Limited approach to the right flank for placement of a duodenostomy tube

2001 ◽  
Vol 37 (2) ◽  
pp. 193-199 ◽  
Author(s):  
RE Novo ◽  
J Churchill ◽  
L Faudskar ◽  
AJ Lipowitz
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Nutritional Support ◽  
Tube Placement ◽  
Site Infection ◽  
Mechanically Ventilated ◽  
Enterostomy Tube ◽  
Gastric Feeding ◽  
The Right ◽  
Placement Technique

A new enterostomy tube placement technique is described for provision of nutrients into the duodenum. Placement of the duodenostomy tube (d-tube) is performed through a limited right flank approach under sedation and local anesthesia. Seven client-owned animals (three dogs and four cats) requiring enteral nutritional support were selected for d-tube placement. Patients were fed via the d-tube for two to 28 days. Complications included discomfort when manipulating and exteriorizing the duodenum, discomfort with bolus feedings, local cellulitis, and tube site infection. All complications resolved without further incident. This technique should be considered in patients that are not good candidates for prolonged general anesthesia or esophageal or gastric feeding, or patients being mechanically ventilated.

Open Gastrostomy under Local Anesthesia for Patients with Neuromuscular Disorders

2010 ◽  
Vol 76 (4) ◽  
pp. 369-371 ◽  
Author(s):  
Amit Sharma ◽  
John R. Bach ◽  
Kenneth G. Swan
Keyword(s):  
Quality Of Life ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Neuromuscular Disease ◽  
Neuromuscular Disorders ◽  
Tube Placement ◽  
Intravenous Sedation ◽  
Respiratory Complications

Patients with neuromuscular disease often require gastrostomy, yet respiratory complications in these patients can preclude the use of general anesthesia, intravenous sedation, or endoscopy. The purpose of this study is to report successful use of open gastrostomy that can be performed under local anesthesia. Fifty-four patients underwent this modified procedure. There were no deaths or complications. They lived an average of 43.4 ± 6.2 (SE) months postgastrostomy tube placement. Simplified open gastrostomy can be performed safely for patients with neuromuscular disease with resulting improvements in both longevity and quality of life.

scholarly journals A New Montgomery® Salivary Bypass Tube Placement Technique: Report of Procedures Performed on Patients With Tracheoesophageal Fistula or Pharyngoesophageal Stenosis

2021 ◽  
pp. 014556132110060
Author(s):  
Antonio Gilardi ◽  
Andrea Colizza ◽  
Antonio Minni ◽  
Marco de Vincentiis
Keyword(s):  
General Anesthesia ◽  
Tracheal Tube ◽  
Tracheoesophageal Fistula ◽  
New Technique ◽  
Tube Placement ◽  
A New Technique ◽  
Placement Technique ◽  
Standard Techniques

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.

The Esophageal Detector Device: Accuracy and Reliability in Difficult Airway Settings

1996 ◽  
Vol 11 (1) ◽  
pp. 60-62 ◽  
Author(s):  
Christopher E. Kapsner ◽  
David C. Seaberg ◽  
Charles Stengel ◽  
Kaveh Ilkhanipour ◽  
James Menegazzi
Keyword(s):  
Emergency Medicine ◽  
Pulmonary Edema ◽  
Difficult Airway ◽  
Laboratory Investigation ◽  
Respiratory Arrest ◽  
Tube Placement ◽  
Mainstem Bronchus ◽  
Anatomic Location ◽  
The Right ◽  
Attending Physician

AbstractIntroduction:The esophageal detector device (EDD) recently has been found to assess endotracheal (ET) tube placement accurately. This study describes the reliability of the EDD in determining the position of the ET tube in clinical airway situations that are difficult.Methods:This was a prospective, randomized, single-blinded, controlled laboratory investigation. Two airway managers (an emergency-medicine attending physician and a resident) determined ET-tube placement using the EDD in five swine in respiratory arrest. The ET tube was placed in the following clinical airway situations: 1) esophagus; 2) esophagus with 1 liter of air instilled; 3) trachea; 4) trachea with 5 ml/kg water instilled; and 5) right mainstem bronchus. Anatomic location of the tube was verified by thoracotomy of the left side of the chest.Results:There was 100% correlation between the resident and attending physician's use of the EDD. The EDD was 100% accurate in determining tube placement in the esophagus, in the esophagus with 1 liter of air instilled, in the trachea, and in the right mainstem bronchus. The airway managers were only 80% accurate in detecting tracheal intubations when fluid was present.Conclusions:The EDD is an accurate and reliable device for detecting ET-tube placement in most clinical situations. Tube placement in fluid-filled trachea, lungs, or both, which occurs in pulmonary edema and drowning, may not be detected using this device.

scholarly journals Junctional Rhythm Preoperatively and During General Anesthesia for Oral and Maxillofacial Surgery

2017 ◽  
Vol 64 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Naotaka Kishimoto ◽  
Ikue Kinoshita ◽  
Yoshihiro Momota
Keyword(s):  
General Anesthesia ◽  
Local Anesthesia ◽  
Anesthetic Management ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Anesthesia Induction ◽  
Sagittal Split Ramus Osteotomy ◽  
Junctional Rhythm ◽  
Appropriate Treatment ◽  
Slow Heart Rate

We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). At 90 minutes after anesthesia induction, local anesthesia with 10 mL of 1% lidocaine and 1:100,000 adrenaline was administered. A junctional rhythm appeared 15 minutes after the local anesthesia. We believe that the atrioventricular nodal pacemaker cells accelerated because of the increased sympathetic activity due to the adrenaline. On the preoperative ECG, the junctional rhythm with slow HR appeared as an escaped beat caused by slowing of the primary pacemaker. Therefore, we think that the preoperative junctional rhythm and the junctional rhythm that appeared during general anesthesia were due to different causes. Understanding the cause of a junctional rhythm could lead to more appropriate treatment. We therefore believe that identifying the cause of the junctional rhythm is important in anesthetic management.

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