Fire during thoracotomy: A need to control the inspired oxygen concentration
Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, United StatesAnesthesia & Analgesia (Impact Factor: 3.42). 09/2005; 101(2):612. DOI: 10.1213/01.ANE.0000159015.66892.D2
Journal of cardiothoracic and vascular anesthesia 03/2012; 26(3):520-1. DOI:10.1053/j.jvca.2012.02.004 · 1.48 Impact Factor
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ABSTRACT: To assess the efficacy of intraoperative inspired oxygen fractions (FIO(2)) of 0.8 and 0.5 when compared with standard FIO(2) of 0.3 in the prevention of postoperative nausea and vomiting (PONV). Prospective, randomized, double-blinded, controlled study. General hospital, postanesthesia care unit (PACU), and gynecology floor room. 120 ASA physical status I and II women, aged 21 to 76 years, undergoing elective gynecologic laparoscopic surgery. Patients were randomized to receive a gas mixture of 30% oxygen in air (FIO(2) = 0.3, Group G30), 50% oxygen in air (FIO(2) = 0.5, Group G50), or 80% oxygen in air (FIO(2) = 0.8, Group G80); there were 36 patients in each group. A standardized sevoflurane general anesthesia, postoperative pain management, and antiemetic regimen were used. Frequency of nausea, vomiting, and both was assessed for early (0 to two hrs) and late PONV (two to 24 hrs), along with use of rescue antiemetic, degree of nausea, and severity of pain. There was no overall difference in the frequency of PONV at the early and late assessment periods among the three groups. G80 patients had significantly less vomiting than Group G30 at two hours, 3% (1/36) vs. 22% (8/36), respectively, P = 0.028. Nausea scores, rescue antiemetic use, pain scores, and opioid consumption did not differ among the groups. High intraoperative FIO(2) of 0.8 and FIO(2) of 0.5 do not prevent PONV in patients without antiemetic prophylaxis. An intraoperative FIO(2) of 0.8 has a beneficial effect on early vomiting only.Journal of clinical anesthesia 11/2010; 22(7):492-8. DOI:10.1016/j.jclinane.2009.10.013 · 1.21 Impact Factor
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ABSTRACT: A surgical fire is potentially devastating for a patient. Fire has been recognised as a potential complication of surgery for many years. Surgical fires continue to happen with alarming frequency. We present a review of the literature and an examination of possible solutions to this problem. The PubMed and Medline databases from 1948 onwards were searched using the subject headings "operating rooms", "fire", "safety" and "safety management". "Surgical fire" was also searched as a keyword. Relevant references from articles were obtained. Fire occurs when the three elements of the fire triad, fuel, oxidiser and ignition coincide. Surgical fires are unusual in the absence of an oxygen-enriched atmosphere. The ignition source is most commonly diathermy but lasers carry a relatively greater risk. The majority of fires occur during head and neck surgery. This is due to the presence of oxygen and the extensive use of lasers. The risk of fire can be reduced with an awareness of the risk and good communication. Surgery will always carry a risk of fire. Reducing this risk requires a concerted effort from all team members.The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 04/2010; 8(2):87-92. DOI:10.1016/j.surge.2010.01.005 · 2.21 Impact Factor
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