Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2007
Clinical experience of pain treatment for postherpetic neuralgia in elderly patients.
Postherpetic neuralgia (PHN) is a neuropathic pain syndrome that occurs following acute herpes zoster infection. The main clinical problem is intractable pain which interferes with activity of daily life and reduces the quality of life in the elderly patients. This retrospective study was to evaluate the outcome of pain treatment for the elderly patients with PHN at the Pain Clinic of Kaohsiung Medical University Hospital. ⋯ Our study results showed that the concurrent combination therapy with proper medications and appropriate nerve blocks could offer satisfactory pain relief in the majority of elderly patients with PHN.
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Acta Anaesthesiol Taiwan · Mar 2007
Case ReportsBirth asphyxia during general anesthesia for a morbidly obese parturient with gestational diabetes mellitus undergoing cesarean section--a case report.
A 26-year-old pregnant woman with a body mass index of 60 was scheduled for cesarean section at 36 weeks' gestation. She was found having affected with gestational diabetes mellitus and hypertension at 17 weeks of pregnancy. The blood glucose level as controlled by subcutaneous injection of insulin was maintained at the level of 110-140 mg/dL. ⋯ General anesthesia was thought as the root cause of this event at first. After a series of examination and management, hypoglycemia and uteroplacental perfusion insufficiency were considered as the causes of this morbidity. The neonate's condition was improved in 48 hr after close care.
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Acta Anaesthesiol Taiwan · Mar 2007
Case ReportsPostoperative delayed respiratory failure caused by Guillain-Barré syndrome--a case report.
Postoperative respiratory failure caused by Guillain-Barré syndrome (GBS) is a rare complication after general anesthesia. We report a GBS patient who after receiving an operation for polycystic liver disease under general anesthesia developed weakness of upper and lower extremities on the 3rd postoperative day, with decreased deep tendon reflex, which ultimately evolved into respiratory failure. Slurred speech and bilateral ptosis were also noted. ⋯ But it may sometimes be related to some rare neurological diseases. To prompt an accurate diagnosis of Guillain-Barré syndrome is important because it can help forestall fatal complications. In addition, the prognosis will be encouraging with early treatment.
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Acta Anaesthesiol Taiwan · Mar 2007
Immediate extubation in the operating room after cardiac operations with thoracotomy and sternotomy.
Immediate extubation after cardiac operations in the operating room (OR) is rarely practised in Taiwan. The increased use of the minimally invasive and off-pump coronary artery bypass surgery (CABG) and the financial pressure from health insurance have raised the interest of its application after cardiac operations. The purpose of the study was to investigate the practice of immediate extubation in patients undergoing cardiac operations via minimal invasive thoracotomy against via midline sternotomy. ⋯ We consider that immediate extubation after cardiac procedures either through thoracotomy or sternotomy is a rather safe practice and if possible minimally invasive technique should be chosen because it causes smaller wound and offers safer immediate extubation and shorter ICU stay.
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Acta Anaesthesiol Taiwan · Mar 2007
The feasibility of surface landmark for coracoid infraclavicular brachial plexus block by ultrasonographic assessment.
The coracoid infraclavicular block first introduced by Whiffler provides a safer and easily approach than classic infraclavicular block. In this technique, the anatomy-based puncture site is 2 cm medial and 2 cm caudal from the coracoid process. This prospective study was purposed to evaluate the feasibility of surface landmark-based coracoid block by ultrasonography. ⋯ Ultrasonographic guidance is suggested whenever anatomical precision is inadequate or meeting with great individual bodily variance which renders landmark-based technique difficult. However, if this facility is not available, the gender discrepancy in measurement should be seriously considered when coracoid process is used as the landmark.