The comparison of anesthesia effect of lung surgery through video-assisted thoracic surgery: A meta-analysis
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Abstract:
Objective: The epidural anesthesia and general anesthesia are the most commonly used in lung surgery through video-assisted thoracic surgery (VATS). Each of these methods has their advantages and disadvantages, so the aim of this meta-analysis is to identify which anesthesia is more conducive to lung surgery under VATS and rehabilitation of patients.Materials and Methods: The Cochrane Library Database (Issue 12, 2013), PubMed (1966–2015), and China National Knowledge Infrastructure (1950–2015) were searched without language restrictions. Meta-analyses were conducted using Review Manager 5.2 software (The Cochrane Collaboration, Software Update, Oxford). We calculated odds ratio (OR) and its confidence interval (95% CI) to estimate the difference between epidural anesthesia and general anesthesia through finishing of the collected data.Results: Due to our search results, 7 studies were included in our study. Studies among them show that different contents of these articles are not all the same about research direction. Our findings suggested that epidural anesthesia had more advantages than general anesthesia for operative time (mean difference = − 23.85, 95% CI: − 29.67–− 18.03, P = 0.0001). More than that, epidural anesthesia showed a good surgical outcome on postoperative hospital stay (mean difference = − 0.43, 95% CI: − 0.85–− 0.01, P = 0.04) than general anesthesia. But we found that there were no different on numbers of people with complications (OR = 0.45, 95% CI: 0.23–0.89, P = 0.97) and headache occurrence (OR = 2.69, 95% CI: 0.62–11.70, P = 0.91) between epidural anesthesia and general anesthesia.Conclusion: These results indicated that epidural anesthesia can save operating time and postoperative hospital stay time. But epidural anesthesia and general anesthesia have the same effect on complications.Keywords:
Cardiothoracic surgery
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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ABSTRACT Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre- mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app- lication of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial defor- mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest- hesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies. Key Words: Caudal anaesthesia, children, congenital anomaly OZET Havayolu yonetimi, ciddi konjenital anomalileri olan cocuklarda ozellikle zordur. Bu tur hastalar anestezik ilaclarin solunum depresan etkilerine karsi asiri derecede duyarlidir. Kaudal anestezinin inguinal herni onarimindaki basarili ve guvenli uygulamasi konjenital anomalileri (Joubert sendromu, I-cell hastaligi) olan uc olguda gosterilmistir. Ilgili uc cocuk hastada, ciddi yuz deformitesi, solunum yetmezligi ve kardiyovaskuler bozukluk dahil konjenital bozuk- luklar vardi. Genel anesteziyle iliskili komplikasyonlari onlemek icin inguinal herni cerrahisinde tek doz kaudal epi- dural anestezi uygulandi. Kaudal anestezide %0.25 levobupivakain 1 mL/kg kullanildi. Kaudal epidural anestezinin, ciddi konjenital bozukluklari olan cocuklarda inguinal herni onarimi acisindan genel anesteziye veya endotrakeal entubasyona gerek duyulmadan etkili, uygun ve guvenli bir alternatif anestezi teknigi olabilecegi sonucuna varildi. A na h ta r Sozcukler: Kaudal anestezi, cocuk, konjenital bozukluk
Levobupivacaine
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Budd–Chiari syndrome
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