Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Mar 2009
Randomized Controlled Trial Comparative StudyHaloperidol plus ondansetron prevents postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.
A combination of antiemetic drugs could be an effective method to prevent severe postoperative nausea and vomiting (PONV). Therefore, we examined the prophylactic effect of haloperidol plus ondansetron on PONV. ⋯ We conclude that the combination of prophylactic haloperidol (2 mg) plus ondansetron (4 mg) provides a higher complete response rate and greater patient satisfaction after laparoscopic cholecystectomy than either drug used alone.
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Acta Anaesthesiol Taiwan · Mar 2009
Comparative StudyComparison of the effect of epidural and intravenous patient-controlled analgesia on bowel activity after cesarean section: a retrospective study of 726 Chinese patients.
Epidural patient-controlled analgesia (EPCA) and intravenous patient-controlled analgesia (IVPCA) have been used widely in parturients after cesarean section. Although many studies have demonstrated the safety and effectiveness of both EPCA and IVPCA, their effects on bowel activity of patients who have undergone cesarean section delivery have not yet been investigated. The purpose of this study was to compare the effect of EPCA and IVPCA on bowel activity after cesarean section. ⋯ PCA is safe and effective in alleviating postoperative pain following cesarean section. EPCA offers a faster return of bowel activity, lower VAS scores, and better patient satisfaction than IVPCA.
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Acta Anaesthesiol Taiwan · Mar 2009
Randomized Controlled TrialEffects of ephedrine on intubating conditions following priming with atracurium: a randomized clinical trial.
Priming is a well-known method to accelerate the onset of action of nondepolarizing neuromuscular-blocking agents. It consists of administration of a small dose of neuromuscular blocking agent several minutes before the principal dose is given. Ephedrine has been shown to improve the intubating conditions of rocuronium following its priming with a small dose. However, the potential effects of ephedrine on intubating conditions using atracurium after its priming with a small dose have not yet been studied. Since rocuronium is not available in Iran, atracurium is widely used as an alternative. ⋯ The effects of ephedrine on improving intubating conditions following atracurium priming were not statistically significant. Given the risk of exacerbation of coronary ischemia by tachycardia, and the negative results on intubating conditions in our study, we cannot recommend the use of ephedrine for improving intubating conditions following priming with atracurium.
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Acta Anaesthesiol Taiwan · Mar 2009
Case ReportsTransient unilateral hypoglossal nerve palsy after orotracheal intubation for general anesthesia.
Perioperative hypoglossal nerve palsy is a rare postoperative complication. Here, we present a case of transient unilateral hypoglossal nerve palsy after shoulder surgery. ⋯ Therefore, in order to prevent this complication, we must perform mask ventilation and direct laryngoscopy carefully. Head and neck manipulation should be gentle during anesthesia for shoulder surgery.
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Acta Anaesthesiol Taiwan · Mar 2009
Case ReportsPerioperative airway management in a child with Treacher Collins syndrome.
We report the perioperative airway management in a 12-year-old boy suffering from Treacher Collins syndrome (TCS) and severe mental retardation who was scheduled for elective dental treatment under general anesthesia. TSC is also known as mandibulofacial dysostosis or Franceschetti syndrome, usually with a potentially difficult airway presentation. It is a major challenge for the anesthesiologist to manage an uncooperative child with such a congenital airway anomaly. ⋯ In an expedient critical trial, with the cooperation of two anesthesiologists, one performing nasal fiberoptic intubation and the other maintaining oral mask ventilation, a nasal endotracheal tube was successfully placed at the first attempt, although at the expense of prolonged respiratory depression in the patient. Therefore, fiberoptic nasal intubation simultaneously with mask ventilation for placement of the endotracheal tube is a practical substitute for a difficult airway usually managed by LMA with inadequate ventilation. After extubation, tracheostomy may be indicated if the TCS patient suffers from persistent difficult upper airway in consequence of a traumatic intubation.