Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
-
Acta Anaesthesiol Taiwan · Mar 2008
Case ReportsPenetrating injury of the palatoglossal arch associated with use of the GlideScope videolaryngoscope in a flame burn patient.
The GlideScope is used to facilitate exposure of the larynx in both routine and difficult airways. A 38-year-old woman with a flame burn (second/third-degree, 40% total body surface area) and inhalation injury accompanied by acute respiratory failure under mechanical ventilation support presented for wound debridement and split thickness skin grafting. After the surgery, the endotracheal tube was reinserted successfully with a GlideScope because we anticipated a problematic airway. ⋯ This is a report on a rare complication caused by tracheal intubation associated with the use of the GlideScope. We recommend manipulation of the GlideScope should be performed with care under vigilant surveillance to minimize injury to the oropharyngeal tissues when an endotracheal tube is advanced from the mouth to the pharynx. Potential complications should be always kept in mind when the GlideScope is used for intubation.
-
Acta Anaesthesiol Taiwan · Mar 2008
Evaluation of the adequacy of general anesthesia in cesarean section by auditory evoked potential index: an observational study.
One of the hazards of general anesthesia for cesarean section (C/S) is the risk of intraoperative awareness with or without recall of the event. We examined the relationship between auditory evoked potential index (AAI), end-tidal isoflurane concentration and hemodynamic parameters to evaluate the adequacy of our routine general anesthetic technique in C/S. ⋯ Our current general anesthetic technique appears to provide an inadequate depth of anesthesia, especially before uterine closure as a milestone. Also, we found a moderate correlation between AAI and end-tidal isoflurane concentration and, to a lesser extent, with heart rate and mean blood pressure during isoflurane-N2O anesthesia for C/S.
-
Acta Anaesthesiol Taiwan · Mar 2008
Case ReportsIntrapleural misplacement of a thoracic epidural catheter in an anesthetized patient.
Thoracic epidural analgesia provides adequate postoperative pain relief and favorable outcomes in major operations. However, a small number of devastating complications have been reported. Here we present a case of asymptomatic but potentially life-threatening intrapleural insertion of a thoracic epidural catheter intended for postoperative analgesia. ⋯ After right thoracotomy, the epidural catheter was found in the right pleural cavity and was instantly removed. The patient underwent the operation smoothly and was discharged 10 days later without any sequelae. We recommend practitioners estimate the depth from the skin to the epidural space by computed tomography scan before operation and perform the placement of thoracic epidural catheter while the patient is awake to avoid accidental intrapleural misplacement.
-
Acta Anaesthesiol Taiwan · Mar 2008
Factors associated with vomiting in orthopedic patients receiving patient-controlled epidural analgesia.
Although patient-controlled epidural analgesia (PCEA) can effectively relieve postoperative pain in orthopedic patients, some adverse effects are still troublesome. We conducted this study to survey the possible risk factors related to vomiting induced by PCEA. ⋯ Our study demonstrated the risk factor associated with vomiting for orthopedic patients receiving PCEA was female sex. Other demographic variables and factors related to surgery or anesthesia did not have an influence on vomiting.