SummaryPrevious studies reported that complications associated with removal of the laryngeal mask were more frequent in awake patients than in anaesthetised patients; however, these studies did not comply with the method described in the manufacturer's instruction manual. The reported incidences of regurgitation during the use of the laryngeal mask also differ considerably between studies. We studied these factors in 66 patients in whom the method described in the manual was used. After induction of anaesthesia, the laryngeal mask and a pH probe were inserted and the cuff of the mask was inflated with a minimum volume of air. Anaesthesia was maintained with nitrous oxide and isoflurane in oxygen. At the end of the operation, we randomly allocated patients to one of two groups and the laryngeal mask was removed either while they were still deeply anaesthetised or after they had regained consciousness. No apparent regurgitation occurred in any patient during operation, but one patient in the anaesthetised group regurgitated immediately after removal of the mask. The incidence of complications during or after removal of the laryngeal mask was significantly greater in the anaesthetised group than that in the awake group (p << 0.001; difference [95% CI]: 48.5 [30.5-66.5]%). Therefore, the laryngeal mask can be safely left in place until the patient has regained consciousness after emergence from anaesthesia.
Introducción: Los divertículos yeyunales son saculaciones localizadas en el borde mesentérico del yeyuno, cuya incidencia es de 0.2 a 4%. El neumoperitoneo suele ocasionar abdomen agudo quirúrgico, pero puede presentarse en patologías que no requieren exploración quirúrgica. Objetivo: Reconocer esta patología como causa infrecuente de dolor abdominal crónico o abdomen agudo quirúrgico. Establecer recomendaciones para su manejo. Caso clínico: Hombre de 66 años con dolor abdominal intenso, tipo cólico, postprandial, nocturno con distensión abdominal severa, meteorismo, náusea persistente, diarrea crónica y saciedad temprana con pérdida del apetito. Abdomen doloroso, timpánico, peristalsis muy incrementada sin datos de irritación peritoneal. Antecedentes personales patológicos (APP): hipertensión arterial sistémica controlada con antagonistas del receptor de la angiotensina 2 (ARA-2). Se realiza tomografía axial computarizada (TAC) de abdomen con reporte de diverticulitis yeyunal y aire libre en cavidad abdominal. Conclusión: La diverticulitis yeyunal, patología infrecuente, es susceptible de tratamiento médico conservador siempre y cuando las condiciones del paciente lo permitan; en casos de complicaciones, el tratamiento quirúrgico con resección y anastomosis intestinal es el abordaje recomendado.
The Giant Ovarian Cyst is not frequently seen, usually benign tumor, which eventually become malignant. It grows up slowly, free symptoms despite of some constipation, breath difficulties, and lose weight. At the beginning sonogram could miss the diagnosis, it usually be done by Axial Tomography, and needs surgical procedure by laparoscopy if they are less than 10 centimeters in diameter or laparotomy whenever longer to spread avoided. 1,2
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.