scholarly journals Appeared inexplicable disorders of consciousness after general anesthesia tracheal tube drawing in endoscopic tympanoplasty

Ibrain ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 113-118
Author(s):  
Kun Qian ◽  
Song Cao ◽  
Xing‐Kui Liu
2018 ◽  
Vol 65 (4) ◽  
pp. 259-260 ◽  
Author(s):  
Tsuyoshi Hoshi ◽  
Takashi Suzuki ◽  
Masayuki Somei ◽  
Takehiko Iijima ◽  
Yuka Kurihara

A 23-year-old healthy man was scheduled for extraction of his mandibular third molars under general anesthesia with nasotracheal intubation. Sudden sinus tachycardia up to 170 beats/min occurred when applying an epinephrine solution-soaked swab into the nasal cavity for preventing epistaxis during intubation. This was presumably evoked by submucosal migration of the swab into a false passage created because of the force applied during a prior failed attempt at nasal passage of the tracheal tube, and rapid epinephrine absorption by the traumatized mucosa. The causes of the unexpected severe tachycardia in our patient are discussed.


2021 ◽  
pp. 014556132110060
Author(s):  
Antonio Gilardi ◽  
Andrea Colizza ◽  
Antonio Minni ◽  
Marco de Vincentiis

Salivary Bypass Tube is an important tool to prevent or treat some complications of laryngeal and hypopharyngeal surgery and its placement may prove difficult. In this article, we propose a new technique to simplify its management by using an Oral/Nasal Tracheal Tube Cuffed-Reinforced that allowed us to reduce operating times, complications related to prolonged general anesthesia, and the traumas on the tissues incurred during the forced positioning of the device with standard techniques.


2020 ◽  
Author(s):  
Jee-Eun Chang ◽  
Jung-Man Lee ◽  
Jiwon Lee ◽  
Jin-Young Hwang ◽  
Tae Kyong Kim ◽  
...  

Abstract Background: High cuff pressure can induce ischemic injury to the trachea. An esophageal stethoscope can increase the cuff pressure. The purpose of this study was to evaluate the effect of an esophageal stethoscope insertion on the cuff pressure.Methods: Patients, who were scheduled for surgeries under general anesthesia, were enrolled in this prospective observational study. After induction of anesthesia, an anesthesiologist intubated a tracheal tube into the patient’s trachea and inflated the cuff manually. Then, an investigator checked the initial cuff pressure using a manometer. Next, the cuff pressure was adjusted to 24-26 mmHg. The cuff pressure was rechecked after insertion of an esophageal stethoscope. We recorded the change in cuff pressure by esophageal stethoscope.Results: One hundred twelve patients completed this study. The cuff pressure increased by an esophageal stethoscope in almost all patients and the mean cuff pressure change was 3.0 ± 3.4 cmH2O in all patients. Among all subjects, cuff pressure change over 5 cmH2O was recorded in 24 patients. When we compared the patient characteristics between patients whose cuff pressure changed over 5 cmH2O with that of other patients, females were more affected by insertion of an esophageal stethoscope, in terms of cuff pressure increase.Conclusion: Esophageal stethoscope insertion could increase cuff pressure, and females are more affected by it. Therefore, anesthesiologists should check the cuff pressure with a manometer after insertion of an esophageal stethoscope and readjust the pressure appropriately.Trial registration: ClinicalTrials.gov Identifier NCT03375554, registered on 12 December 2017 (https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007N0H&selectaction=Edit&uid=U00026JX&ts=2&cx=-ivu5vz)


Author(s):  
Parmod K. Bithal ◽  
Shahenda S. Abdalla ◽  
Ravees Jan ◽  
Vandan D. Ward

AbstractAwake craniotomy (AC) is indicated to excise a lesion close to an eloquent area of the brain. Success of this procedure depends upon the patient’s active participation during the awake phase of the surgery, especially for brain mapping. Occasionally, a patient may refuse to remain awake during the surgical procedure and demand general anesthesia (GA). A 27-year-old male with uncontrolled seizures from recurrent brain tumor near motor area refused to consent for AC citing his past unpleasant experience; so, the decision to administer GA was taken. To avoid straining/coughing on tracheal tube, his airway was anesthetized with transtracheal xylocaine, bilateral superior laryngeal nerve block, and inflation of tracheal tube cuff with xylocaine. GA was maintained with sevoflurane, infusion of fentanyl, and rocuronium. To awaken him, anesthetics were discontinued and rocuronium antagonized with sugammadex. Intravenous lignocaine and midazolam were administered to supress cough reflex and produce amnesia, respectively. He tolerated the entire duration of 30 minutes of brain mapping with electrocorticography and neurological testing comfortably. Upon completion of brain mapping, GA was reintroduced and the lesion excised. The surgical outcome was good with no neurological deficit. When interviewed postoperatively, the patient had no recall of the awake phase.


2014 ◽  
Vol 30 (4) ◽  
pp. 526 ◽  
Author(s):  
Asha Tyagi ◽  
Surendra Kumar ◽  
AshokKumar Sethi ◽  
Manisha Desai

2015 ◽  
Vol 51 (5) ◽  
pp. 325-328 ◽  
Author(s):  
Manuel Martin-Flores ◽  
Catherine C. Cortright ◽  
Samantha J. Koba

A Silky terrier weighing 4.7 kg was presented with an airway foreign body after having aspirated a fragment of an orotracheal tube that was identified on radiological examination. Due to the small size of the patient, flexible endoscopy could not be performed through the lumen of a tracheal tube. Following IV induction of general anesthesia, the airway was instrumented with a laryngeal mask airway that was attached via a three-way connector to an anesthesia breathing circuit. A flexible endoscope was passed through the free port of the connector. That arrangement allowed for the passage of an endoscope through the lumen of the laryngeal mask airway and into the trachea without interrupting the continuous supply of O2 and sevoflurane.


2016 ◽  
Vol 16 (2) ◽  
pp. 37-43
Author(s):  
A A Skutchanova ◽  
B Saniova

Abstract Consciousness is enigmatic beast. It is present with us, comforting, and intuitive core of us. Yet this familiar beast, if we try to touch and describe it, escapes. Questioning and exploring consciousness accompanies mankind since ever. In 20th century we met never before seen states of severe disorders of consciousness – nonresponding people with eyes wide open. Also advancements in general anesthesia made us reexplore this phenomena. Article sums up current philosophic and two most prominent current neuroscientific approaches to what consciousness is and how we can assess it in other human beings. These theories may extend our understanding of ourselves and also help to asses this core quality in our patients in moments, when they do not intelligibly respond or do not respond at all.


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