Perioperative Multimodal Anesthetic Care Incorporating Transversus Abdominis Plane Block Is Associated With Reduced Narcotic Use in Laparoscopic Sleeve Gastrectomy.

Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed bariatric surgery performed in North America. As our knowledge of the importance in limiting narcotic use in postoperative patients increases, we sought to evaluate the effect of transversus abdominis plane (TAP) blocks on inpatient narcotic use in patients undergoing LSG.

Methods: A retrospective review of LSG performed at a single institution by 3 bariatric surgeons was performed.

Failures of the Oxygen Supply.

Oxygen supply failures are potentially life-threatening and are often associated with death or brain damage. Knowledge of how oxygen is supplied is essential for understanding how failures are caused and their management. Even though safety mechanisms exist to reduce the likelihood of a supply failure, events still occur.

A surgeon's assessment of inadequate neuromuscular antagonism in a case of prolonged neuromuscular blockade.

Evaluation of the degree of neuromuscular blockade by the surgeon using clinical criteria alone is unreliable. We report a case of prolonged neuromuscular blockade lasting 5.5 h, where an additional intra-operative dose of neuromuscular relaxant was given at the request of the surgical team.