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How to read out the work of A.G. Baumgarten after Duchamp’s anesthesia? The author of this interpretation of aesthetics as asteiology (Greek: asteidzomai – to be witty) seeks to reconstruct the foundations of aesthetic thinking as the art, science and paideia of wit, and he proves that the category of acutum ingenium occupies the central role in Baumgarten’s aesthetics. From Quintilianus to Kant wit (ingenium) was comprehended as a form of invention, cognition, expression and a talent for social communication, and in Baumgarten’s asteiology as the ideal (habitus) of arts and sciences. Raising the issue of asteism (Greek: asteísmos) as a mental process in the Polish art, starting with – nomen omen – the wit of Witkacy, we have to make use of a normative model of asteic intelligence. This is the author’s answer to the wit – often without asteism – of the contemporary post-art, post-aesthetics or post-philosophy.
EN
Introduction: Perioperative care of primary hyperparathyroidism patients is a significant challenge. The challenge increases when the preoperative optimization of the patient is suboptimal due to any reason. Concomitant complications like osteitis fibrosa cystic, renal involvement, and multiple electrolyte abnormalities predispose these patients towards multiple morbidities and even mortality during the perioperative period. It is known that the hypercalcemia causes shortened QT, and the inhalational and intravenous anesthesia drug-induced QT prolongation is likely to be buffered. On the other hand, prolonged QTc in primary hyperparathyroid patients in the presence of hypercalcemia is more uncommon, but an extremely challenging situation for anesthesiologists as these patients are more prone to torsadogenesity. Materials and methods: A case-based review is presented in this paper. To review the current practice and opinions, we searched PubMed and Google Scholar using the advanced search engine with the combination index words of primary hyper-parathyroidism, anesthesia, anaesthesia, anesthesia management, and anaesthesia management with a time frame of January 1, 2000, to August 30, 2018. Results: The results are enumerated in the text. Although anesthetic management of primary hyperparathyroid patients is available in the literature, anesthetic management of primary hyperparathyroid patients with prolonged or borderline QTc is not well described. In this paper, we present a case that was successfully managed using Desflurane based minimal flow anesthesia, which is probably also the first of such. Conclusion: Balanced anesthesia with Propofol induction and modern inhalational agents for maintenance and non-depolarizing neuromuscular blockade appears to be safe method of anesthesia.
EN
Introduction and aim. This study evaluated whether ethyl chloride spray had an analgesic effect on pain intensity caused by venepuncture compared to a placebo. Material and methods. A total of 339 patients were randomly divided into two groups: The group in which ethyl chloride spray was applied (n=212) and the placebo group (n=127). The analgesic efficacy of ethyl chloride spray was compared with the placebo group using the Visual Analog Scale (VAS). Results. When the analgesic efficacy of ethyl chloride spray was compared with the placebo group, the VAS score was 4 [interquartile range (IQR): 1.0] for the ethyl chloride spray group and 5 (IQR: 2.0) for the placebo group. The efficacy of ethyl chloride spray in reducing pain was statistically significant compared to the placebo (p<0.001). Conclusion. Ethyl chloride spray has analgesic activity in venepuncture. Therefore, this spray can be used at the emergency departments to reduce pain intensity in patients undergoing such interventions.
PL
Wprowadzenie. W ostatnich latach obserwujemy wzrost ilości cięć cesarskich, głównie wykonywanych w trybie planowym. Najczęstszą metodą znieczulenia wykorzystywaną w porodzie operacyjnym jest znieczulenie przewodowe, głównie znieczulenie podpajęczynówkowe. Cel pracy. Analiza porównawcza sposobów znieczulenia do cięcia cesarskiego w wybranych dwóch szpitalach województwa małopolskiego (powiat tarnowski) w roku 2014. Materiał i metody. Przeprowadzono analizę dokumentacji medycznej 1097 znieczuleń cięć cesarskich (w tym: wiek, dane antropometryczne, wartość skali ASA, rodzaj wykonanego znieczulenia, płyny zastosowane przed znieczuleniem, rodzaj igły, spadki ciśnienia po wykonanym bloku). Do analizy zebranych danych użyto testów: parametryczny chi kwadrat, oraz nieparametryczne testy Kruskala- Wallisa i U Mana- Whitneya. Przyjęto poziom istotności p < 0,05. Wyniki. Średni wiek kobiet poddawanych zabiegowi cięcia cesarskiego wyniósł 32,3±5,42. Średnia ocena w skali ASA badanych kobiet wyniosła1,02±0,15. Najczęściej wybieraną metodą znieczulenia było znieczulenie przewodowe podpajęczynówkowe, w grupie B zdecydowanie częściej podczas znieczulenia podpajęczynówkowego stosowano igłę 26G Standard oraz większą ilość marcainy. Częściej wybieraną formą nawodnienia pacjentek z grupy B było stosowanie HAES. Wykazano, że nawodnienie koloidami (HAES) przed zabiegiem skutkuje mniejszymi spadkami ciśnienia tętniczego po znieczuleniu. Wnioski. Znieczulenie podpajęczynówkowe jest najczęstszą metodą znieczulenia podczas cięcia cesarskiego. Najczęstszym powikłaniem znieczulenia przewodowego w cięciu cesarskim był spadek ciśnienia tętniczego krwi. Jako prewencję hipotonii stosowano nawadnianie płynami koloidowymi i krystaloidami.
EN
Background. Recent years have witnessed an increase in the number of elective caesarean deliveries. Conduction anesthesia, mainly spinal, is the type of anesthesia most frequently used for caesarean delivery. Purpose. The survey aimed to conduct comparative analysis of anesthesia types used for caesarean deliveries in two selected hospitals of the Małopolska Province (county of Tarnow), Poland, in 2014. Material and methods. Anesthetic records for 1097 caesarean deliveries were analyzed (including: patients’ age, anthropometric data and ASA physical status score, type of performed anesthesia, pre-anesthetic fluids, type of spinal needles and a drop in arterial blood pressure after the blockade). The parametric chi-squared test and the nonparametric Kruskal- Wallis and U-Mann Whitney tests were used to analyze the data collated. The level of significance was accepted at < 0.05. Results. The mean age of females subjected to caesarean section equaled 32.3±5.42 and their mean ASA score was 1.02±0.15. On balance, conduction spinal anesthesia was the most frequently selected anesthetic to prevent pain, and in group B, 26G standard spinal needles and a greater dose of Marcaine were far more routinely used. The HAES solution was in group B the most frequently selected method of hydration. It was disclosed that hydration with the HAES colloidal solutions before the surgical intervention resulted in a smaller drop in ABP after anesthesia. Conclusions. Spinal anesthesia was the most frequently selected method of anesthesia for caesarean delivery. The ABP drop was the most prevailing complication resulting from conduction anesthesia for caesarean delivery. Hydration with colloid and crystalloid fluids was implemented as a preventive measure against hypotension.
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