The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.
Tracheal stenosis in pregnancy is a relatively rare occurrence and there are limited data regarding the perioperative management of these patients. Various surgical treatment options are available to include open repair, long-term tracheostomy, or endoscopic repair (rigid versus balloon dilation). We report the case of a woman in her third trimester of pregnancy, with known recurrent and worsening history of subglottic tracheal stenosis, who underwent awake microlaryngoscopy with potassium titanyl phosphate laser radial incision and serial tracheal balloon dilation under topical anesthesia with sedation. We further discuss her perioperative multidisciplinary management.
A 23-year-old woman at 41 weeks and 6 days estimated gestational age underwent continuous spinal analgesia for labor after a recognized, unintended dural puncture. Excellent analgesia was maintained throughout labor and vaginal delivery, the intrathecal catheter was left in situ for 24 hours postpartum, and the catheter was subsequently removed without apparent complication. On physical examination during her anesthesia postoperative visit, clear fluid was noted to be slowly draining from the catheter insertion site. Although she denied all symptoms associated with a dural puncture, including headache, a cerebrospinal fluid-cutaneous fistula was diagnosed. An epidural blood patch was placed, which terminated the cerebrospinal fluid leak. No long-term complications were evident. Subsequent literature review revealed a rare incidence of this type of complication and varied recommendations for intervention and optimal management. We review the literature with regard to this complication and offer discussion regarding the various suggested means of diagnosis and therapy.
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