Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2009
Closed-loop control of anesthesia using the bispectral index in open heart surgery.
The introduction of the bispectral index (BIS) as a comprehensive indicator of depth of anesthesia has prompted research in the automated delivery of anesthetics. This trial aimed to evaluate the usefulness of the BIS as the feedback variable in a closed-loop anesthesia control system during cardiac surgery under cardiopulmonary bypass (CPB). ⋯ The closed-loop control of anesthetic delivery adjusted to BIS is feasible and may be useful in open heart surgery under hypothermic CPB.
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Acta Anaesthesiol Taiwan · Sep 2009
Effects of propofol sedation during the early postoperative period in hemorrhagic stroke patients.
The early postoperative period is a critical time for patients after receiving a decompressive craniotomy. Prompt detection and early management of postoperative recurrent/residual hemorrhagic complications may dramatically improve clinical outcomes. ⋯ Our results support the use of propofol sedation during the early postoperative period after craniotomy in hemorrhagic stroke patients, because it improved both neurologic and clinical outcomes. However, early postoperative use of propofol sedation at larger dosages warrants special attention.
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Acta Anaesthesiol Taiwan · Sep 2009
Accuracy of the central landmark for catheterization of the right internal jugular vein after placement of the ProSeal laryngeal mask airway.
Catheterization of the internal jugular vein (IJV) after placement of a laryngeal mask airway (LMA) has been reported to be difficult. The purpose of this study was to evaluate the accuracy of the central landmark for catheterization of the right IJV after placement of a ProSeal LMA. ⋯ After placement of the ProSeal LMA, the central landmark could not offer a good success rate at the first puncture attempt. When using the central landmark to catheterize the IJV after a ProSeal LMA placement, medial deviation of the central landmark should be considered. Ultrasound guidance may be helpful in difficult cases.
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Acta Anaesthesiol Taiwan · Sep 2009
Comparative StudyPlatelet function analyzer (PFA-100) offers higher sensitivity and specificity than thromboelastography (TEG) in detection of platelet dysfunction.
The development of advanced surgical procedures requires novel and early diagnostic techniques. One of the prime difficulties that need to be overcome is an abnormality in the coagulation system. The blood clot formation and fibrinolysis processes are very complicated and important perioperatively. However, most of the major surgeries, such as liver transplantation, use thromboelastography (TEG) for detection of coagulation abnormalities, even though TEG is not actually an ideal option. Therefore, we compared the sensitivity and specificity of the platelet function analyzer (PFA-100) and thromboelastogram (TEG) in predicting platelet dysfunction and bleeding risk. ⋯ We conclude that PFA-100 offers a higher sensitivity and specificity than TEG in detection of platelet dysfunction.
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Acta Anaesthesiol Taiwan · Sep 2009
Case ReportsAnesthetic management of a patient with congenital methemoglobinemia.
Methemoglobinemia occasionally causes cyanosis particularly in congenital methemoglobinemia. Avoidance of exposure to oxidizing agents is important for patients with congenital methemoglobinemia because of their deficient enzymatic pathways and decreased oxygen-carrying capacity. ⋯ Methemoglobinemia was first suspected intraoperatively because of a mismatch of SpO2 of finger pulse oximetry and SaO2 of arterial blood, and was later confirmed by multiple-wavelength CO-oximetry. The pathophysiology, etiology, clinical manifestations, anesthetic considerations, and treatment options of methemoglobinemia are discussed.