Paresia transitoria unilateral combinada del nervio hipogloso y del nervio lingual después de la intubación para anestesia

ResumenDurante la anestesia general pueden lesionarse los nervios en la región faringolaríngea. Los nervios más a menudo lesionados son el hipogloso, lingual y laríngeo recurrente. Las lesiones pueden surgir como resultado de varios factores que pueden ser, durante la laringoscopia, intubación endotraqueal e inserción del tubo y por presión del balón, ventilación con mascarilla, maniobra aérea triple, vía aérea orofaríngea, modo de inserción del tubo, posición de la cabeza y del cuello, y aspiración.Las lesiones nerviosas en esa región pueden comprometer un solo nervio aislado o causar la parálisis de 2 nervios en conjunto, como la del nervio laríngeo recurrente hipogloso (síndrome de Tapia). Sin embargo, la lesión combinada de los nervios lingual e hipogloso, después de la intubación para la anestesia, es una condición mucho más rara. El riesgo de una lesión se puede reducir con medidas preventivas. A continuación describimos un caso de paresia unilateral combinada de los nervios hipogloso y lingual después de la intubación para la anestesia

The Effect of Dexmedetomidine on Oxidative Stress during Pneumoperitoneum

. Purpose. This study was intended to investigate the effect of dexmedetomidine on oxidative stress response in pneumoperitoneum established in rats. Methods. Animals were randomized into three groups, group S: with no pneumoperitoneum, group P: with pneumoperitoneum established, and group D: given 100 mcg intraperitoneal dexmedetomidine 30 min before establishment of pneumoperitoneum. Plasma total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) activity were measured 30 min after conclusion of pneumoperitoneum. Results. The mean TOS level was significantly higher in group P than in the other two groups, and the TOS level was significantly higher in group D than in group S ( < 0.05). Plasma TAS level was found to be lower in group P than in the other two groups, and the TAS level was lower in group D than in group S ( < 0.05). Consequently, the OSI was significantly higher in group P than in groups D and S ( < 0.05). Conclusions. Ischemiareperfusion phenomenon that occurs during pneumoperitoneum causes oxidative stress and consumption of plasma antioxidants. Dexmedetomidine decreases oxidative stress caused by pneumoperitoneum and strengthens the antioxidant defense system

Anaesthesia for infant with Jarcho Levin syndrome: case report

ABSTRACTJarcho Levin syndrome is a rare disorder. There are various vertebral and costal anomalies. Severe deformities and abnormal fusion of ribs and vertebrae cause respiratory insufficiency and pneumonia. We present anaesthesia in a patient with Jarcho Levin syndrome for vesicoureteral reflux

Remoção endovascular percutânea de cateter totalmente implantável com migração intracardíaca em criança com leucemia linfoblástica aguda

ResumoMenino com dois anos de idade com leucemia linfoblástica aguda foi apresentado com disfunção de cateter central perifericamente inserido. O exame radiológico revelou um fragmento do cateter no átrio direito que se estendia até a veia pulmonar. O fragmento foi removido com sucesso por intervenção endovascular percutânea, sem qualquer complicação.AbstractA 2‐year‐old boy with acute lymphoblastic leukemia was presented with peripherally inserted central catheter dysfunction. Radiological examinations revealed a catheter remnant in the right atrium extending into pulmonary vein. The catheter remnant was successfully removed from the right atrium by percutaneous endovascular intervention without any complications

Percutaneous endovascular removal of intracardiac migrated port A catheter in a child with acute lymphoblastic leukemia

A 2-year-old boy with acute lymphoblastic leukemia was presented with peripherally inserted central catheter dysfunction. Radiological examinations revealed a catheter remnant in the right atrium extending into pulmonary vein. The catheter remnant was successfully removed from the right atrium by percutaneous endovascular intervention without any complications

Paresia transitória unilateral combinada do nervo hipoglosso e do nervo lingual após intubação para anestesia

Lesões de nervos podem ocorrer na região faringolaríngea durante a anestesia geral. Os nervos mais comumente lesionados são o hipoglosso, lingual e laríngeo recorrente. As lesões podem surgir em decorrência de vários fatores, como, por exemplo, durante a laringoscopia, intubação endotraqueal e inserção de tubo e por pressão do balão, ventilação com máscara, manobra aérea tripla, via aérea orofaríngea, modo de inserção do tubo, posição da cabeça e do pescoço e aspiração. As lesões nervosas nessa região podem acometer um único nervo isolado ou causar a paralisia de dois nervos em conjunto, como a do nervo laríngeo recorrente e hipoglosso (síndrome de Tapia). No entanto, a lesão combinada dos nervos lingual e hipoglosso após intubação para anestesia é uma condição muito mais rara. O risco dessa lesão pode ser reduzido por meio de medidas preventivas. Descrevemos um caso de paresia unilateral combinada dos nervos hipoglosso e lingual após intubação para anestesia

Transient unilateral combined paresis of the hypoglossal nerve and lingual nerve following intubation anesthesia

Nerve damage may occur in the pharyngolaryngeal region during general anesthesia. The most frequently injured nerves are the hypoglossal, lingual and recurrent laryngeal. These injuries may arise in association with several factors, such as laryngoscopy, endotracheal intubation and tube insertion, cuff pressure, mask ventilation, the triple airway maneuver, the oropharyngeal airway, manner of intubation tube insertion, head and neck position and aspiration.Nerve injuries in this region may take the form of an isolated single nerve or of paresis of two nerves together in the form of hypoglossal and recurrent laryngeal nerve palsy (Tapia's syndrome). However, combined injury of the lingual and hypoglossal nerves following intubation anesthesia is a much rarer condition. The risk of this damage can be reduced with precautionary measures. We describe a case of combined unilateral nervus hypoglossus and nervus lingualis paresis developing after intubation anesthesia. Keywords: Hypoglossal paralysis, Lingual paralysis, Intubation anesthesi

One-lung ventilation: For how long?

ObjectiveLung injury induced by one-lung ventilation is rare, but it is a condition that may result in high mortality. This study evaluates the effects of one-lung ventilation and occlusion time on collapsed and contralateral lungs.MethodsSprague–Dawley rats were allocated randomly into 7 groups consisting of 6 animals each: sham; O1, 1 hour of occlusion/2 hours of re-expansion; C1, 3 hours of mechanical ventilation control; O2, 2 hours of occlusion/2 hours of re-expansion; C2, 4 hours of mechanical ventilation control; O3, 3 hours of occlusion/2 hours of re-expansion; and C3, 5 hours of mechanical ventilation control groups. In the occlusion groups, the left lung was collapsed by bronchial occlusion. Malondialdehyde activity was determined in the blood, and myeloperoxidase and malondialdehyde activity was determined in the collapsed and contralateral lungs. Lung tissues were also examined histopathologically.ResultsMalondialdehyde and myeloperoxidase levels rose as occlusion duration increased. This increase was greater in the occlusion groups than that in their own control groups. Increases were significant in the O2 compared with the O1 groups (P < .005). Histologically, tissue damage increased as occlusion time rose injury in collapsed and contralateral lungs. Injury was greater in the occlusion groups than injury in their own control groups (P < .005).ConclusionsOur findings show that biochemical and histopathologic injury occur in collapsed and contralateral lungs in one-lung ventilation, and this injury increases as occlusion time rises. We believe that occlusion and occlusion time–related injury should be borne in mind in the clinic under conditions requiring the application of one-lung ventilation