Airway management in a case of expanding neck hematoma after carotid endarterectomy

Background: Respiratory obstruction is a fatal complication following carotid endarterectomy, which caused direct compression of trachea secondary to venous and lymphatic congestion.Cases Report: In this study, we report a complicated case of carotid endarterectomy   that required emergency intubation in difficult circumstance due to progressing hematoma and soft tissue edema.Conclusion: we report a case of hematoma and edema causing compromised airway following carotid endarterectomy (CEA), in which quick action to decompress the hematoma and prepare a secure airway lead to successful outcome

Pulmonary Edema Following Intrathecal Fluorescein Injection; a Case Report

Intrathecal Fluorescein has been used widely for detection of cerebrospinal fluid (CSF) leakage. After administration of fluorescein many serious complications may happen. Pulmonary edema is one of the most serious complications that require emergency responses. In this study, we report a complicated case of pulmonary edema following Intrathecal fluorescein injection

Dexmedetomidine is as effective as Ketamine in post operative sore throat a randomized double – blind study

Background: sore throat as one of the common postoperative challenges, with a prevalence of 65%, mandates more attention. Many therapeutic approaches have been tested; including ketamine gargle. This study compares the effect dexmedetomidine versus ketamine, both used as preoperative gargle, on the incidence and severity of postoperative sore throat in emergency surgical procedures. Materials and Methods: All patients undergoing emergency surgical procedures who referred to Shohadaye-Tajrish Hospital and needed anesthesia using succinylcholine for rapid sequence induction were considered as the target population and patients with ASA class 1-2, who aged 18-64 years, were enrolled. Inside the operating theatre, patients’ vital signs recorded and they were divided into ketamine and dexmedetomidine groups, each including 20 patients, receiving 0.5 mg/kg ketamine or 0.25µg/kg dexmedetomidine in 100cc water to gargle before induction of anesthesia. Standard similar anesthesia protocols were applied for all patients. In PACU sore throat was assessed using a visual analog scale (VAS) scoring. Results: in the ketamine group, 8 cases and in the dexmedetomidine group, 12 had dry throat (p= 0.150). The mean severity of the postoperative sore throat was 2.10± (minimum score of one and a maximum of 3) without significant difference between the two groups (p=0.344). mean diastolic pressure and SpO2 were significantly lower in the dexmedetomidine group compared with the ketamine group (p=0.047 and 0.001). Conclusion: both dexmedetomidine and ketamine gargle could be equally useful and effective in reducing postoperative sore throat