Abstract
Objective: Our aim was to detect swallowing abnormalities in patients after short-term neurosurgical interventions under general anaesthesia, comparing patients with supratentorial operations with a group undergoing extracranial neurosurgery (nucleotomy).
Methods: 20 patients in each group were examined by fiberoptic endoscopic evaluation of swallowing (FEES) after general anaesthesia.
Results: No patient demonstrated dysphagia, aspiration, or oxygen desaturation.
Conclusion: In these patient groups, early postoperative feeding was safe. Postoperative food intake can probably be allowed early after general anaesthesia.
Key words
Deglutition - intubation - dysphagia
References
1
Aldrete J A.
The post-anesthesia recovery score revisited.
J Clin Anesth.
1995;
7
89-91
2
Rimaniol J M, D'Honneur G, Duvaldestin P.
Recovery of the swallowing reflex after propofol anaesthesia.
Anesth Analg.
1994;
79
856-859
3
D'Honneur G, Rimaniol J M, el Sayed A, Lambert Y, Duvaldestin P.
Midazolam/propofol but not propofol alone reversibly depress the swallowing reflex.
Acta Anaesthesiol Scand.
1994;
38
244-247
4
Murphy P J, Langton J A, Barker P, Smith G.
Effect of oral diazepam on the sensitivity of upper airway reflexes.
Br J Anaesth.
1993;
70
131-134
5
Murphy P J, Erskine R, Langton J A.
The effect of intravenously administered diazepam, midazolam and flumazenil on the sensitivity of upper airway reflexes.
Anaesthesia.
1994;
49
105-110
6
Burgess G E, Cooper J R, Marino R J.
Laryngeal competence after tracheal extubation.
Anesthesiology.
1979;
51
73-77
7
Hamdy S, Aziz Q, Rothwell J C, Crone R, Hughes D, Tallis R C, Thompson D G.
Explaining oropharyngeal dysphagia after unilateral hemispheric stroke.
Lancet.
1997;
350
686-692
8
Leder S B, Cohn S M, Moller B A.
Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients.
Dysphagia.
1998;
13
208-212
9
Ajemian M S, Nirmul G B, Anderson M T, Zirlen D M, Kwasnik E M.
Routine fiberoptic endoscopic evaluation of swallowing following prolonged intubation: implications for management.
Arch Surg.
2001;
136
434-437
10
DeVita M A, Spierer-Rundback L.
Swallowing disorders in patients with prolonged orotracheal intubation or tracheostomy tubes.
Crit Care Med.
1990;
18
1328-1330
11
DeLarminat V, Mantravers P, Dureuil B, Desmonts J M.
Alteration in swallowing reflex after extubation in intensive care unit patients.
Crit Care Med.
1995;
23
486-490
12
Bishop M J, Hibbard A J, Fink B R.
Laryngeal injury in a dog model of prolonged endotracheal intubation.
Anesthesiology.
1985;
62
770-773
13
Bishop M J.
Mechanisms of laryngeal injury following prolonged tracheal intubation.
Chest.
1989;
96
185-186
14
Bastian R W.
Videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallow.
Otolaryngol Head Neck Surg.
1991;
104
339-350
15
Langmore S E, Schatz M A, Olsen N.
Endoscopic and videofluoroscopic evaluations of swallowing and aspiration.
Ann Otol Rhinol Laryngol.
1991;
100
678-681
16
Kearney R, Mack C, Entwistle L.
Withholding oral fluids from children undergoing day surgery reduces vomiting.
Paediatr Anaesth.
1998;
8
331-336
17
Jin F, Norris A, Chung F, Ganeshram T.
Should adult patients drink fluids before discharge from ambulatory surgery?.
Anesth Analg.
1998;
87
306-311
18
Leder S B, Sasaki C T, Burrell M I.
Fiberoptic endoscopic evaluation of dysphagia to identify silent aspiration.
Dysphagia.
1998;
13
19-21
19
Barquist E, Brown M, Cohn S, Lundy D, Jackowski J.
Postextubation fiberoptic endoscopic evaluation of swallowing after prolonged endotracheal intubation: a randomized, prospective trial.
Crit Care Med.
2001;
29
1710-1713
20
Brady M, Kinn S, Stuart P.
Preoperative fasting for adults to prevent perioperative complications. Cochrane Data Base Syst.
Rev.
2003;
(4)
CD 004 423
21
Brehmer D, Laubert A.
Diagnosis of postoperative dysphagia and aspiration. Fiberoptic-endoscopic controlled methylene blue drinking.
HNO.
1999;
47
479-484
Thomas Kerz, M. D.
Department of Neurosurgery · Johannes Gutenberg-University Hospital School of Medicine
Langenbeckstrasse 1
55131 Mainz
Germany
Telefon: +49-6131-172006
Fax: +49-6131-176634
eMail: kerz@mail.uni-mainz.de