Assuntos
Doenças por Armazenamento dos Lisossomos/patologia , Doenças Musculares/patologia , Adolescente , Autofagia , Biópsia , Humanos , Imuno-Histoquímica , Doenças por Armazenamento dos Lisossomos/genética , Masculino , Microscopia Eletrônica , Músculo Esquelético/patologia , Doenças Musculares/congênito , Doenças Musculares/genética , Fagossomos/patologia , Vacúolos/patologiaAssuntos
Cabelo , Máscaras Laríngeas , Religião e Medicina , Idoso , Humanos , Masculino , Cuidados Pré-Operatórios/métodosRESUMO
We conducted a postal survey of 221 anaesthetists in the Oxford region to determine their views and actual clinical practice regarding regional anaesthesia in adult patients undergoing limb surgery, when a combined regional and general anaesthetic was planned. Of the 162 respondents (73.3%), 142 (87.6%) regularly practised regional blocks for limb surgery in adult patients. For all the regional anaesthetic techniques in question, more anaesthetists felt it was safer to perform these blocks before induction of general anaesthesia than after induction. However, their actual practice varied markedly from their views, with more anaesthetists performing these blocks after general anaesthesia. Overall, trainees performed blocks before induction of general anaesthesia more often than consultants (p = 0.047).
Assuntos
Anestesia por Condução/métodos , Anestesia Geral/métodos , Anestesiologia , Extremidades/cirurgia , Padrões de Prática Médica , Adulto , Anestesia por Condução/efeitos adversos , Atitude do Pessoal de Saúde , Distribuição de Qui-Quadrado , Inglaterra , Humanos , Corpo Clínico Hospitalar , Inquéritos e QuestionáriosRESUMO
The cuffed oropharyngeal airway is a modified Guedel airway and is recommended for anaesthesia in spontaneously breathing patients. To our knowledge this is the first report of transient unilateral lingual nerve palsy after the use of a cuffed oropharyngeal airway to maintain anaesthesia during arthroscopy of an ankle. The aetiology of lingual nerve damage is multifactorial. The possible mechanisms involved include anterior displacement of the mandible during insertion of the cuffed oropharyngeal airway (as in the jaw thrust manoeuvre), compression of the nerve against the mandible, or stretching of the nerve over the hyoglossus by the cuff of the cuffed oropharyngeal airway. We recommend gentle airway manipulation with the use of the cuffed oropharyngeal airway, avoidance of excessive cuff inflation and early recognition of such a complication if it occurs.
