Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2011
Randomized Controlled TrialThe effect of combined ephedrine and lidocaine pretreatment on pain and hemodynamic changes due to propofol injection.
Injection pain and hypotension are two main adverse effects of propofol that discourage uniform acceptation. The aim of this study was to compare the effect of ephedrine-lidocaine combination with lidocaine and ephedrine alone on injection pain and hemodynamic changes caused by propofol injection. ⋯ Pretreatment with combination of small-dose ephedrine and lidocaine could reduce the incidence and intensity of propofol-induced pain and also result in more stable hemodynamic profile, but however, the combination of two drugs failed to work better in further reduction of pain.
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Acta Anaesthesiol Taiwan · Jun 2011
Case ReportsBacterial infection in deep paraspinal muscles in a parturient following epidural analgesia.
We report a case of paraspinal muscle infection shortly after epidural analgesia for labor pain in a nulliparous parturient who was subjected to emergent Cesarean section because of fetal distress. Epidural morphine was administered for 3 days for postoperative pain control. She began to have constant lower back pain on postpartum Day 4. ⋯ Epidural analgesia is effective to control labor pain and, in general, it is safe. However, the sequelae of complicated infection may be underestimated. We herein report a case complicated by iatrogenic infection, discuss the causes, and give suggestions for prevention.
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Acta Anaesthesiol Taiwan · Jun 2011
Case ReportsSuccessful reversal of bupivacaine and lidocaine-induced severe junctional bradycardia by lipid emulsion following infraclavicular brachial plexus block in a uremic patient.
Cardiac toxicity of bupivacaine has long been documented and it could be potentiated in certain circumstances, such as preexisting cardiac conduction abnormality or uremic status. The concept that lipid emulsion acts as a rescue of bupivacaine's toxicity has prevailed pending universal recognition. Herein, we report the successful use of lipid to resuscitate a female uremic patient who sustained junctional bradycardia while she was receiving ultrasound-guided infraclavicular brachial plexus block with the dose of local anesthetics far below the currently recommended maximum one. The possible mechanisms for the occurrence of cardiotoxicity in this case are discussed and the role of lipid emulsion as a treatment is reviewed.
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Acta Anaesthesiol Taiwan · Jun 2011
Case ReportsModified lightwand intubation in a child with spondyloepiphyseal dysplasia congenita.
This is the case report on a 1-year 9-month-old boy suffering from spondyloepiphyseal dysplasia congenita who was successfully intubated with our modified lightwand intubation procedure for general anesthesia to undergo bilateral herniorrhaphy despite the great likelihood of facing a difficult airway because of unstable cervical spine. We bent the pediatric wand after it was encased in an endotracheal (ET) tube of appropriate diameter. The light tip of the wand was let to protrude just out of the bevel of the ET tube. ⋯ The patient recovered from anesthesia smoothly and was discharged on the next day. This maneuver can facilitate both visual and tactile confirmations of the position and proper tube size. The effectiveness and safety of our modified lightwand intubation procedure is well demonstrated.
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Acta Anaesthesiol Taiwan · Mar 2011
Randomized Controlled Trial Comparative StudyComparison of auditory evoked potential index and clinical signs as indicator for laryngeal mask airway insertion.
Auditory evoked potential (AEP) index is one of the several physiological parameters for assessing the depth of anesthesia. The purpose of this study was to investigate whether the AEP monitoring could provide a better information for assessment of anesthesia level in classic laryngeal mask airway (C-LMA) insertion than the use of clinical signs in general anesthesia with single standard dose of intravenous propofol and fentanyl. ⋯ This study demonstrated that AEP index provided better information for C-LMA insertion with higher successful rate, less emergence of airway reflex and lower incidence of movement during induction of general anesthesia with single dose of intravenous propofol and fentanyl.