Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2005
Randomized Controlled Trial Clinical TrialEvaluation of the effects of caudal or cephalic epidural catheterization on the characteristics of lumbar epidural anesthesia.
The delayed and incomplete sensory block of the sacral roots in epidural anesthesia often results from too huge the size of the first sacral nerve root. To overcome the problem, the enhancement of anesthetic effect on the sacral segment by injecting the local anesthetic toward the caudal direction has been reported. Thus, in this study, we compared the anesthetic effects of epidural anesthesia by catheterization toward caudal direction with that toward cephalic direction on the areas innervated by the sacral nerve roots. ⋯ Epidural injection of local anesthetic via catheter oriented caudad or cephalad did not change the characteristics of epidural anesthesia including onset time, duration, anesthetic level, and analgesic effect on the surgical areas innervated by the sacral roots.
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Acta Anaesthesiol Taiwan · Jun 2005
Case ReportsSubcutaneous emphysema associated with pneumomediastinum after general anesthesia--closed rhinolalia as an initial presentation in one of two cases.
We report two cases of subcutaneous emphysema associated with pneumomediastinum after general anesthesia. One of them was devoid of common symptoms such as chest pain and dyspnea, but significant closed rhinolalia was noted initially. ⋯ Close observation was the best treatment since neither trachea injury was in evidence nor was there the occurrence of other complication. The differential diagnosis and approach to therapy are presented after review of the relevant literature.
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsAcute cardiovascular collapse after pericardial drainage in a patient with aortic dissection.
Proximal aortic dissection is frequently associated with cardiac tamponade. The treatment sometimes is difficult. We present a 69-year-old female patient who after repeated episodes of syncope received an open drainage of pericardial effusion that ended in a fatal outcome. ⋯ She developed sudden cardiovascular collapse following drainage of pericardial effusion to which she succumbed in spite of vigorous resuscitation. We suggest that the patients with cardiac tamponade complicated by aortic dissection must receive direct aortic repair together with intraoperative pericardial drainage. Selective or single pericardiocentesis should better be avoided.
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Acta Anaesthesiol Taiwan · Mar 2005
Randomized Controlled Trial Clinical TrialThe optimal injection time of alfentanil for blunting circulatory responses to tracheal intubation.
The aim of this study is to investigate the optimal injection time of alfentanil during induction of anesthesia to blunt the circulatory responses induced by laryngoscopy and tracheal intubation. ⋯ Considering equal effectiveness and fewer side effects, one minute before intubation is the optimal injection time of alfentanil to blunt the circulatory responses induced by laryngoscopy and tracheal intubation.
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsDelayed recovery of radial nerve function after axillary block in a patient receiving ipsilateral ulnar nerve transposition surgery.
A 68-year-old female who underwent right ulnar nerve transposition surgery under axillary block (AB) by dual-technique (paresthesia and axillary artery penetration techniques) developed postoperative wristdrop. Physical examination showed local hematoma formation with ecchymosis at her right axillary region. ⋯ Fortunately, she was completely restored to her right hand function 20 h after anesthesia, and was discharged without sequelae 17 days later. In this case, delayed recovery of radial nerve function after AB was suspected and the mechanism which led to this unusualness is discussed.