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ABSTRACT: There are reports in the literature regarding the effects of hyperbaric conditions on various medical devices. In the current study we evaluated the performance of an elastomeric infusion device during exposure to a hyperbaric environment.
Nineteen disposable 400-mL On-Q pain ball infusion devices were filled with 0.2% ropivacaine and connected to an infusion catheter. The regulator of the device was set to deliver 14 mL/h. Hyperbaric oxygen therapy included 7 minutes to achieve the desired hyperbaric pressure level, 90 minutes at the specific pressure (atm), and 7 minutes to return to normal atmospheric pressure (1 atm), thereby resulting in a study interval or dive of 104 minutes. The trials were performed for the devices in the following sequence of dives with a return to 1 atm between: 1, 2, 2.4, 2.8, 3, and 1 atm. The fluid delivered during each dive was measured with a graduated column. Additionally, the collection device was weighed before and at the completion of each dive to determine the change in weight as a measure of the total amount of fluid infused. The output over 104 minutes was also studied in 5 infusion devices without hyperbaric pressure (control group).
No difference in output of the devices was noted when comparing the study group and the control group. Although there was a decrease in the output of the devices over 8 to 9 hours, no difference between the 2 groups was noted.
This preliminary investigation demonstrates no clinically significant change in the function of the On-Q pain device during exposure to a hyperbaric environment.
Anesthesia and analgesia 04/2011; 113(2):275-7. · 3.08 Impact Factor
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ABSTRACT: BACKGROUND: Changes in oxygenation occur during one-lung ventilation (OLV) due to intrapulmonary shunt. Although arterial oxygenation is generally adequate, there are no studies evaluating the effect of these changes on cerebral oxygenation. MATERIALS AND METHODS: Cerebral oxygenation (rSO(2)), heart rate (HR), blood pressure (BP), oxygen saturation (SaO(2)), and end-tidal carbon dioxide (ETCO(2)) were prospectively monitored during OLV in adults. Cerebral oxygenation was monitored using near infrared spectroscopy. No clinical decisions were made based on the rSO2 value. BP and HR were the inspired oxygen concentration was adjusted as needed to maintain the SaO(2) >/= 95%. RESULTS: The study cohort included 40 adult patients. 18,562 rSO(2) values were collected during OLV. The rSO(2) was >/= baseline at 3,593 of the 18,562 data points (19%). The rSO2 was 0-9 </= baseline in 7,053 (38%) of the readings, 10-19 </= baseline in 4,084 (22%) of the readings, and 20-29 </= baseline in 3,898 (21%) of the readings. 2,599 (14%) of the rSO(2) values were less than 75% of the baseline value. Thirteen patients (32.5%) had at least one rSO2 value that was less than 75% of the baseline. Eight patients (20%) had rSO(2) values less than 75% of baseline for >/= 25% of the duration of OLV. These patients were older (63.7 +/- 10.2 vs 54.6 +/- 9.8 years, P<0.025), weighed more (95.8 +/- 17.4 vs 82.6 +/- 14.6 kgs, P=0.038), and were more likely to be ASA III vs II (7 of 8 versus 25 of 32, relative risk 1.75) than the remainder of the cohort. CONCLUSIONS: Significant changes in rSO2 occur during OLV for thoracic surgical procedures. Future studies are needed to determine the impact of such changes on the postoperative course of these patients.
Journal of Minimal Access Surgery 01/2008; 4(4):104-107.
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ABSTRACT: The Johanson-Blizzard Syndrome (JBS) is an autosomal recessive disorder with a characteristic phenotype, including dwarfism, a beaked nose with aplastic alae nasi, a high forehead, mid-line ectodermal scalp defects with sparse hair and absent eyelashes/eyebrows, prominent scalp veins, low set ears, a large anterior fontanelle, micrognathia, thin lips, absent permanent dentition and microcephaly. In addition to the characteristic facial features, associated conditions include congenital heart disease, exocrine/endocrine pancreatic dysfunction, hypothyroidism, hypopituitarism, mental retardation, sensorineural hearing loss and vesico-ureteral reflux. A case is presented and the potential anaesthetic implications of this syndrome are discussed.
Pediatric Anesthesia 02/2003; 13(1):72-5. · 2.10 Impact Factor
