Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2010
Case ReportsTakayasu aortoarteritis with dilated cardiomyopathy: anesthetic management of labor analgesia.
Takayasu aortoarteritis in a pregnant patient is often associated with severe life-threatening complications. The coexistence of associated dilated cardiomyopathy can further complicate the pregnancy, particularly during parturition and at the time of delivery. ⋯ The patient was man-aged with graded epidural analgesia instituted early in labor. Intermittent boluses of 0.0625% bupivacaine with 2 microg/mL fentanyl were administered epidurally, which provided adequate analgesia without impaired hemodynamic status.
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Acta Anaesthesiol Taiwan · Jun 2010
Case ReportsHypothermia as a cause of coagulopathy during hepatectomy.
We report a 27-year-old hemostatically competent female scheduled for partial hepatectomy. During the operation, she experienced an accidental inferior vena cava tear and suffered acute blood loss. ⋯ Despite sufficient blood transfusion and correction of her electrolyte imbalance, the poor hemostasis persisted. After per-forming peritoneal lavage with warm saline, her condition dramatically improved and her hypothermia and severe coagulopathy were reversed.
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Acta Anaesthesiol Taiwan · Jun 2010
Comparative StudyEpidural analgesia with low-concentration levobupivacaine combined with fentanyl provides satisfactory postoperative analgesia for colorectal surgery patients.
Epidural patient-controlled analgesia (EPCA) with a mixture of low-concentration levobupivacaine (0.0625% or 0.1%) plus fentanyl, with basal infusion, has been extensively used for postoperative analgesia in our allied institutions. To elucidate whether these two EPCA regimens provide satisfactory analgesia, we compared the analgesia efficacy and incidence of drug-related side effects for both EPCA regimens with those of the most widely used postoperative analgesia regimen, intra-venous PCA (IVPCA) with morphine. ⋯ Epidural analgesia with low-concentration levobupivacaine plus fentanyl provides satisfactory postoperative analgesia with few side effects for patients after colorectal surgery.
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Acta Anaesthesiol Taiwan · Jun 2010
Evaluation of the relationships between intravenous patient-controlled analgesia settings and morphine requirements among patients after lumbar spine surgery.
To evaluate the association between daily morphine requirement and the intravenous patient-controlled analgesia (IVPCA) setting in patients undergoing spinal surgery. ⋯ The number of vertebrae involved was significantly associated with the daily IVPCA requirement. The IVPCA settings, including priming dose, basal infusion rate and bolus dose, did not affect the daily morphine requirements.
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Acta Anaesthesiol Taiwan · Mar 2010
Case ReportsButterfly-like knotting of a lumbar epidural catheter.
We report a female patient with osteoarthritis of both knees, who was scheduled for bilateral total knee arthroplasty under spinal and lumbar (L) epidural anesthesia. An epidural catheter was inserted at the L3-L4 intervertebral space and threaded 9 cm cephalad beyond the tip of the Tuohy needle. Attempts to remove the catheter met with resistance. ⋯ After explaining to the patient and her family the need for surgical removal of the catheter and its associated risks, the catheter was successfully removed by an orthopedist by laminectomy. A butterfly-like knot was found about 5 cm away from the tip of the epidural catheter. She experienced no complications during surgery and no neurological sequelae were observed during her stay in hospital.