Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2013
Hyperglycemia is associated with poor outcomes in surgical critically ill patients receiving parenteral nutrition.
Hyperglycemia, a major side effect of patients receiving total parenteral nutrition (PN), is associated with higher mortality in critically ill patients. The aim of this study was to determine whether elevated blood glucose levels would be associated with worse outcomes in patients receiving PN. ⋯ The blood glucose level was associated with patient outcome and should be intensively monitored in critically ill surgical patients. We suggest that blood glucose levels should be controlled below 180 mg/dL in postoperative critically ill patients.
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Acta Anaesthesiol Taiwan · Jun 2013
ReviewEfficacy and practical issues of repetitive transcranial magnetic stimulation on chronic medically unexplained symptoms of pain.
Chronic pain is a common issue worldwide and remains a big challenge to physicians, particularly when the underlying causes do not meet any specific disease for settlement. Such medically unexplained somatic symptoms of pain that lack an integrated diagnosis in medicine have a high psychiatric comorbidity such as depression, and will require a multidisciplinary treatment strategy for a better outcome. Thus, most patients deserted management in spite of being inadequately treated and even presented with high resistance to analgesic drugs. ⋯ So far, some case series and randomized rTMS studies have reported on patients with certain medically unexplained symptoms (MUSs) of pain (e.g., psychogenic pain or somatic symptoms in major depression and fibromyalgia). However, there is still no review article that is specific to the efficacy of rTMS on chronic unexplained symptoms of pain. Therefore, in the present review, we ventured to clarify the terminology and summarized the analgesic effects of rTMS on chronic MUSs of pain.
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Acta Anaesthesiol Taiwan · Jun 2013
A combination of the modified Mallampati score, thyromental distance, anatomical abnormality, and cervical mobility (M-TAC) predicts difficult laryngoscopy better than Mallampati classification.
Unanticipated difficult tracheal intubation is a significant source of morbidity and mortality in anesthetized patients. A number of modules have been developed to predict difficult airways, but they are often complex in nature. We combined the modified Mallampati score (M), thyromental distance (T), anatomical abnormality (A), and cervical mobility (C) into a single scoring system with the acronym M-TAC, and evaluated it against Mallampati scoring. ⋯ The M-TAC scoring system has provided a higher sensitivity and specificity in predicting difficult laryngoscopy in comparison with Mallampati classification.
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Acta Anaesthesiol Taiwan · Jun 2013
Case ReportsA novel modified method of using Trachway intubating stylet for awake tracheal intubation in patients with anticipated difficult airway.
The Trachway intubating stylet is designed to facilitate tracheal intubation in anesthetized patients with a normal or difficult airway anatomy. The shortcoming of this device is the lack of a working channel to provide topicalization of the airway. ⋯ Transtracheal lidocaine injection was technically difficult in these patients because of neck obesity and thyroid enlargement, respectively. We believe that this modified method can be used to provide effective airway topicalization when Trachway intubating stylet is used for awake orotracheal intubation.
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Acta Anaesthesiol Taiwan · Jun 2013
Randomized Controlled TrialAddition of dexmedetomidine to ropivacaine improves cervical plexus block.
To investigate the sensory block onset time, duration time, and side effects of adding dexmedetomidine to ropivacaine for cervical plexus block. ⋯ The addition of 1 μg kg(-1) dexmedetomidine to ropivacaine for cervical plexus block could shorten the sensory block onset time and extend the duration of analgesia, and increased the quality of analgesia, with the patients being sedated and arousable.