Rapid induction of hypothermic arrest maintains viability of brain during repair of lethal vascular injuries. Long-term survival is influenced by the rate of reversal of hypothermia.

Hypothermic metabolic arrest can be used to maintain viability of key organs during repair of lethal injuries. Survival is influenced by the rate of cooling with the best outcome following rapid induction of hypothermia.

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While videothoracoscopic surgery has rapidly become accepted as an effective method of performing minimally invasive surgery, the advantages and feasibility of using this surgical technique for the treatment of neurogenic tumors of the thorax are not yet well defined. Between August 1992 and May 1999, 15 solitary thoracic neurogenic tumors were surgically excised using videothoracoscopic surgery in our hospital. The patients comprised six women and nine men, with a mean age of 38.1 years. The mean tumor size was 3.5 cm, with a range of 1.5-6.5 cm and included 12 schwannomas, 2 ganglioneuromas, and 1 neurofibroma. Among the 15 patients, 4 were treated using videothoracoscopic surgery plus minithoracotomy. The only complication associated with videothoracoscopic surgery was hoarseness which developed in one patient. Our experience indicates that videothoracoscopic surgery is a useful alternative to facilitate the excision of small thoracic neurogenic tumors.

A sore throat is the most frequent adverse side effect of general anesthesia. The purpose of this study was to compare the different types and timing of lidocaine application based on the effectiveness of reducing postoperative sore throat (POST) after endotracheal intubation. In group A, 8% lidocaine was sprayed on laryngopharyngeal structures immediately before intubation, and the distal ends of the endotracheal tubes (ETTs) were lubricated with 2% lidocaine gel. In group B, 8% lidocaine was sprayed, and ETTs were lubricated with normal saline. In groups C and D, no lidocaine was sprayed, and the ETTs were lubricated with normal saline (C, control) or with 2% lidocaine gel (D). In group E, 8% lidocaine was sprayed 10 min prior to endotracheal intubation, and the ETTs were lubricated with normal saline. In 527 patients, 28.2% reported POST at 24 h following extubation. Statistically significant differences in the incidence of POST were found only between group E (16.0%) and each of the other groups (28.4-38.5%), except for group B (26.5%). In conclusion, 8% lidocaine spray significantly reduced the incidence of POST if it was sprayed on laryngopharyngeal structures 10 min prior to endotracheal intubation.

A case of endobronchial metastasis from renal cell carcinoma developing 5 years after a right nephrectomy in a 63-year-old man is reported. Bronchoscopic examination performed after the patient presented with hemoptysis showed a polypoid tumor obstructing the entrance to the left upper bronchus. A snare was introduced through a bronchofiberscope to remove the endobronchial tumor, following which his atelectasis improved remarkably and his hemoptysis resolved. No side effects were observed. Electrosurgical snaring proved useful as palliative treatment to relieve bronchial obstruction due to an endobronchial metastasis in this patient.

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