High-frequency ventilation with a conventional anesthetic ventilator during cardiac surgery.
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Biomedical subjects
Publications and source records attributed to M S Shulman.
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A 68-year-old patient was scheduled for a thoracotomy. A double-lumen endobronchial tube was requested by the surgeon to facilitate operating conditions. Initial attempts at intubation by conventional methods were unsuccessful. The proximal ends of a 37F double-lumen tube were then shortened and a 4-mm fibreoptic bronchoscope was passed through the bronchial lumen. The patient's larynx was easily visualized and the bronchoscope was passed into the trachea. The double lumen tube was then advanced over the bronchoscope and correctly positioned. Shortening a double-lumen tube allows the use of a fibreoptic bronchoscope to aid in tracheal intubation in a patient whose larynx is difficult to visualize by conventional methods.
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Two case reports are presented of patients with post-thoracotomy pain treated with epidural morphine who developed somnolence several hours after the procedure. Physostigmine, 1 mg IV successfully reversed the somnolence without any effect on analgesia.
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