Importance of half-the-air pressure test in Shamrock lumbar plexus block

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Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Correspondence Source Type: research

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Thoracic surgery has evolved into minimally invasive surgery, in terms of not only surgical approach but also less aggressive anesthesia protocols and lung-sparing resections. Nonintubated anatomic segmentectomies are challenging procedures but can be safely performed if some essentials are considered. Strict selection criteria, previous experience in minor procedures, multidisciplinary cooperation, and the 4 cornerstones (deep sedation, regional analgesia, oxygenation support and vagal blockade) should be followed. Better outcomes in postoperative recovery, including resumption of oral intake, chest tube duration, and hos...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Nonintubated video-assisted thoracoscopic surgery (VATS) lobectomy to treat lung cancer has gained attention in recent decades, but there is very little literature on this topic. This review aims to explore the state-of-the-art, recent progress, and future prospects of this method. Its feasibility and safety have been demonstrated, and its potential benefits are faster postoperative recovery and fewer intubation-related complications. Nonintubated VATS lobectomy is a feasible and safe alternative for lung cancer treatment. This work provides information for those who would like to start using this technique and want a more...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Nonintubated thoracic surgery (NITS) has a good safety record in experienced hands, but has pitfalls for beginners. The main aim of NITS is to keep the patient under spontaneous respiration, avoiding adverse effects, such as hypoxemia, hypercapnia, panic attacks, and finally conversion to general anesthesia. In this paper, the safety aspects of anesthesia for NITS is discussed based on data from the literature and personnel clinical experiences.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Nonintubated thoracic surgery arose as supplemental evolution of minimally invasive surgery and is gaining popularity. A proper nonintubated thoracic surgery unit is mandatory and should involve surgeons, anesthesiologists, intensive care physicians, physiotherapists, psychologists, and scrub and ward nurses. Surgical training should involve experienced and young surgeons. It deserves a step-by-step approach and consolidated experience on video-assisted thoracic surgery. Due to difficulty in reproducing lung and diaphragm movements, training with simulation systems may be of scant value; instead, preceptorships and invited...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
The article describes an anesthetic management strategy for resection of the cervical trachea due to benign stenosis without using an endotracheal tube. The strategy includes: (1) insertion of an airway stent in the stenotic area, (2) insertion of a supraglottic airway device (SGAD), and (3) advancing a jet ventilation catheter through the SGAD. The stent is removed during surgery together with the resected part of the trachea. The technique of nonintubated tracheal resection allows the surgeon to work most comfortably and helps the anesthesiologist properly maintain the patient ’s vital functions in the operating room.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Nonintubated anesthesia is feasible and might be associated with shorter surgery time and shorter hospitalization for tracheal/carinal resection and reconstruction. Only case reports and a few small retrospective series study were conducted to evaluate nonintubated anesthesia for tracheal/carinal resection and reconstruction; no randomized control trials exist. Further exploration should focus on selection of optimal candidates and prospective validation.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Wedge resection in peripheral lung cancer is considered a suboptimal procedure. However, in elderly and/or frail patients it is a reliable and safer alternative. This procedure can be easily performed under nonintubated anesthesia, allowing the recruitment of patients considered otherwise marginal for a surgical treatment. Nonintubated anesthesia can reduce lung trauma, operative time, postoperative morbidity, hospital stay, and global expenses. Furthermore, nonintubated anesthesia produces less immunologic impairment and this may affect postoperative oncological long-term results. Wedge lung resection through nonintubated...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Chest infection is a health care problem in many regions of the world, and pleural empyema is the most common type of surgical chest infection. In the past decennium, the introduction of nonintubated surgery and uniportal video-assisted thoracic surgery changed considerably surgical treatment of pleural empyema. Although the advantages seem evident, the need for randomized controlled trials is necessary to confirm the usefulness. Moreover, in the future, an education and training program for thoracic surgeons and anesthesiologists would allow increasing the number of awake surgical options in caring for patients with stages II to III empyema.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
This study provides information pertaining to the physiologic, surgical, and anesthetic aspects and describes the potential benefits of nonintubated thoracoscopic surgery for the management of primary and secondary spontaneous pneumothorax.
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Authors: Yang F, Jia X, Lei P, He Y, Xiang Y, Jiao J, Zhou S, Qian W, Duan Q Abstract OBJECTIVE: To develop and test a novel method for automatic quantification of hepatic steatosis in histologic images based on the deep learning scheme designed to predict the fat ratio directly, which aims to improve accuracy in diagnosis of non-alcoholic fatty liver disease (NAFLD) with objective assessment of the severity of hepatic steatosis instead of subjective visual estimation. MATERIALS AND METHODS: Thirty-six 8-week old New Zealand white rabbits of both sexes were fed with high-cholesterol, high-fat diet and sacrifice...
Source: Journal of X-Ray Science and Technology - Category: Radiology Tags: J Xray Sci Technol Source Type: research
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