Factor V congenital deficiency is a rare hereditary disease, it exposes patients to hemorrhagic risk, with high morbi-mortality. Its management is a real challenge for practitioners. Perioperative management of patients with Factor V congenital deficiency needs anesthetists, hematologists and surgeons to work in close collaboration.
Case numbers reported in literature with neurological manifestations potentially linked to COVID-19 is constantly increasing. Most often it is sudden anosmia, headache, encephalopathy or stroke. Pathophysiology of this neurological involvement is still poorly understood. While viral genome is very rarely detected in cerebrospinal fluid, inflammatory involvement is often very significant. We report a case of SARS-CoV-2 encephalopathy without respiratory distress or cytokine storm.
Post-operative sore throat (POST) represents a real discomfort for patients. In short duration surgeries, sore throat complain can replace the post-operative pain. Many studies intended to reduce its incidence using multiples medications.
ObjectiveAssess the efficiency of extra cuff lidocaine jelly 2% associated with intra cuff liquid lidocaine 2% on the post extubation syndrome.
Materials and methodProspective study lead during 3 months in Otorhinolaryngology operating rooms. Inclusion criteria: Every intubation (naso or orotracheal) performed during this period. Exclusion criteria: upper airways surgery, tonsillectomy and patient's refusal. Patients were randomized in 3 groups: First (G1): Control group (inflated cuff with air), Second (G2): liquid lidocaine 2% injected intra cuff, Third (G3): Lidocaine 2% jelly applied on the external surface of the cuff associated with liquid lidocaine intra cuff. Patients were assessed for post-operative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery.
ResultsNinety-nine patients were randomized (G1 n=30, G2 n=34, G3 n=35). The association of liquid and jelly lidocaine reduced POST at H1, H6, and H24 after patient's discharge (p respectively at 0.0001; 0.002; 0.003 and 0.004). There was no significant difference in blunting coughing (p=0.053) and post-operative nausea and vomiting (p=0.198)
ConclusionThe association of liquid and jelly lidocaine was efficient in reducing the POST. This result needs to be supported by a larger study including an important number of patients.
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