Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Mar 2006
Case ReportsSevere bronchospasm during laryngeal mask airway placement in an infant.
A 35-day-old male infant was scheduled for bilateral inguinal herniorrhaphy. No history of recent upper airway infection or other reactive respiratory disease was noted before anesthesia. Breath holding was noted immediately after laryngeal mask airway (LMA) insertion. ⋯ After deepening the inhalational anesthesia of sevoflurane and concomitant administration of intravenous lidocaine, the patient's respiratory condition turned for the better and became compliable. Respiratory dysfunction may be caused by severe bronchospasm induced by placement of the LMA. The pathophysiology and risk factors of bronchospasm related to the LMA placement are discussed in the text.
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Acta Anaesthesiol Taiwan · Mar 2006
Case ReportsDifficult oral endotracheal intubation in an acromegalic patient receiving transsphenoidal surgery--a case report.
Patients suffering from acromegaly are associated with increased risks of difficult airway management. We report a case of acromegaly scheduled for transsphenoidal resection of pituitary adenoma under general anesthesia in whom all possible means failed us in the insertion of the endotracheal tube (ET) through the mouth, a procedure essential for transsphenoidal surgery. ⋯ Five days later, awake oral fiberoptic intubation was successful under topical anesthesia. We suggest that oral endotracheal intubation performed awake under topical anesthesia with the aid of a fiberoptic bronchoscope is a choice approach in acromegalic patients with predicated difficult airway who are to receive surgery.
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Acta Anaesthesiol Taiwan · Mar 2006
Randomized Controlled TrialClosed-circuit anesthesia preserves skin blood flow during surgery.
Closed-circuit anesthesia (CCA) has been suggested to provide better hemodynamic stability, but the relative contribution of CCA to the control of blood flow in microcirculation is not defined. It is hypothesized that isoflurane-based CCA provides a favorable skin blood flow mediating via lesser circulatory response to surgical stimulation. This study was purposed to compare the effects of isoflurane conveyed by CCA with that by semiclosed anesthesia (SCA) on the preservation of skin blood flow in the forearm. ⋯ Closed circuit technique for isoflurane anesthesia is feasible and advantageous. It not only facilitates favorable skin blood flow but also provides better hemodynamic stability in comparison with semiclosed technique for isoflurane anesthesia.
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Acta Anaesthesiol Taiwan · Mar 2006
Case ReportsCardiac arrest during spinal anesthesia: a report of two cases.
Spinal anesthesia is a widely practiced technique for both elective and emergency procedures. It is so recommended because of its efficacy and safety. ⋯ We report here two instances of cardiac arrest during spinal anesthesia in young healthy people. Discussions on the causes, management, and prevention of cardiac arrest following spinal anesthesia are also brought forward in the text.
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Acta Anaesthesiol Taiwan · Mar 2006
Case ReportsCardioversion corrects cardiac arrhythmia and reverts the resultant reversed shunt flow direction during transcatheter closure of atrial septal defect--a case report.
Closure of atrial septal defect (ASD) is critically dependent on the shunt flow direction. However, shunt flow direction through ASD may change under variable clinical conditions. ⋯ The cardiac arrhythmia and altered shunt direction simultaneously reverted to the old state after cardioversion. A successful placement of Amplatzer septal occluder was successfully performed afterward and she recovered uneventfully.