Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2007
Effect of cervical epidural blockade with 2% lidocaine plus epinephrine on respiratory function.
Cervical epidural anesthesia has been used widely for surgery of upper limbs. Although cervical epidural anesthesia with local anesthetic of 2% lidocaine (plain) has demonstrated the safety in respiratory function in spite of unavoidable phrenic and intercostal palsies to certain extent, the replacement of local anesthetics with 2% lidocaine plus epinephrine has not been investigated yet. I conducted this study to look into the effect of 2% lidocaine plus epinephrine on respiratory function. ⋯ Cervical epidural anesthesia with 2% lidocaine plus epinephrine could reduce lung volumes and capacities, resulting from partially paralytic intercostal muscles and diaphragm innervated respectively by thoracic intercostal nerve and phrenic nerve. Without inadvertant total spinal or intravenous anesthesia or pre-existing pulmonary dysfunction, the patients with normal lungs could tolerate these changes well with the procedure.
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Acta Anaesthesiol Taiwan · Dec 2007
Sternocleoidomastoid muscle length predicts depth of central venous catheter insertion.
Correct central venous catheter (CVC) insertion avoids serious complications, especially fatal intracardiac impalement. There are only few methods which discussed the depth of CVC insertion previously. Predicting the depth of CVC by body surface landmark is an easy and quick way, which is applied most wildly. Chest X-ray is a standard procedure to examine the depth of CVC. However, chest X-ray is not routinely availale, especially in emergency situations. Recent publications demonstrated that the determination of accurate placement by chest X-ray can be substituted by ECG guidance. We would like to find the correlation between surface anatomic landmarks and the depth of CVC insertion, and a method that could be applied easily and quickly to predict the depth of CVC insertion through ECG guidance. ⋯ Both the length of SCM muscle and body height have statistically meaning for predicting the depth of CVC insertion (P < 0.001 vs. P = 0.012). In point of accuracy, SCM muscle length might be more significant in view of yielding a smaller P-value. And, the depth of CVC is equal to half of the length of SCM muscle plus 6.5 cm in adults aged 18 to 78 yrs.
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Acta Anaesthesiol Taiwan · Dec 2007
Randomized Controlled TrialCost analysis of three anesthetic regimens under auditory evoked potentials monitoring in gynecologic laparoscopic surgery.
Cost analyses of different anesthetic techniques have not been investigated in Taiwan. We compared propofol-based total intravenous anesthesia (TIVA), sevoflurane (SEVO) and desflurane (DES) anesthesias for cost and outcome under A-line auditory evoked potentials (AEP) monitoring. ⋯ The cost of TIVA with propofol was less than SEVO or DES anesthesia and moreover, propofol TIVA offered benefit of faster recovery in our study.
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Acta Anaesthesiol Taiwan · Dec 2007
Case ReportsTemporary femoral nerve palsy after ilioinguinal nerve blockade combined with splash block for post-inguinal herniorrhaphy analgesia in a pediatric patient.
Transient femoral nerve palsy (TFNP) is a complication of ilioinguinal nerve block that may result from spread of large volumes of local anesthetics at the inner surface of the different fascial planes. We report a 7-year-old healthy boy who underwent right inguinal hernia repair under general anesthesia. After induction of anesthesia, a percutaneous ilioinguinal nerve block was performed with 3 mL of 2% lidocaine in single-shot. ⋯ In the recovery room, quadriceps weakness and sensory loss over the anterior thigh were noted. The patient made a complete recovery 8 hrs after surgery without any treatment. We discuss the mechanism of this complication and strategies to reduce this complication.