Phenol lumbar sympathetic block in diabetic lower limb ischemia.

Background: Patients with arteriosclerotic peripheral vascular disease and lower limb ischemia have painful ulceration or incipient gangrene of the lower limb with intractable rest pain. The arteriosclerotic changes may preclude any surgery other than amputation.

Methods: We examined whether chemical sympathectomy could relieve pain, arrest gangrene and postpone amputation, even in diabetic patients.

[Combined intrapleural and low epidural anesthesia for upper abdominal surgery].

Intrapleural administration of local anesthetics to achieve postoperative analgesia was recently described by Kvalheim and Reiestad. It has been stated that the intrapleural technique provides analgesia, but not surgical anesthesia. However, this method has been used recently for anesthesia during minor surgical procedures.

[Delayed post-anoxic encephalopathy].

A case of the rare condition, delayed postanoxic encephalopathy is presented. This condition occurs after an acute hypoxic insult followed by an interval of apparent full recovery, but relapses to various degrees of renewed neurological impairment, coma or even death. Anesthetists should be aware of this entity and establish proper follow-up in patients at risk.

[Benefits of perioperative hemodynamic monitoring in coronary patients].

During 1987-1991, 78 coronary patients were admitted to the intensive care unit (ICU) for noncardiac surgery. 40 were under invasive hemodynamic monitoring and treatment before operation (group A) and 38 were only admitted to the ICU postoperatively, since ICU beds were not available before surgery (group B). The overall incidence of the perioperative complications, ischemic heart, myocardial infarction and cardiac arrhythmias was significantly higher in group B than in group A (p < 0.

Bronchiolitis obliterans--current concepts.

We review current concepts about the clinical manifestations, diagnosis and treatment of patients with bronchiolitis obliterans (BO) with emphasis on clinical/pathological correlations and recent developments. BO is a relatively rare disease, but its incidence is probably higher than generally believed and is continuously rising, partly because of better recognition, but also because of increased exposure to industrial fumes, and its occurrence in lung transplantation. BO is characterized histologically by varying degrees of obliteration of the lumen of the respiratory bronchioles by organizing connective tissue often extending into the alveoli ('proliferative' BO with organizing pneumonia--BOOP) or by more extensive fibrosis and scarring of the more proximal, conductive bronchioles ('constrictive' BO).

Adult respiratory distress syndrome after radical neck dissection.

The clinical management of an unusual case of postoperative ARDS is reported. A few hours following neck surgery and septic insult, the patient developed unexpected ARDS. Aetiologic and supportive treatment were successfully instituted and after 72 hours of intensive therapy, the patient's clinical status improved.

Lidocaine inhalation attenuates the circulatory response to laryngoscopy and endotracheal intubation.

Study Objective: To evaluate the effect of lidocaine inhalation on the circulatory response to direct laryngoscopy and endotracheal intubation.

Design: Prospective, randomized study.

Setting: Operating theater at a public hospital.

Painless intussusception. Giving conservative treatment another chance.

Treatment options for intussusception in children range from reduction by barium enema to surgical intervention. The authors describe a case in which a conservative option--a fifth attempt to reduce an ileocolic intussusception by barium enema, this time using general anesthesia--successfully resolved the problem.

Pulse oximetry from the nasal septum.

Study Objective: To evaluate the accuracy of the nasal septum site for pulse oximetry measurement of arterial oxyhemoglobin saturation (SpO2) in hypothermic patients.

Design: Prospective study.

Setting: Operating theater of a public hospital.

Laser treatment of eye disorders in children.

The increasing range of indications for laser treatment and the development of new modalities of lasering have led to a growing tendency to extend this type of treatment to the pediatric population. Problems of compliance in this age group often necessitate the use of general anesthesia. This report describes the operative technique used in 11 children (13 eyes) under the age of 13 years, all of whom underwent laser treatment under general anesthesia for a variety of ocular conditions.

Influence of epidural anaesthesia on the course of labour in patients with antepartum fetal death.

The course of labour in 22 patients with antepartum fetal death who received epidural anaesthesia was evaluated as compared to 22 controls matched for parity and gestational age, who received narcotic pain relief. Both groups had similar preinduction cervical dilatation and the induction was performed by amniotomy and oxytocin infusion. The mean first stage of labour was 5.