Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2004
Case ReportsSuccessful detection and management of unexpected endotracheal tube kinking during neurosurgery--a case report.
Kinking of endotracheal tube (ETT) is not an infrequent problem during general anesthesia. However, failure to secure free airway following airway obstruction due to kinking of endotracheal tube or other tube problems may lead to lethality instead of lifesaving. We describe a case of unexpected kinking of ETT intraorally while craniotomy was underway. ⋯ In this case report we would like to highlight how to accurately and quickly diagnose and manage the ETT kinking intraorally while craniotomy was in process under anesthesia. Emphasis is also laid on the importance of properly positioning of the head and neck prior to any operation especially in craniotomy. Besides, the flexometallic (FM) or armoured endotracheal tubes may be good substitutes for the polyvinyl chloride (PVC) ones in preventing the ETT kinking during general anesthesia.
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Acta Anaesthesiol Taiwan · Jun 2004
Randomized Controlled Trial Clinical TrialOral slow release dextromethorphan premedication provides a pethidine spare effect on posthemorrhoidectomy pain management.
In our previous study, we had demonstrated that intramuscular (i.m.) dextromethorphan (DM) could provide a preemptive analgesic effect and improve postoperative pain management. Regrow is a long-duration slow-release oral dextromethorphan available for clinical use with good patient compliance. The present study was designed to examine whether oral regrow may also offer the same preemptive analgesic effect as i.m. DM does in postoperative pain management. ⋯ This study revealed that premedication of oral regrow 240 mg provided a preemptive analgesic effect, thus reducing the severity of postoperative pain and pethidine requirement in post-hemorrhoidectomy patients.
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Acta Anaesthesiol Taiwan · Jun 2004
Randomized Controlled Trial Clinical TrialEffect of intravenous midazolam premedication on postoperative nausea and vomiting after cholecystectomy.
Several drugs and techniques have been used to reduce the incidence of postoperative nausea and vomiting (PONV). However PONV continues to be a common postoperative complication. Midazolam premedication in pediatric patients has been reported to reduce the incidence of PONV. In the present study the effect of intravenous midazolam premedication on the incidence and severity of PONV was investigated in a sample of adult patients undergoing anesthesia for cholecystectomy. ⋯ The results of this study suggest the effectiveness of prophylactic intravenous midazolam premedication to reduce the incidence and severity of postoperative nausea and vomiting. Possible mechanisms for this effect of midazolam may be GABA receptor antagonism, inhibition of dopamine release, and anxiolytic effects.