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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...

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Indocyanine Green-Guided Intraoperative Imaging to Facilitate Video-Assisted Retroperitoneal Debridement for Treating Acute Necrotizing Pancreatitis
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Rapid sequence induction for appendectomies: a retrospective case-review analysis.

Juraj Istvan1, Marc Belliveau, François Donati

  • 1Département d'Anesthésiologie, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Quebec, Canada. jristvan@gmail.com

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|January 6, 2010
PubMed
Summary

Rapid sequence induction (RSI) is frequently used for appendectomies, with high rates of opioid, propofol, and neuromuscular agent administration. This common practice showed low airway complication rates, supporting its continued use.

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Area of Science:

  • Anesthesiology
  • Surgical Procedures
  • Patient Safety

Background:

  • Rapid sequence induction (RSI) with cricoid pressure is a technique used to reduce aspiration risk during anesthesia.
  • The efficacy and safety of RSI, particularly regarding airway and hemodynamic complications, have been debated.
  • Understanding the current application and outcomes of RSI in appendectomy patients is crucial for optimizing anesthetic protocols.

Purpose of the Study:

  • To evaluate the frequency of RSI use in patients undergoing appendectomy.
  • To identify the specific anesthetic agents administered during RSI for appendicitis.
  • To determine the incidence of airway and hemodynamic complications associated with RSI in this patient population.

Main Methods:

  • Retrospective review of patient charts for appendectomy cases over a one-year period.
  • Data collection included airway evaluation (Mallampati score), preoxygenation, RSI, and induction drugs.
  • Complications such as difficult intubation, hypotension, hypertension, and oxygen desaturation were recorded.

Main Results:

  • General anesthesia with tracheal intubation was performed in 248 of 250 cases.
  • RSI was employed in 81% of cases, with common use of opioids, propofol, and neuromuscular blocking agents.
  • Low rates of difficult intubation (1.2%), aspiration (0%), and oxygen desaturation were observed, though hypotension occurred in 27% of patients.

Conclusions:

  • Rapid sequence induction using opioid, induction agent, and succinylcholine is the standard anesthetic technique for appendectomies at this institution.
  • The low incidence of airway complications suggests that the current RSI practice is safe and effective for appendectomy.
  • No changes in the current anesthetic practice for appendectomies are recommended based on these findings.