The criminal offense of counterfeiting money in France from the revolution to the end of the 19th century

Milica Marinkovic
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Abstract

Introduction. General anesthesia is frequently employed in neck surgery procedures. However, in patients at high risk for general anesthesia, regional anesthesia options, such as the superficial cervical plexus block, warrant careful consideration. Patients with mediastinal lymph node enlargement face an elevated risk of airway obstruction and hemodynamic mediastinal instability during anesthesia induction. In selected neck surgeries, including thyroglossal cyst excision, thyroglossal fistula repair, bronchial cyst removal, thyroidectomy, and lymph node excision, the superficial cervical plexus block presents a viable and secure alternative to general anesthesia. Case report. This report details the case of a patient with mediastinal lymphadenopathy and multiple brain metastases who underwent cervical lymph node excision. Given the patient?s severe comorbidities, pronounced risk of complete distal airway obstruction, hemodynamic instability, and the potential for compression effects from mediastinal mass, a superficial cervical block was administered. This block facilitated effective perioperative analgesia without inducing respiratory or cardiovascular instability. Conclusion. The superficial cervical plexus block emerges as a prudent alternative to general anesthesia in high-risk patients necessitating cervical lymph node excision procedures. Its utilization should be considered in such cases to enhance patient safety and perioperative management.
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法国从革命时期到19世纪末的伪钞犯罪
介绍。全身麻醉常用于颈部外科手术。然而,对于全麻风险高的患者,区域麻醉的选择,如颈浅丛阻滞,值得仔细考虑。在麻醉诱导过程中,纵隔淋巴结肿大的患者面临气道阻塞和纵隔血流动力学不稳定的高风险。在某些颈部手术中,包括甲状舌囊肿切除、甲状舌瘘修复、支气管囊肿切除、甲状腺切除术和淋巴结切除,颈浅丛阻滞是一种可行且安全的替代全身麻醉的方法。病例报告。本文报告一例纵隔淋巴结病变合并多发性脑转移的患者行颈部淋巴结切除术。考虑到病人?严重的合并症,明显的远端气道完全阻塞风险,血流动力学不稳定,以及纵隔肿块的潜在压迫作用,给予浅颈阻滞。这种阻滞有助于有效的围手术期镇痛,而不会引起呼吸或心血管不稳定。结论。对于需要进行颈部淋巴结切除手术的高危患者,浅颈神经丛阻滞是全身麻醉的一种谨慎选择。在这种情况下应考虑使用它,以加强患者的安全和围手术期管理。
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