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Medical ArticlesThe Healing Crisis And RetracingCertain unpleasant somatics that occur while fasting (or whil... Affection Of The Brain When the _brain_ is affected, the patient suddenly complains ... Esophageal Foreign Body After initial choking and gagging, or without these, there m... The Effort Of Digestion Digestion is a huge, unappreciated task, unappreciated becaus... Lues Of The Esophagus Esophageal syphilis is a rather rare affection, and may show ... Enlargement Or Ossification Of The Heart Treat these two affections in the same way. Take the A D curr... Contraindications To Esophagoscopy In the presence of aneurysm, advanced organic disease, exten... Giddiness And Trembling This comes very often as the result of loss of nerve power in ... Amaurosis Paralysis Of The Optic Nerve Use B D current, moderate force, three or four times, and the... Suppression Of The Menses Amenorrhoea For sudden suppression from taking cold, as by wetting the ... A Summing Up GIVE up resentment, give up unhealthy resistance. ... Chloroform Or Ether (inhaled) Fresh air. Pull tongue forward, and begin artificial respirati... Cold Settled A cold is often easily overcome. At other times it "sits down,... Technic For General Anesthesia For esophagoscopy and gastroscopy, if general anesthesia is ... Brain Exercise Proper exercise for the brain is most important. But this is n... ... Paralysis Take the B D current, medium force. If the paralysis be in a ... Cardiac Drugs Whether any drug should be used which acts directly on the he... Problems THERE are very few persons who have not I had the experience ... Indications Esophagoscopy is demanded in every case in which a foreign b... |
Preparation Of The Patient For Peroral EndoscopyCategory: ANESTHESIA FOR PERORAL ENDOSCOPY Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery The suggestions of the author in the earlier volumes in regard to preparation of the patient, as for any operation, by a bath, laxative, etc., and especially by special cleansing of the mouth with 25 per cent alcohol, have received general endorsement. Care should be taken not to set up undue reaction by vigorous scrubbing of gums unaccustomed to it. Artificial dentures should be removed. Even if no anesthetic is to be used, the patient should be fasted for five hours if possible, even for direct laryngoscopy in order to forestall vomiting. Except in emergency cases every patient should be gone over by an internist for organic disease in any form. If an endolaryngeal operation is needed by a nephritic, preparatory treatment may prevent laryngeal edema or other complications. Hemophilia should be thought of. It is quite common for the first symptom of an aortic aneurysm to be an impaired power to swallow, or the lodgment of a bolus of meat or other foreign body. If aneurysm is present and esophagoscopy is necessary, as it always is in foreign body cases, to be fore-warned is to be forearmed. Pulmonary tuberculosis is often unsuspected in very young children. There is great danger from tracheal pressure by an esophageal diverticulum or dilatation distended with food; or the food maybe regurgitated and aspirated into the larynx and trachea. Therefore, in all esophageal cases the esophagus should be emptied by regurgitation induced by titillating the fauces with the finger after swallowing a tumblerful of water, pressure on the neck, etc. Aspiration will succeed in some cases. In others it is absolutely necessary to remove food with the esophagoscope. If the aspirating tube becomes clogged by solid food, the method of swab aspiration mentioned under bronchoscopy will succeed. Of course there is usually no cough to aid, but the involuntary abdominal and thoracic compression helps. Should a patient arrive in a serious state of water-hunger, as part of the preparation the patient must be given water by hypodermoclysis and enteroclysis, and if necessary the endoscopy, except in dyspneic cases, must be delayed until the danger of water-starvation is past. As pointed out by Ellen J. Patterson the size of the thymus gland should be studied before an esophagoscopy is done on a child. Every patient should be examined by indirect, mirror laryngoscopy as a preliminary to peroral endoscopy for any purpose whatsoever. This becomes doubly necessary in cases that are to be anesthetized. Next: Anesthesia For Peroral Endoscopy Previous: Direction Of The Esophagus
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