Search

The incidence of postoperative nausea and vomiting (PONV) has been studied in a prospective group of 92 female patients in the generative period, undergoing thyroid surgery. In a subgroup of 47 examinees we analyzed PONV incidence according to the surgery time within the frame of their menstrual cycle. The highest number was observed in periovulatory and premenstrual periods (p < 0.02). In the formal trial, 24 patients that randomly received ondansetron (8 mg in 4 mL i.v.) and significantly less PONV than their 21 placebo controls (4 mL saline i.v.): 4 or 16.8% vs. 11 or 53.6% (p < 0.04).

Records on 28 children (19 boys and 9 girls), mean age 3.1 years (range 6 months to 11 years), treated for foreign body aspiration (FBA) at the Department of Pediatrics, Split Clinical Hospital, during the 1992-1997 period, were analyzed. The mean hospital stay was 12.3 days (range 1 h to 92 days). History data on tracheobronchial FBA were available in 23 (82%) children. Radiologic findings pointed to FBA in 22 (77%) children. Rigid tracheobronchoscopy was performed in all patients, and proved successful in 26 (93%) of children. Digestible foreign bodies and food particles were removed in 22 (78%) children. Right-sided and left-sided bronchial FBA was recorded in 14 (50%) and 13 (46%) patients, respectively, whereas bilateral obstruction was present in one patient. The importance of suspected FBA in children with pronounced symptoms of coughing, dyspnea and choke is emphasized. Rigid tracheobronchoscopy and foreign body removal by forceps under anesthesia is an efficient and safe method, and we recommend its wider use in clinical practice.

The development of pulmonary edema after the relief of upper airway obstruction in two patients is described. Pulmonary edema in those patients was the result of increased negative intrapleural and intra-alveolar pressure during forceful inspiration and in the course of upper airway obstruction. An increase in the venous return occurs and the established transpulmonary pressure gradient promotes transudation into the interstitium and alveoli. Consequent alveolar hyperventilation results in hypoxia and acidosis. All patients developing pulmonary edema should be treated with positive pressure ventilation within 24-36 hours. The aim of this study was to alert physicians that besides know factors for the development of cardiogenic and noncardiogenic pulmonary edema there are also other significant mechanisms that cause the accumulation of fluid in pulmonary tissue.