Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Mar 2010
Case ReportsUse of the Rusch Flexi-Slip stylet for patients with difficult insertion of the ProSeal laryngeal mask airway.
The ProSeal laryngeal mask airway (PLMA) offers a more effective seal and is easier for gastric tube placement to prevent aspiration than the classical laryngeal mask airway. However, it is more difficult to insert with the digital and introducer tooling techniques. The Rusch Flexi-Slip stylet (RFSS) is an accessory intubation tool that consists of a malleable coated wire and a soft atraumatic tip. ⋯ The RFSS technique offers several advantages for PLMA insertion, including the provision of effective support and a soft tip for the PLMA insertion. Other techniques to facilitate the insertion of the PLMA, including priming the drain tube with a guide are discussed. We recommend that the RFSS technique offers an effective method for cases with difficult insertion of the PLMA.
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Acta Anaesthesiol Taiwan · Mar 2010
Bloodless and non-inotropic cardiac surgery under closed-circuit anesthesia.
The safety of homologous blood transfusion has become a major concern for patients and physicians. Current transfusion practice is highly variable and may be associated with inappropriate blood use. Inotropic agents have been almost routinely administered perioperatively to patients undergoing cardiac surgery to overcome low cardiac output due to cardiopulmonary bypass (CPB) and cardioplegia-induced cardiac ischemic arrest. In this study, we evaluated the feasibility of bloodless and non-inotropic open-heart surgery. ⋯ In conclusion, bloodless and non-inotropic cardiac surgery is feasible with the aid of a cell-saver and closed-circuit anesthesia in combination with new practice guidelines.
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Acta Anaesthesiol Taiwan · Mar 2010
Intramuscular bupivacaine injection dose-dependently increases glutamate release and muscle injury in rats.
Local anesthetics may cause reversible skeletal muscle injury, which is most common with bupivacaine. Glutamate is present in most skeletal muscles and may regulate muscular metabolic pathways. The aim of study was to examine the changes in intramuscular glutamate level and the severity of myopathy after intramuscular administration of bupivacaine. ⋯ A single intramuscular injection of bupivacaine induced dose-dependent increases in intramuscular glutamate levels and muscular damage.
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Acta Anaesthesiol Taiwan · Mar 2010
Phenothiazine-type antipsychotics elicit cutaneous analgesia in rats.
Local anesthetics exert their anesthetic and analgesic effects by blocking the sodium channels in the nervous system. Phenothiazine-type antipsychotics also block sodium channels, but the local anesthetic characteristics of these drugs have not been evaluated. The aim of this study was to evaluate the cutaneous analgesic effect of phenothiazine-type antipsychotics. ⋯ Of the antipsychotic drugs tested, mesoridazine is potentially the best candidate for development into a potent, long-acting local anesthetic. However, toxicity studies are needed before these agents can be used clinically as analgesics.
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Acta Anaesthesiol Taiwan · Dec 2009
Randomized Controlled TrialOptimizing epidural fentanyl loading dose for early labor pain.
Sufficient sensory blockade between L1 and T10 is required to relieve visceral pain during early labor. We examined whether the addition of fentanyl to a loading dose of 0.0625% bupivacaine could provide dose-dependent analgesic effects on early-stage labor pain. ⋯ The addition of fentanyl to epidural bupivacaine dose-dependently increased the analgesic effect and higher loading doses of fentanyl increased the dermatomic coverage. We suggest that 0.0625% bupivacaine plus 4 microg/mL fentanyl is the ideal loading dose to provide the greatest segmental analgesia for early labor pain with minimal side effects.