Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2008
Effects of dexmedetomidine on regulating pulmonary inflammation in a rat model of ventilator-induced lung injury.
We sought to elucidate the effects of dexmedetomidine, a selective alpha2-adrenergic receptor agonist, on the regulation of pulmonary inflammation in ventilator-induced lung injury (VILI) in a rat model. ⋯ Dexmedetomidine at clinically relevant doses had no significant effect in attenuating VILI. In contrast, dexmedetomidine at a dose approximately 10 times higher than the clinical dose significantly attenuated VILI. These effects of dexmedetomidine were mediated, at least in part, by the alpha2-adrenergic receptor.
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Acta Anaesthesiol Taiwan · Sep 2008
Case ReportsSpontaneous intracranial hypotension treated by epidural blood patches.
We present a case of spontaneous intracranial hypotension (SIH) diagnosed from the clinical symptoms and magnetic resonance imaging brain scans. After failure of conservative treatment, and lack of identification of the cerebrospinal fluid leak site, the headache was managed successfully and simply with two applications of an epidural blood patch (EBP). The strategy of our management for the patient was as follows: (1) application of an EBP to the lumbar epidural space initially and manipulating it into the proximity of the possible leak site; (2) a greater volume of autologous blood was injected at the second attempt of EBP; and (3) the patient was required to lie flat for at least 2 hours after the procedure. ⋯ Hence, the EBP has proven to be more effective in treating SIH patients. Early EBP application may offer immediate relief of clinical symptoms. The role of the EBP in treating SIH patients should have greater emphasis and its application is worth recommendation.
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Acta Anaesthesiol Taiwan · Sep 2008
Randomized Controlled Trial Comparative StudyUse of spectral entropy monitoring in reducing the quantity of sevoflurane as sole inhalational anesthetic and in decreasing the need for antihypertensive drugs in total knee replacement surgery.
The use of spectral entropy for monitoring the depth of anesthesia or level of hypnosis in surgery or painful procedures can reduce the consumption of drugs and shorten the recovery time of total intravenous anesthesia such as by propofol. The aim of this study was to investigate: (1) the consumption of sevoflurane as the sole anesthetic; and (2) hemodynamic stability in orthopedic surgery with tourniquet inflation under the guidance of spectral entropy, in contrast with the conventional method. ⋯ Using spectral entropy monitoring for guiding the depth of sevoflurane anesthesia in total knee replacement surgery can reduce its consumption and the frequency of use of antihypertensive drugs.
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Acta Anaesthesiol Taiwan · Sep 2008
Case ReportsUpper airway obstruction after cervical spine fusion surgery: role of cervical fixation angle.
Upper airway obstruction is one of the life-threatening events in cervical spine surgery. The risk is particularly great during the period immediately after operation. We present the case of a 56-year-old female with breast cancer and metastasis to the cervical spine. ⋯ Over-flexion of the cervical spine fixation and severe prevertebral soft tissue swelling were the most probable causes of upper airway obstruction. With a well-adjusted angle for fixation of the cervical spine under fluoroscopic guidance before the procedure, such a surgical mishap could be avoided. Reintubation with a fiberscope might be considered first, and sustaining intubation for 2-3 days postoperatively could be safer in such high risk patients.