Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2013
Comparative StudyFeasibility of combined paravertebral block and subcostal transversus abdominis plane block in postoperative pain control after minimally invasive esophagectomy.
Subcostal transversus abdominis plane (TAP) block and paravertebral block (PVB) offer postoperative analgesia for laparoscopic and thoracoscopic surgery, respectively. We investigated the early postoperative analgesic effects of PVB in combination with subcostal TAP block in patients undergoing minimally invasive esophagectomy (MIE) for esophageal cancer. ⋯ PVB in combination with subcostal TAP block could reduce morphine consumption and pain severity in the early postoperative period but did not offer other clinical benefits in MIE.
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Acta Anaesthesiol Taiwan · Sep 2013
Agonal gasps of cardiac arrest victim can aid in confirming tracheal intubation using Umesh's intubation detector.
Several patients of cardiac arrest may be found in a state of agonal gasps that are of insufficient tidal volume and are not considered as a sign of life. However, this volume is sufficient enough to cause appreciable inflation and deflation of the reservoir bag of Umesh's intubation detector (UID) as evidenced in all 12 victims of cardiac arrest with gasping efforts in this study. Therefore, we conclude that the agonal gasps during cardiac arrest can reliably be used to confirm tracheal intubation using the UID device.
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Acta Anaesthesiol Taiwan · Sep 2013
Case ReportsBrainstem anesthesia presenting as contralateral third nerve palsy following peribulbar anesthesia for cataract surgery.
Brainstem anesthesia is a serious complication that has been reported to occur more commonly with retrobulbar anesthesia compared to peribulbar anesthesia. We herein report a case of contralateral third nerve palsy following administration of peribulbar anesthesia for cataract surgery. Two hours after the surgery, the patient recovered completely without any residual neurological deficit. The importance of immediate recognition of clinical signs and symptoms of central spread of the local anesthetic and the mechanical factors of the block that could have contributed to this complication are discussed in this report.
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Acta Anaesthesiol Taiwan · Sep 2013
Timing of epidural analgesia intervention for labor pain in nulliparous women in Taiwan: a retrospective study.
Labor pain is probably the most painful event in a woman's life. By the present consensus, epidural analgesia is the most effective and least depressive treatment for labor pain. Recent systematic reviews concluded that the risk of cesarean delivery or instrumental vaginal delivery for women receiving early epidural analgesia has not increased. However, studies designed for discussing this topic in Taiwan are few. In this study, the association of the intervention timing with labor outcomes in nulliparous women in Taiwan is discussed. ⋯ Our results revealed that the timing of epidural intervention affects neither the cesarean delivery rate nor the instrumental delivery rate on nulliparae in Taiwan with the cervical dilatation width ranging from 1 cm to 4 cm. The fear of increasing cesarean section rate after early epidural analgesia is unfounded. Women in labor can choose pain relief at any time.