1/7. Accidental full thickness burn of the ear lobe following division of the great auricular nerve at parotidectomy.Division of the great auricular nerve is commonly performed during superficial parotidectomy and leads to anaesthesia of the ear lobe. In the case presented here, this gave rise to an accidental self-inflicted thermal burn of the ear lobe. This might have been avoided had the posterior branch of the nerve been preserved.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/7. Continuous brachial plexus blockade. A technique that uses an axillary catheter to allow successful skin grafting.An 82-year-old woman sustained a full thickness burn of her hand. A technique for producing anaesthesia of the brachial plexus via an indwelling catheter is described. Confirmation of the catheter position was obtained by X ray. bupivacaine was infused via the catheter after operation to produce immobilisation of the hand to ensure multiple skin grafts would take. Consequent with this goal was excellent postoperative analgesia.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/7. Oxidised regenerated cellulose: an effective emergency haemostatic in burns surgery.A 26-year-old man with 40% full-thickness burns was treated by excision and split-skin grafting on the 7th post-burn day. He developed bleeding 1 hour post-operatively which persisted despite the use of pressure dressings, elevation of the limbs, the administration of fresh frozen plasma, platelet-rich plasma, calcium, whole blood and cryoprecipitate respectively over a period of 11 hours. The bleeding was finally controlled under general anaesthesia by clot removal, bipolar electro-coagulation of miniscule oozing points, replacement of the meshed skin graft and the application of a layer of oxidised regenerated cellulose over the grafted area. The properties and uses of oxidised regenerated cellulose are outlined.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/7. nicardipine: perioperative applications in children.nicardipine is the first intravenously administered dihydropyridine calcium channel blocker. Its primary physiological actions include vasodilatation with limited effects on the inotropic and dromotropic function of the myocardium. Several reports have documented its use in adult patients for pharmacological control of blood pressure. We present our experience with the perioperative use of nicardipine in children to treat intraoperative hypertension, as an agent for controlled hypotension during spinal fusion and LeFort I maxillary osteotomies and to treat postoperative hypertension. Dosing regimens and possible applications in paediatric anaesthesia are discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/7. Oesophageal ECG in a child for burns surgery.Continuous monitoring of heart rate and rhythm are regarded as minimal standards of monitoring during anaesthesia. However, when the thoracic area is exposed for surgery as for debridement of burns and split skin grafting then placement of surface electrodes for electrocardiographic (ECG) monitoring is not possible. We report the intraoperative use of an old technique, oesophageal ECG (OesECG) in a child presenting for major burns surgery. The positioning of the probe, electrical safety and P-QRS morphology, are discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/7. The haemodynamic effect of thoracoscopic cardiac sympathectomy.A patient with angina pectoris who had been successfully treated by thoracoscopic cardiac sympathectomy was scheduled to have scalp debridement under general anaesthesia for a scald burn. There were haemodynamic changes during and after the operation including anaesthetic induction, endotracheal intubation, maintenance, and early recovery period. The sympathetic denervated heart showed little chronotropic response to anaesthetic and surgical stimulation. On the contrary, the parasympathetic response was predominant. An episode of severe bradycardia occurred during endotracheal suctioning prior to extubation. The haemodynamic response to cardiac sympathetic denervation corresponded to the efferent effect of beta-receptor blockade- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/7. skin grafting of full thickness burns under local anaesthesia with EMLA cream.Two elderly patients with 6 and 4 per cent total body surface area (TBSA) full thickness burns were entirely skin grafted solely under topical anaesthesia with EMLA cream. Both patients had several concurrent illnesses. The risk of general or regional anaesthesia for their general condition was much greater than the risk of unhealed burn wounds which substantially impaired the patients' quality of life. The surgical procedures were painless to both patients. The taking of the skin grafts and the healing of the donor sites were uneventful. It seems that the late skin grafting of full thickness burns up to 10 per cent TBSA may be accomplished solely under the topical anaesthesia with EMLA cream and thus avoiding the general or spinal anaesthesia in a high risk group of thermally injured patients.- - - - - - - - - - ranking = 8keywords = anaesthesia (Clic here for more details about this article) |