Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2011
The use of the GlideScope® for tracheal intubation in patients with halo vest.
GlideScope® provides better laryngoscopic view and is advantageous in tracheal intubation in ankylosing spondylitis patients with difficult airway. ⋯ The use of the GlideScope® for tracheal intubation could be an alternative option in patients with a difficult airway, whose surgery was circumscribed under general anesthesia with tracheal intubation.
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Acta Anaesthesiol Taiwan · Sep 2011
Apparatus and simple method of monitoring neuromuscular function.
The use of muscle relaxant is an integral part of anesthetic management in present-day practice. Clinically, the neuromuscular blockade is evaluated by determining the thumb twitching to train-of-four (TOF) ulnar nerve stimulation at elbow.(1-3) There are many ways for the assessment of twitch response, such as the use of electromyography(4,5); force displacement transducer techniques(2,6-9); and most recently, the acceleration transducer-based system of neuromuscular monitoring.(10-15) These equipments are, however, bulky, cumbersome, expensive, or time consuming for operation. Because of these limitations, the routine use of such monitors is impractical. ⋯ Clearly, there is a need for a simple and practical way of measuring the twitch responses to TOF stimulation during anesthesia. Based on the current method of stimulation of the ulnar nerve over the ulnar groove at the elbow, which elicits a string thumb adduction (because of stimulation of the flexor carpi ulnaris muscle), a simple method that can objectively monitor and record the thumb twitch is developed. The unique features of the method or device are its simplicity and its ability to adapt to any pressure transducer to display the twitch response to TOF simultaneously with electrocardiogram, arterial, or central venous pressure.
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Acta Anaesthesiol Taiwan · Sep 2011
Editorial CommentDexamethasone: not only an effective antiemetic.
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Acta Anaesthesiol Taiwan · Sep 2011
ReviewDexamethasone prevents postoperative nausea and vomiting: benefit versus risk.
Postoperative nausea and vomiting (PONV) is a common annoying experience after surgery. The overall incidence of PONV in adults is 20-30%; the incidence rate in patients of high-risk groups can be as high as 70-80%. Children are not exempted from attacking either; the incidence rate in children above the age of 3 is more than 40%. ⋯ Additionally, the use of dexamethasone to prevent nausea and vomiting triggered by intravenous or epidural morphine for pain control can also offer a good therapeutic effect. To date, clinically, dexamethasone as a preventative drug against PONV has not caused fatal outcome; therefore, it is generally considered to be an effective and safe antiemetic. Nevertheless, its use in this regard may lead to adverse effects, principally postoperative hyperglycemia and infection.
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Acta Anaesthesiol Taiwan · Sep 2011
Randomized Controlled TrialPostoperative agitation in preschool children following emergence from sevoflurane or halothane anesthesia: a randomized study on the forestalling effect of midazolam premedication versus parental presence at induction of anesthesia.
The effect of midazolam premedication on forestalling postoperative agitation in children is not yet concluded. The purpose of this study was to compare the effects of midazolam premedication and parental presence during anesthetic induction on the incidence of postoperative agitation in pediatric patients. ⋯ Based on our data, the presence of a parent at induction of sevoflurance anesthesia was as effective as midazolam premedication in decreasing the incidence of postoperative agitation. Midazolam premedication, however, decreased postoperative agitation when halothane was used as the anesthetic agent.