Journal Issue: Volume: 32, No. 1, April 2010
Loading...
Volume
Number
Issue Date
2010
Journal Title
Journal ISSN
ISSN (Print) : 1993-2979 | ISSN (Online) : 1993-2987
Journal Volume
Articles
Anesthetic management of tracheobronchial foreign body removal
(Institute of Medicine, 2010) Pradhan, B
Abstract
Introduction: Tracheobronchial foreign body removal, is a common emergent problem especially in pediatric population and it is associated with greatest challenge to the anesthesiologist as well as to the surgeon as the airway has to be shared by both. Various pulmonary changes associated with foreign body impaction also occurs.
Methods: This is a retrospective analysis of foreign body removal of tracheobronchial tree in Institute of Medicine, Tribhuvan University Teaching Hospital over the last three years (April 2006 – April 2009). Data regarding age, sex, presentation/signs, anesthetic technique, site and types of foreign body, intraoperative events and postoperative outcomes were collected.
Results: The age range of the patients was from 6 months to 18 years. Total cases were 49. Most of the foreign bodies were organic (60%) and the common site was in right bronchus (64%). The cases were managed either with assisted ventilation or controlled ventilation intraoperatively. Most of the cases presented with dyspnoea. Postoperatively few cases (5 cases) needed to be ventilated electively in intensive care unit, while most of the cases needed oxygen supplement for few hours postoperatively.
Conclusions: Anesthetic management of tracheobronchial foreign body is challenging for both the anesthesiologist and the surgeon. The only way for the better outcome, is excellent communication in both parts i.e. anesthesiologists and surgical team, as well as timely information and involvement of other experts like paediatrician, before the procedure.
Keywords: Anesthetic management, bronchoscopy, tracheobronchial foreign body
Anesthetic management of tracheobronchial foreign body removal
(Institute of Medicine, 2010) Pradhan, B
Abstract
Introduction: Tracheobronchial foreign body removal, is a common emergent problem especially in pediatric population and it is associated with greatest challenge to the anesthesiologist as well as to the surgeon as the airway has to be shared by both. Various pulmonary changes associated with foreign body impaction also occurs.
Methods: This is a retrospective analysis of foreign body removal of tracheobronchial tree in Institute of Medicine, Tribhuvan University Teaching Hospital over the last three years (April 2006 – April 2009). Data regarding age, sex, presentation/signs, anesthetic technique, site and types of foreign body, intraoperative events and postoperative outcomes were collected.
Results: The age range of the patients was from 6 months to 18 years. Total cases were 49. Most of the foreign bodies were organic (60%) and the common site was in right bronchus (64%). The cases were managed either with assisted ventilation or controlled ventilation intraoperatively. Most of the cases presented with dyspnoea. Postoperatively few cases (5 cases) needed to be ventilated electively in intensive care unit, while most of the cases needed oxygen supplement for few hours postoperatively.
Conclusions: Anesthetic management of tracheobronchial foreign body is challenging for both the anesthesiologist and the surgeon. The only way for the better outcome, is excellent communication in both parts i.e. anesthesiologists and surgical team, as well as timely information and involvement of other experts like paediatrician, before the procedure.
Keywords: Anesthetic management, bronchoscopy, tracheobronchial foreign body
Assessment of stump invagination versus simple ligation in open appendicectomy
(Institute of Medicine, 2010) Khan, S
Abstract
Introduction: Operation of appendix is very common abdominal surgery that is done by general surgeons. Some surgeon prefer to invaginate the appendix stump while others don’t. Aim of the study was to compare the technique of ligation and invagination of the appendix stump with simple ligation of the appendix stump during appendicectomy for acute appendicitis.
Methods: A prospective comparative study of 150 appendicectomies were done in the Department of General Surgery, Nepalgunj medical college (NGMC),Nepalgunj, Nepal from June 2001-May 2007in unit III. All patients with uncomplicated and complicated acute appendicitis who underwent open appendicectomy and had appendicular stump for ligation and invagination or simple ligation, were divided into two groups. In group-I ligation with invagination and in group-II, simple ligation of appendix stump was carried out. Patients were followed up for 3-6 months to check the development of complications.
Results: Both groups were similar with respect to age and sex. Invagination of the stump after ligation of the stump was done in 70 patients while simple ligation was done in 80 cases. The incidence of postoperative pyrexia (18.57% and 22.5%), wound infection (27.15% and 30.0%) and postoperative paralytic ileus (25.71% and 27.5%) was in group-I and group-II respectively.
Conclusions: Simple ligation of appendix stump is as safe a procedure as ligation and invagination of appendix stump during appendicectomy.
Keywords: Acute appendicitis, appendix stump, invagination, simple ligation