Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2009
Randomized Controlled TrialOptimal duration of urinary catheterization after thoracotomy in patients under postoperative patient-controlled epidural analgesia.
Epidural analgesia is widely used for efficient pain relief after major surgery. However, it may cause urinary retention, leading to delayed removal of bladder catheters with prolonged patient discomfort. Using a specific regimen in patient controlled epidural analgesia (PCEA), we examined the optimal duration of urinary catheterization in patients undergoing major thoracic surgery. ⋯ Routine continuous bladder catheterization may not necessarily be required after thoracotomy in patients with ongoing continuous thoracic epidural analgesia.
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Acta Anaesthesiol Taiwan · Dec 2009
Analysis of manpower and career characteristics of nurse anesthetists in Taiwan: results of a cross-sectional survey of 113 institutes.
Manpower and the quality of nurse anesthetists (NA) have become critical concerns in Taiwan over the past few decades because of increasing clinical demand and the supervision of NAs by anesthesiologists. To understand manpower distribution, clinical load, job description and limitations, and job satisfaction of NAs, we conducted a cross-sectional survey in Taiwan in 2005. ⋯ This study represents the first large-scale assessment of the distribution, clinical load, and job satisfaction for NAs in Taiwan. The roles of NAs, which include preoperative preliminary preparation and postoperative intensive care, need to be more well-defined. To improve the quality of NAs and anesthetic care in Taiwan, it is vital to establish an official accreditation system and formal education programs, to institute well-defined and standardized job descriptions, and to improve resource allocation for NAs.
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Acta Anaesthesiol Taiwan · Dec 2009
Case ReportsRecurrent attacks of post-intubation right upper lobe atelectasis.
A 22-year-old woman with no history of asthma developed an acute recurrent attack of severe bronchoconstriction and right upper lobe atelectasis immediately after laryngoscopy and endotracheal intubation. The first attack had taken place 2 months earlier under identical circumstances. ⋯ The atelectasis was quickly resolved with mechanical ventilation and spasmolytic treatment on both occasions. The surgical procedure could proceed soon after resolution of the atelectasis.
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Acta Anaesthesiol Taiwan · Dec 2009
Case ReportsTemporomandibular joint dislocation during orotracheal extubation.
Temporomandibular joint (TMJ) dislocation can occur whenever the mouth is opened wide during upper airway manipulation, even without external force. In the perioperative period, the majority of TMJ dislocations occur during anesthetic induction. We report the occurrence and management of bilateral TMJ dislocation upon orotracheal extubation in a 35-year-old woman. ⋯ The bilateral TMJ dislocation was reduced with the traditional transoral approach under morphine analgesia/sedation. The dislocation possibly occurred in consequence of her compliance with our request to open her mouth excessively before she was fully awake. As TMJ dislocation is a possible complication of upper airway manipulation, anesthesiologists should be prepared for its occurrence and to manage it competently.
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Acta Anaesthesiol Taiwan · Sep 2009
Closed-loop control of anesthesia using the bispectral index in open heart surgery.
The introduction of the bispectral index (BIS) as a comprehensive indicator of depth of anesthesia has prompted research in the automated delivery of anesthetics. This trial aimed to evaluate the usefulness of the BIS as the feedback variable in a closed-loop anesthesia control system during cardiac surgery under cardiopulmonary bypass (CPB). ⋯ The closed-loop control of anesthetic delivery adjusted to BIS is feasible and may be useful in open heart surgery under hypothermic CPB.