Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2005
Case ReportsClipping of the appendix induced cardiac arrest during appendectomy under spinal anesthesia.
Bradycardia is commonly seen in high spinal anesthesia, however, evolution of cardiac arrest from sudden onset of severe bradycardia is infrequent. Prompt recognization and resuscitative measures are of paramount importance because they may insure a complete recovery without sequela as an aftermath. ⋯ Cardiac massage, manual ventilation with oxygen and low-dose epinephrine successfully resuscitated the patient. The possible mechanisms and management of this complication are also discussed.
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Acta Anaesthesiol Taiwan · Sep 2005
Randomized Controlled Trial Clinical TrialIntrathecal midazolam combined with low-dose bupivacaine improves postoperative recovery in diabetic mellitus patients undergoing foot debridement.
Intrathecal midazolam acts synergically with other anesthetics to relieve surgical pain, and the drug combination may decrease complications attributable to each component drug. This prospective study was to determine the spinal effects of low-dose of bupivacaine (5 mg) combined with intrathecal midazolam (2 mg) in diabetes mellitus (DM) patients undergoing foot debridement. ⋯ The combination of intrathecal midazolam and bupivacaine was a safe and effective anesthetic technique, and it also provided early recovery of motor function and reduced the requirement of analgesics postoperatively.
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Acta Anaesthesiol Taiwan · Sep 2005
Randomized Controlled Trial Clinical TrialClinical trial of nitroglycerin-induced controlled hypotension with or without acupoint electrical stimulation in microscopic middle ear surgery under general anesthesia with halothane.
Transcutaneous electrical stimulation (ES) has been shown to produce long-lasting fall of arterial blood pressure in animal or human models. Previous reports have shown that ES of acupuncture points (acupoints) enhances the hypotensive effect of isoflurane anesthesia. This study was designed to investigate the combined effect of acupoint ES and different infusion rates of nitroglycerin on controlled hypotension. ⋯ The result of this study shows that ES of ST36 combined with nitroglycerin infusion facilitates lowering of blood pressure and produces a bloodless surgical field. The mechanism of blood pressure lowering effect of acupoint ES may be reducing of norepinephrine and other sympathomimetic substances in the blood.
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Overactive inflammatory responses that destroy rather than protect are the crucial issues in the development of a spectrum of septic disease states, such as adult respiratory distress syndrome, systemic inflammatory response syndrome, septic shock, and multiple organ failure. This review focuses on an area in which alternative actions of intravenous anesthetics show much promise for sepsis: their effects on the inflammatory response and on inflammatory cells in vitro and in vivo. ⋯ Different intravenous anesthetics, such as propofol, ketamine, benzodiazepine and barbiturates, which produce different levels of inhibition of inflammatory effects, are discussed in this article. In addition, such modulations of inflammatory responses may be of great relevance to the practice of intensive care, and intravenous anesthetics may play significant roles in this regard.
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Acta Anaesthesiol Taiwan · Sep 2005
Does a new videolaryngoscope (glidescope) provide better glottic exposure?
The GlideScope (Saturn Biomedical Systems Inc, Burnaby, British Columbia, Canada) is a new videolaryngoscope designed as an alternative to the conventional laryngoscope. It was designed to facilitate glottic exposure during tracheal intubation. This study assessed the effectiveness of the GlideScope in providing glottic exposure. ⋯ The laryngeal view was better in the GildeScope group using this grading system. The GlideScope provided a better view of the glottis and is a useful alternative in airway management.