Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
-
Acta Anaesthesiol Taiwan · Dec 2011
Case ReportsTrachway intubating stylet for tracheal intubation in an ankylosing spondylitis patient undergoing total hip replacement under general anesthesia.
The Trachway is a new device which provides better glottic view than conventional direct laryngoscopy during tracheal intubation. This intubating stylet consists of a camera on the distal tip of the style, with a monitor attached to the rechargeable handle, so that it can overcome the difficulty of limited neck motion and mouth opening in tracheal intubation. ⋯ The Trachway was successfully used for oral tracheal intubation at the first attempt. The Trachway can be an alternative choice for intubation in ankylosing spondylitis patients.
-
Acta Anaesthesiol Taiwan · Dec 2011
Biphasic effects of chronic intrathecal gabapentin administration on the expression of protein kinase C gamma in the spinal cord of neuropathic pain rats.
Patients suffering from neuropathic pain are difficult to treat and many methods are used to resolve this issue. In this study, we used a model of neuropathic pain comprising rats with chronic constriction injury (CCI) on the left sciatic nerve to investigate the chronic effect of gabapentin via intrathecal administration. We also observed the expression of dorsal spinal protein kinase C gamma subunit (PKCγ) and other pain-related molecules in the spinal area which included cyclooxygenase 2 (COX2), c-Fos and cyclic AMP-dependent transcription factor (ATF3) in the neuropathic pain animals. ⋯ Our results indicate that chronic intrathecal gabapentin has beneficial effects on the behaviors of both thermal and mechanical stimulations in the neuropathic pain animals and the NMDA blocker can potentiate this effect. Furthermore, gabapentin has biphasic effect on the expression of PKCγ in the spinal cord on Day 7 and Day 14 for the model rats with CCI.
-
Acta Anaesthesiol Taiwan · Dec 2011
Review Case ReportsIncidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports.
Dexmedetomidine has predictable, complex, and negative cardiovascular effects that lead to additional adverse effects such as bradycardia and hypotension in up to 42% of patients and might cause profound left ventricular dysfunction and refractory shock. Usually, these temporary effects can be successfully counteracted with atropine, ephedrine, and volume supplementation. ⋯ Here, we report the clinical characteristics of six patients who were scheduled for various neurosurgical procedures within a period of three months and suffered from cardiac arrest following dexmedetomidine administration. We urge clinicians to take caution against the negative effects of dexmedetomidine, especially when it is used in patients older than 50 years with underlying cardiac disease and in combination with cardiodepressant drugs.
-
Increasing evidence indicates that inhalational anesthetics may cause or increase the risk of developing postoperative cognitive dysfunction (POCD), especially in the elderly population. POCD may exist as a transient or long-term complication of surgery and anesthesia and is associated with reduced quality of life. ⋯ Other factors such as neuroinflammation and pro-inflammatory cytokines may also play a role. This paper reviews the role of inhalational anesthetics in the etiology and underlying mechanisms that result in POCD.