Latency period can be from 4-7 days depending on age, blood supply, irradiation to the area, scar tissue, etc. The rate and rhythm of distraction is how far and how often. A rate of 1mm/day at a rhythm of 0.25mm four times a day is ideal. Consolidation period begins when active distraction stops and is […]
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Serotonin syndrome is characterized by confusion, agitation, tachycardia, fever, hyperreflexia, and myoclonus. Normeperidine is an active metabolite of meperidine metabolism and has a half-life of 15 to 30 hours in an adult. Normeperidine’s elimination is dependent upon renal function and can accumulate with high repeated dosages or in the presence of renal impairment. Serotonin antagonists,
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Administration of methohexital produces modest decreases in systemic blood pressure that are transient due to compensatory increase in heart rate. This decrease in systemic blood pressure is principally due to peripheral vasodilatation. The resulting dilation of peripheral capacitance vessels leads to pooling of blood, decreased venous return and the potential for decreases in cardiac output
Etomidate is one of the few anesthetics that suppresses the adrenocortical axis. Etomidate causes adrenocortical suppression by producing a dose-dependent inhibition of the enzyme 11-beta-hydroxylase which is necessary for conversion of cholesterol to cortisol. This suppression lasts 4 to 8 hours after an induction dose of etomidate. Etomidate maintains hemodynamic stability and has little effect
Propofol has a direct smooth muscle effect on the bronchi, causing bronchodilation. Propofol decreases intracranial and intraocular pressure, and it does not potentiate neuromuscular blockade.
Frey syndrome, or “gustatory sweating” is a relatively common complication of parotidectomy but uncommon following temporomandibular joint arthrotomy. It is believed to be caused by aberrant regeneration of postganglionic parasympathetic parotid secretomotor fibers with severed post-ganglionic sympathetic fibers innervating facial sweat glands.
Caused by a disruption in the sympathetic innervation to the ipsilateral maxillofacial region, is characterized by: Ptosis (by loss of sympathetic innervation to Mueller’s muscle) Anhidrosis (by interruption of sympathetic innervation to cutaneous sweat glands). Miosis or a constricted pupil (by unopposed parasympathetic constriction) Remember the pnemonic, PAM is Horny (Ptosis, Anhydrosis, Miosis is Horner’s
Superior Orbital Fissure Syndrome vs Orbital Apex Syndrome Lesions involving the superior orbital fissure or orbital apex can produce overlapping cranial nerve deficits. The critical difference between these two syndromes is optic nerve (CN II) involvement, which is present only in orbital apex syndrome. Superior Orbital Fissure Syndrome (SOFS) Superior orbital fissure syndrome results from
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Blood Pressure Cuff Size: Accurate Measurement and Common Errors Accurate blood pressure measurement depends not only on proper technique, but also on correct blood pressure cuff size. Improper cuff selection is a common and preventable cause of falsely abnormal blood pressure readings in both outpatient and perioperative settings. When selecting a blood pressure cuff, two
Glasgow Coma Scale (GCS): Interpretation, Posturing, and Airway Management The Glasgow Coma Scale (GCS) is one of the most widely used clinical tools for assessing level of consciousness in patients with head injury, neurologic trauma, or altered mental status. It provides a standardized method for evaluating neurologic function and plays a critical role in trauma
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