RESUMO
OBJECTIVE: To compare the complication rates of bowel perforation during colonoscopy performed with or without anesthesia. METHODS: We retrospectively analyzed 9501 case records of colonoscopy performed at the Chi Mei Medical Center between 2000 and 2004, and compared the rates of bowel perforation between patients receiving anesthesia during the procedure versus those that did not receive anesthesia. Poisson distribution was used for statistical analysis. RESULTS: Only one case of perforation was found in the non-anesthetized group (n = 2460) compared with two cases in the anesthetized group (n = 7041). No statistical difference was found (p = 0.6173; risk ratio = 0.6988; 95% confidence interval by Byar's method = 0.063-7.705). CONCLUSION: During colonoscopy, anesthesia per se does not affect the rate of bowel perforation.
Assuntos
Anestesia/efeitos adversos , Colonoscopia/efeitos adversos , Perfuração Intestinal/epidemiologia , Adulto , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
We describe a case of the sudden onset of cardiovascular collapse during emergence from anesthesia resulting from a massive venous air embolism, which was detected by transesophageal echocardiography. We present this case to remind anesthesiologists to be aware of the risk of a sudden return of air trapped in the venous system during emergence from anesthesia. The air is freed because the sympathetic tone is increased, muscle-pumping power is regained, ventilation shifts from positive-pressure to negative-pressure spontaneous ventilation, and the patient is repositioned after surgery.
Assuntos
Anestesia/efeitos adversos , Embolia Aérea/etiologia , Ecocardiografia Transesofagiana , Embolia Aérea/diagnóstico por imagem , Embolia Aérea/prevenção & controle , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
"Piton-S", a preparation of synthetic hormone of oxytocin, is the most common pharmacologic agent used for the induction and augmentation of labor, as well as preventing postpartum hemorrhage owing to its uterotonic properties. There are many adverse effects reported with oxytocin, including hypotension and tachycardia. Anaphylactoid reaction to oxytocin is extremely rare. Here we bring forth a case who sustained from anaphylactoid shock following oxytocin administration during the act of cesarean section. We would like to discuss the proper management of perioperative anaphylaxis after review of similar cases in the literature.