Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsAcute cardiovascular collapse after pericardial drainage in a patient with aortic dissection.
Proximal aortic dissection is frequently associated with cardiac tamponade. The treatment sometimes is difficult. We present a 69-year-old female patient who after repeated episodes of syncope received an open drainage of pericardial effusion that ended in a fatal outcome. ⋯ She developed sudden cardiovascular collapse following drainage of pericardial effusion to which she succumbed in spite of vigorous resuscitation. We suggest that the patients with cardiac tamponade complicated by aortic dissection must receive direct aortic repair together with intraoperative pericardial drainage. Selective or single pericardiocentesis should better be avoided.
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Acta Anaesthesiol Taiwan · Mar 2005
Randomized Controlled Trial Clinical TrialThe optimal injection time of alfentanil for blunting circulatory responses to tracheal intubation.
The aim of this study is to investigate the optimal injection time of alfentanil during induction of anesthesia to blunt the circulatory responses induced by laryngoscopy and tracheal intubation. ⋯ Considering equal effectiveness and fewer side effects, one minute before intubation is the optimal injection time of alfentanil to blunt the circulatory responses induced by laryngoscopy and tracheal intubation.
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsDelayed recovery of radial nerve function after axillary block in a patient receiving ipsilateral ulnar nerve transposition surgery.
A 68-year-old female who underwent right ulnar nerve transposition surgery under axillary block (AB) by dual-technique (paresthesia and axillary artery penetration techniques) developed postoperative wristdrop. Physical examination showed local hematoma formation with ecchymosis at her right axillary region. ⋯ Fortunately, she was completely restored to her right hand function 20 h after anesthesia, and was discharged without sequelae 17 days later. In this case, delayed recovery of radial nerve function after AB was suspected and the mechanism which led to this unusualness is discussed.
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsAirway obstruction caused by endotracheal tube cuff herniation during creation of tracheal stoma.
We report an unusual case of airway obstruction caused by herniation of endotracheal tube (ETT) cuff in a 62-year-old male who underwent surgery for hypopharyngeal carcinoma. During the procedure of creating a tracheal stoma, a new oral ETT was inserted by the surgical team to the lower portion of the trachea through the cut opening to replace the old for ventilation and prevention of soiling of the airway. Upon resumption of surgical manipulation, right endobronchial intubation was disclosed. ⋯ It was conceivable that endobronchial intubation with over-inflation of the tube cuff may cause cuff herniation, particularly when surgical manipulation was active at the adjacency, in spite of the use of a modern tube with low-pressure high-volume cuff. Performing the "cuff deflation test" is the simple way to diagnose cuff herniation. Awareness of this condition, especially when anesthesiologists lose direct control of the airway during such procedures is important because undesirable complications can be prevented through quick decision and action.
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A long-acting analgesic may be particularly desirable in patients with long-lasting pain. In order to provide a long-acting analgesic effect, a novel buprenorphine ester, buprenorphine palmitate, was synthesized in our laboratory. The aim of the study was to evaluate whether the ester had a long-lasting effect. ⋯ Intramuscular injection of buprenorphine palmitate in rats produced a long-lasting antinociceptive effect which was much longer (18-fold) than did intramuscular buprenorphine HCl.