Our aim was to investigate if the intraoperative administration of IV tramadol decreases the need for postoperative pain medication in children. Because tramadol has well-known pro-emetic effects, we also assessed the incidence of postoperative nausea and vomiting (PONV). METHODS: We performed a retrospective observational study in 314 children aged 1-13 years undergoing elective adenotonsillectomy...
2016: Acta Anaesthesiologica Belgica
M Bissot, P Y Henin, S Aunac, B Colinet, L Barvais, O Simonet, M De Kock
Elderly surgical population is growing faster than the rate of population ageing. The risk of postoperative complication is higher in this population, the type of complication and the risk indicators are different from younger patients. There is also a huge heterogeneity in the elderly population. The concept of frailty-emerges to explain these specific aspects and to risk stratify older patients. The present work intends to help the anaesthesiologist to take into account the concept of frailty at the preoperative visit...
2016: Acta Anaesthesiologica Belgica
S Engelen, J Derks, I Beenakkers
BACKGROUND: Remifentanil patient controlled intravenous analgesia (PCIA) during labor has rapidly gained popularity. Its pharmacological profile makes it suitable for this indication. However, remifentanil is a potent respiratory depressant that might cause serious maternal hypoventilation, respiratory arrest and desaturation. METHODS: In the present study we compared standard monitoring of parturients (saturation measurements and visual respiratory rate measurements at set times) with continuous monitoring...
2016: Acta Anaesthesiologica Belgica
M Van de Velde, S Devroe, E Roofthooft
No abstract text is available yet for this article.
2016: Acta Anaesthesiologica Belgica
A A Defresen, N Smal, F C Belle, H-J P Renwart, V L Bonhomme
We report the case of a 70-year-old man, with increased anesthetic risk, who beneficiated from a lumbar laminarthrectomy from lumbar vertebra 4 (L4) to sacral 1 (S1). A dural tear facing L5-S 1 levels occurred during surgery and was repaired intra-operatively. Postoperatively, back and radicular pain symptoms appeared along with a pseudo-meningocele. Successful treatment was only achieved after performing an epidural blood patch and closed subarachnoid drainage. This well-known but infrequent management was undertaken after a first epidural blood patch attempt, and after two unsuccessful surgical choking procedures...
2016: Acta Anaesthesiologica Belgica
C Pregardien, T Pirotte, F Veyckemans
Merosin-deficient congenital muscular dystrophy (MD-CMD) is the most common and severe form of congenital muscular dystrophy and is characterized by progressive severe hypotonia due to the absence of the merosin chain around muscle fibers. The main anesthetic concerns include a possible association with malignant hyperthermia, the risk of anesthesia-induced rhabdomyolysis, a difficult airway and postoperative respiratory failure. We report the case of an uneventful general anesthesia (GA) in a two-year-old boy with MD-CMD for the placement of an implantable venous access system...
2016: Acta Anaesthesiologica Belgica
G Micha, P Tzimas, I Zalonis, K Kotsis, G Papdopoulos, E Arnaoutoglou
BACKGROUND: Postoperative cognitive dysfunction is a topic of special importance in the geriatric surgical population which primarily resolves within the short term postoperative period, but it can become a long term disorder with significant impact on patient's quality of life. This study was designed to compare the short and long term postoperative cognitive function after propofol and sevoflurane anaesthesia in the elderly and to evaluate the role of the inflammatory process. METHODS: Patients, aged 60-74, scheduled for a non-cardiac operation of more than two-hour duration were enrolled in this prospective randomized controlled trial and allocated into two groups in order to receive propofol or sevoflurane anaesthesia...
2016: Acta Anaesthesiologica Belgica
J M Belena, M Nunez, A Vidal, C Gasco, C Gilsanz, A Alcojor, D Anta, A E Lopez
INTRODUCTION: Supra-glottic airway devices (SADs) with an inbuilt drain channel, such as the LMA Proseal™ (LMA-P), LMA SupremeTM (LMA-S) and i-gel™ (i-gel), have been used for laparoscopic cholecystectomy. We compared safety, efficacy, and ease of use, as well as the incidence of adverse events between these devices. METHODS: One hundred and eighty adult, ASA 1-3 patients scheduled to undergo elective cholecystectomy under general anesthesia were randomly allocated to one of three groups: LMA-P, LMA-S or i-gel...
2016: Acta Anaesthesiologica Belgica
N Mpotos, C Depuydt, L Herregods, I Deblaere, I Tallier, E Van Damme, J G Bourgots
OBJECTIVES: Since fatigue seems related to poorer physical fitness rather than to gender, we analyzed the physiological responses in female medicine and physical education students during a 30 minutes sustained cardiopulmonary resuscitation (CPR) sequence. METHODS: Handgrip strength and maximal aerobic power (V02 max) determined strength and endurance. Twenty-three medicine (M) and 27 physical education (PE) female students performed 30 minutes CPR. Compression quality and ECG were continuously monitored, heart rate and non-invasive blood pressure (NIBP) every 2 minutes...
2016: Acta Anaesthesiologica Belgica
B Versyck, P Van Houwe
We assessed the practice of obstetric anesthesia in Flanders through an on-line enquiry form and investigated the advancements by comparing the results with those of the 2004 survey. 54 (86%) structured forms were completed, representative for 94% of the accredited maternity beds in Flanders. Obstetric anesthesia is provided in all Flemish acute hospitals and 7/10 deliveries are performed nowadays with neuraxial analgesia. For labor analgesia, classical epidural remains the main neuraxial technique (62%) whereas CSE is used as default technique in 17% of the hospitals and upon indication in 21%...
2016: Acta Anaesthesiologica Belgica
B Wood, K Ismail
A twenty-three year old woman, admitted to the intensive care unit (ICU) with a diagnosis of menin- gitis and associated lower limb ischemia suffered a car- diac arrest, due to extreme hyperkalemia, following the administration of succinylcholine in order to replace an endo-tracheal tube. After prolonged cardiopulmonary resuscitation (CPR) lasting 45 minutes, during which 8 mg of epinephrine was administered, cardiac output was restored. Four weeks later the patient left intensive care, having made a full recovery with no neurological deficit...
2016: Acta Anaesthesiologica Belgica
(no author information available yet)
OBJECTIVE: In this comparative randomized cohort study, we aimed at evaluating the occurrence of sensorineural hearing loss after general and spinal anesthesia using both subjective and objective tests. MATERIAL AND METHODS: Fifty patients scheduled for elective cesarean section were approached, of which 21 patients received spinal anesthesia (group S), and 16 patients received general anesthesia (group G). In group S, a 27 G pencil point spinal needle was used...
2016: Acta Anaesthesiologica Belgica
C Hallet, I Venneman, G Hans, V Bonhomme
BACKGROUND: Sevoflurane induction in chil- dren is performed using different techniques. Constricted, centered, and symmetrical pupils (CCSP) are classically the endpoint to be achieved before laryngoscopy is performed. OBJECTIVES: We investigated whether two different inhalation induction techniques with the same clinical end- point provided similar intubating conditions and comparable depth of anesthesia as assessed by the Bispectral Index (BIS). METHODS: Following IRB approval, and informed parental consent, 20 children were recruited...
2016: Acta Anaesthesiologica Belgica
M Momeni, A Gaudin
Reports on the demographic profile of older populations estimate that, in 2050, 19 countries will have at least 10% of their population aged 80 years or more. Many high risk elderly patients undergo cardiac surgery. In addition, advanced age has been shown to be a strong predictor of adverse neurological outcome. Despite sig- nificant improvements achieved in the perioperative care of cardiac surgical patients, neurological complications remain a global health issue. Recent findings have pointed out that cerebral hypoperfusion and too deep levels of anesthesia are major sources of adverse neurological outcomes...
2016: Acta Anaesthesiologica Belgica
M Van Loo, T Sottiaux
Oxygenation using High Flow Nasal Cannula (HFNC) was initially described in neonatal medicine, but, gradually, its use has extended to adult patients. The efficacy of the device has been linked to higher flows of oxygen delivered to the patients, air tract humidification, alveolar recruitment through a positive end-expiratory pressure (PEEP) effect, prevention of nasopharyngeal collapse, and dead-space washout. Beside the fact that HFNC is a non-invasive way of delivering oxygen to ICU patients, and is well tolerated, results from various clinical trials tend to show positive outcomes for patients presenting with acute hypoxemic respiratory failure (AHRF), during intubation, or during the post-extubation period...
2016: Acta Anaesthesiologica Belgica
J Goode, F Veyckemans, M De Tourtchaninoff, I Grosu
Alpha 2 agonists are appreciated drugs designed for the peri-operative period, because of their anxiolytic, sedative and analgesic properties. However, they are usually avoided during scoliosis surgery, a longlasting major procedure involving healthy patients, because of their potential effects on Somatosensory and Motorevoked potentials. The absence ofrecommendations suggests that their effects on evoked potentials are still unclear. Thus, we tried in this narrative review to identify the literature representative of the effects of clonidine and dexmedetomidine on evoked potentials, on human beings, published between 1988 and 2015 in English or French, using GOOGLE SCHOLAR and PUBMED...
2016: Acta Anaesthesiologica Belgica
F T Mendonça, I Barreto de Moura, D Pellizzaro, B J Grossi, R Carvalho Diniz
OBJECTIVE: We report the anesthesia management of a 15 years-old patient with neurofibromatosis type 1, scheduled for resection of a tumor located in the occipitocervical region. In addition, we review the pertaining literature, emphasizing the anesthetic implications of neurofibromatosis manipulation. CASE : A 15-years-old female patient, with Neurofibromatosis type 1 was diagnosed with a large tumor in occipitocervical region suggestive of a plexiform neurofibroma. She presented with cervical instability, difficulty in positioning due to the large cervical mass and other predictors of airway difficulty...
2016: Acta Anaesthesiologica Belgica
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