Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2008
Case ReportsAcute coronary syndrome in cisatracurium-induced anaphylactic shock: Kounis syndrome.
In this case report, we describe a 70-year-old male patient who sustained Kounis syndrome induced by cisatracurium administration immediately following induction of general anesthesia. Acute coronary syndrome combined with anaphylactic shock, termed Kounis syndrome, should be investigated in percutaneous coronary intervention to solve this complex and life-threatening condition. ⋯ In general, the incidence of an anaphylactic reaction to cisatracurium is low, but a high serum IgE level in combination with a positive skin prick test in our patient was strongly suggestive of cisatracurium-induced Kounis syndrome. In addition, a cross-reaction between cisatracurium and rocuronium is reported.
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Acta Anaesthesiol Taiwan · Dec 2008
Randomized Controlled TrialEfficacy of granisetron in preventing postanesthetic shivering.
Recently, 5-hydroxytryptamine 3 (5-HT3) receptor antagonists have been reported to prevent postanesthetic shivering. This placebo-controlled study was performed to evaluate the efficacy of granisetron, a 5-HT3 antagonist, in comparison with meperidine and tramadol in preventing postanesthetic shivering. ⋯ The prophylactic use of granisetron 40 microg/kg is as effective as meperidine (0.4 mg/kg) and tramadol (0.1 mg/kg) in preventing postanesthetic shivering without prolonging the emergence time from anesthesia.
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Acta Anaesthesiol Taiwan · Dec 2008
Randomized Controlled TrialPropofol infusion shortens and attenuates oxidative stress during one lung ventilation.
Resuming two lung ventilation (2LV) from one lung ventilation (OLV) has been proven to induce significant oxidative stress, mainly by superoxide release. Although total intravenous anesthesia and inhalational anesthesia are both used in thoracic surgery, different anesthetics may alter the oxidant/antioxidant balance. ⋯ Propofol infusion, compared with isoflurane inhalation, attenuates ROS production and limits it for 20 minutes after resuming 2LV from OLV. Propofol infusion may be beneficial to patients with inadequate antioxidant capacity.
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Acta Anaesthesiol Taiwan · Dec 2008
Ultrasonic cardiac output monitor provides accurate measurement of cardiac output in recipients after liver transplantation.
The ultrasonic cardiac output monitor (USCOM; USCOM Pty. Ltd., Sydney, NSW, Australia) has been accepted as a noninvasive device for measuring cardiac function in various clinical conditions. The present study aimed at comparing the accuracy of this device with that of the thermodilution technique in recipients in the early postoperative period after liver transplantation. ⋯ This is the first study to evaluate the accuracy of USCOM in the post-liver transplant setting. This device is accurate in measuring CO in liver transplant recipients postoperatively. Possible risks of arrhythmia, infection and pulmonary artery rupture can be avoided because of its noninvasive nature. USCOM should be considered as an alternative in hemodynamic monitoring after liver transplantation.
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Acta Anaesthesiol Taiwan · Dec 2008
Effects of dexmedetomidine on regulating pulmonary inflammation in a rat model of ventilator-induced lung injury.
We sought to elucidate the effects of dexmedetomidine, a selective alpha2-adrenergic receptor agonist, on the regulation of pulmonary inflammation in ventilator-induced lung injury (VILI) in a rat model. ⋯ Dexmedetomidine at clinically relevant doses had no significant effect in attenuating VILI. In contrast, dexmedetomidine at a dose approximately 10 times higher than the clinical dose significantly attenuated VILI. These effects of dexmedetomidine were mediated, at least in part, by the alpha2-adrenergic receptor.