scholarly journals Anaesthesia management of a case of huge neck mass due to cervical spine chondrosarcoma with distorted anatomy

2021 ◽  
Vol 8 (4) ◽  
pp. 600-603
Author(s):  
Utkarsha P Bhojane ◽  
Jyoti P Deshpande ◽  
Akshay M Salunke ◽  
Noopur D Singh
Keyword(s):  
Cervical Spine ◽  
Anesthetic Management ◽  
Preoperative Evaluation ◽  
Neck Mass ◽  
Fiberoptic Intubation ◽  
Surgical Intensive Care Unit ◽  
Blood Products ◽  
Surgical Intensive Care ◽  
Cervical Spine Surgery ◽  
Mucosal Edema

Chondrosarcoma is the tumor which affects bone and soft tissue with only 2% spinal involvement. Anesthetic management becomes challenging in patients with cervical chondrosarcoma. Here, we are presenting a case of huge neck mass due to cervical spine chondrosarcoma in 70 year old male hypertensive patient. The patient has distorted anatomy with mucosal edema with left tracheal deviation and compression from right side. Awake Nasal Fiberoptic intubation was done with cuffed ETT no 8. The neck mass was removed and Anterior Cervical Discectomy and Fusion (ACDF) with bone grafting. The case was managed with adequate analgesia, replacement of fluids and Blood and Blood products. Considering complex cervical spine surgery and airway edema the patient was shifted to Surgical Intensive Care Unit (ICU) for elective ventilation and advanced monitoring. After serial ABG and proper weaning the patient was extubated next morning smoothly. Extensive preoperative evaluation, planning, clinical judgement and skilled experienced personale are essential for proper execution of difficult airway cases.

scholarly journals Bilateral Submandibular Gland Infection Presenting as Ludwig's Angina: First Report of a Case

2001 ◽  
Vol 80 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Carlo P. Honrado ◽  
Samuel M. Lam ◽  
Matthew Karen
Keyword(s):  
Disease Process ◽  
Fiberoptic Intubation ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Airway Control ◽  
Intravenous Antibiotics ◽  
Ludwig’S Angina ◽  
Proper Diagnosis ◽  
Important Disease ◽  
Ludwig's Angina

We diagnosed and treated a case of Ludwig's angina in a 45-year-old man who had edema of the floor of mouth and the tongue along with bilateral submandibular sialadenitis and sialolithiasis. We secured the patient's airway via nasal fiberoptic intubation in the surgical intensive care unit and administered intravenous antibiotics. The edema subsided, and the patient was extubated on the third postoperative day and discharged shortly thereafter. To our knowledge, this is the first reported case of a patient with bilateral submandibular sialadenitis and sialolithiasis presenting as Ludwig's angina. Despite the decreasing incidence of this disease, Ludwig's angina remains an important disease process because a failure to control the airway can have disastrous consequences. Proper diagnosis, airway control, antibiotic therapy, and occasionally surgical management are essential to ensure the safety of the patient.

Application of Smith-Robinson approach for C2/3 cervical spine surgery

2013 ◽  
Vol 32 (11) ◽  
pp. 1199-1202
Author(s):  
Ying ZHANG ◽  
Jun MA ◽  
Yuan-yuan CHEN ◽  
Xin-wei WANG ◽  
De-yu CHEN ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery

Pulse-oximetry Derived Perfusion Index as a Predictor of the Efficacy of Rescue Analgesia After Major Abdominal Surgeries

2020 ◽  
Vol 14 (1) ◽  
pp. 101-107
Author(s):  
Ashraf Nabil Saleh ◽  
Raham Hasan Mostafa ◽  
Ahmad Nabil Hamdy ◽  
Amr Fouad Hafez
Keyword(s):  
Intensive Care ◽  
Pain Scale ◽  
Perfusion Index ◽  
Surgical Intensive Care Unit ◽  
P Value ◽  
Surgical Intensive Care ◽  
Rescue Analgesia ◽  
Clinical Indicators ◽  
Study Objective ◽  
Behavioural Pain Scale

Study Objective: The use of an easy to apply reliable tool is essential to assess pain in patients in intensive care units. This study aimed primarily to evaluate perfusion index usefulness as an objective indicator of pain. Methods and Measurements: Data were collected from 40 non-intubated adult patients admitted to the surgical intensive care unit postoperatively. The Masimo pulse co-oximetry perfusion index (PI) probe was attached to the patient. At the time of the first request for analgesia (T1), the Behavioural pain scale non-intubated scoring system (BPS-NI) was recorded with the PI and patients' haemodynamics following which rescue analgesia was given. Thirty minutes thereafter (T2), second measurements for the mentioned parameters were taken. Main Results: There was a statistically significant reduction in the BPS-NI score, blood pressure and heart rate after analgesic administration (P-values, <0.001, 0.039 and 0.001, respectively), together with a significant increase in the PI (P-value, 0.004). This means that the PI increases with adequate relief from pain, as indicated by a decrease in BPS-NI score and haemodynamics, but the correlation was not statistically significant between their changes. Conclusion: There was no statistically significant correlation between the PI and the pain score or other clinical indicators of pain either before or after the administration of analgesic.

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