Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
-
Acta Anaesthesiol Taiwan · Jun 2007
Randomized Controlled TrialMagnesium infusion and postoperative atrial fibrillation: a randomized clinical trial.
Postoperative arrhythmias are among the most common complications of cardiac surgery. Total serum magnesium concentration will change after coronary bypass surgery but compensatory prophylactic administration of magnesium has remained a controversial issue. We studied whether prophylactic administration of magnesium could prevent post-coronary artery bypass grafting (CABG) arrhythmias and evaluated the effects of diabetes mellitus on prophylactic magnesium administration. ⋯ The occurrence of atrial fibrillation correlates with serum magnesium level. Diabetes mellitus probably hampers prophylactic effect of supplemental magnesium in preventing the occurrence of Af.
-
Acta Anaesthesiol Taiwan · Jun 2007
Case ReportsMethemoglobinemia induced by exposure to topical benzocaine for an awake nasal intubation--a case report.
Topical benzocaine and lidocaine are widely used in general anesthesia to minimize the stimulation by awake intubation and in very rare occasion they may induce methemoglobinemia. Although this complication is uncommon, it may be potentially lethal. Here we report a 29-year-old female who was scheduled to receive correction of malocclusion and developed acute methemoglobinemia soon after induction of general anesthesia. ⋯ The diagnosis was confirmed by multiple-wavelength CO-oximetry. The methemoglobinemia was resolved gradually after methylene blue was given. In conclusion, we must always take the possibility of methemoglobinemia into consideration for differential diagnosis in case of unexplained cyanosis, particularly when patients have prior exposure to methemoglobin-inducing agents.
-
Acta Anaesthesiol Taiwan · Jun 2007
Ultrasound examination for the optimal head position for interscalene brachial plexus block.
Surface anatomic landmarks have traditionally been used to locate the brachial plexus in the interscalene groove. Head rotation can affect the orientation of neck vessels and may possibly affect the brachial plexus. The optimal degree of head rotation has been specified for better internal jugular vein cannulation but not for interscalene brachial plexus block. The purpose of this study was to evaluate the influence of head rotation on interscalene brachial plexus block. ⋯ Whenever we perform interscalene brachial plexus block, the head rotation angle should not exceed 30 degrees. The measured medial deviation of surface landmark should be considered when it is used to approach interscalene brachial plexus.
-
Acta Anaesthesiol Taiwan · Jun 2007
Case ReportsMassive pulmonary embolism during orthopedic surgery.
A 90-year-old female patient undergoing surgery for knee and hip fractures under general anesthesia sustained cardiac arrest intraoperatively. The transesophageal echocardiography performed during resuscitation revealed massive pulmonary embolism with a 2 x 3 cm oval-shaped thrombus in the bifurcation of pulmonary artery. ⋯ Subsequently the patient developed liver and acute renal failures in consequence of hypoperfusion during the intraoperative resuscitation, and died of multiple organ failure 21 days after the procedure. We conclude that transesophageal echocardiography is a useful diagnostic instrument and should be utilized in high risk patient as early as possible, even before and during surgery.
-
Acta Anaesthesiol Taiwan · Jun 2007
Effect of intrathecal NG-nitro-L-arginine methyl ester administration on Fos expression in the spinal dorsal horn in rats following sciatic nerve ligation.
In the available literature, the pro- or antinociceptive role of nitric oxide (NO) is warmly disputed. As a marker of neuronal activation of the central nervous system, Fos expression has been widely used to assess the change in central neuronal activity evoked by peripheral input. In this study, we examined the effect of intrathecal L-NAME, a non-selective nitric oxide synthase (NOS) inhibitor, on nociceptive behavior and spinal Fos expression in rats following chronic constriction injury (CCI) of sciatic nerve, a model of neuropathic pain similar to that observed in clinical setting. ⋯ Spinal Fos expression could be induced by different mechanisms, and it should not regarded as a reliable marker of pain sensation disorders. NO plays an important role in the development of nociception and spinal Fos expression through central sensitization mediated by peripheral nerve injury.