Should fluid management in thoracic surgery be goal directed?

Purpose of review To find a reliable answer to the question in the title: Should fluid management in thoracic surgery be goal directed? Recent findings 'Moderate' fluid regimen is the current recommendation of fluid management in thoracic anesthesia, however, especially in more risky patients; 'Goal-Directed Therapy' (GDT) can be a more reliable approach than just 'moderate'. There are numerous studies examining its effects in general anesthesia; albeit mostly retrospective and very heterogenic. There are few studies of GDT in thoracic anesthesia with similar drawbacks. Although the evidence level is low, GDT is generally associated with fewer postoperative complications. It can be helpful in decision-making for volume-optimization, timing of fluid administration, and indication of vasoactive agents

Ultrasonographic Measurement of Subglottic Diameter for Paediatric Cuffed Endotracheal Tube Size Selection: Feasibility Report

Objective: The aim of this feasibility study was to investigate the first attempt success of ultrasonography (USG) in paediatric patients in predicting an appropriate cuffed endotracheal tube (ETT) size

Effect of Heart Rate Control on Oxygenation and Vasopressor Need in Sepsis and Septic Shock-A Pilot Randomised Controlled Study

Objective: The goal of this study was to examine the effect of keeping resting heart rate below 95 bpm on oxygenation, organ function, vasopressor need and mortality in sepsis and septic shock

An atypical neuropathic pain; spontaneous epidural hemorrhage under oral anticoagulant therapy

Spontaneous epidural hemorrhage is one of the rare neuropathic pain etiologies. In this case, a 68-year-old patient, who had atrial fibrillation and cardioversion history, is evaluated for neuropathic pain due to spontaneous epidural hemorrhage that arose from oral anticoagulant therapy. As well as being unique in etiologic terms, we thought it is an uncommon occasion for management worth sharing

Airway management of major blunt tracheal and esophageal injury: A case report

Trans-sectional injuries of trachea are quite rare and can be extremely challenging for anesthesiologists to deal with. About 25% of post-traumatic deaths are due to thoracic traumas in which blunt injuries take a rather small place within and the resultant damage of respiratory tract is quite rare with an incidence of 0.5-2%.A recent review from a single trauma center revealed an incidence of 0.4% for tracheobronchial injury (TBI) due to blunt thoracic injuries. Most of the patients having tracheal transection lose their lives on the field due to loss of airway. Patients mostly present with a large spectrum of clinical features varying from hoarseness to respiratory collapse; though subcutaneous emphysema is the most common presenting sign which should remind possible TBI. Emergent surgery is preferred seldomly; such in cases of partial damage or because of late diagnosis, due to favorable outcome of conservative approach. Herein, we report the management of a case on TBI due to blunt thoracic trauma, experiencing difficult ventilation despite tracheal intubation. Fiber-optic bronchoscope (FOB) seems obligatory to visualize site and severity of injury and to ensure safe airway during procedures such as the neck exploration, primary end-to-end anastomosis of the trachea, tracheostomy, diversion pharyngostomy, and feeding jejunostomy

Postoperative analgesia after arthroscopic shoulder surgery: A comparison between single-shot interscalene block and single-shot supraclavicular block.

Objectives: In arthroscopic rotator cuff surgery for postoperative analgesia opioids, nonsteroid analgesics, and local anesthetics can be used. This study aimed to compare the effectiveness, additional analgesic requirements, patients satisfaction, and complications of single-shot interscalene and supraclavicular blocks