Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2004
Randomized Controlled Trial Clinical TrialImproving the success rate of laryngeal mask airway insertion during etomidate induction by using fentanyl or succinylcholine.
Smooth and successful insertion of a laryngeal mask airway (LMA) during etomidate induction requires a proper mouth opening and efforts to minimize airway reflexes such as gagging, coughing, or laryngospasm. We hypothesized that the concurrent use of fentanyl or succinylcholine with etomidate, the induction agent, could reduce the occurrence of airway reflexes and increase the success rate of LMA. ⋯ As an induction agent to facilitate insertion of LMA, etomidate alone was far from perfect. The concurrent use of 2 microg/kg of fentanyl with etomidate might significantly reduce the occurrence of airway reflexes in response to LMA insertion and increase the success rate of insertion. However, concurrent use of 1 mg/kg succinylcholine with etomidate might provide better results in terms of shortened time for the LMA insertion, jaw relaxation, and the success rate of LMA insertion than that of fentanyl.
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Acta Anaesthesiol Taiwan · Dec 2004
Case ReportsMalignant hyperthermia with excellent response to small dose of dantrolene.
Malignant hyperthermia (MH) is an operative emergency associated with general anesthesia. Early diagnosis and prompt treatment are the keynotes in management of MH. ⋯ Nonetheless, the enormous expenditure on stockpile and 3-year validity make a large reserve of the drug to forestall MH, a disorder of rare occurrence, seems disputable, especially in small hospitals where general anesthesia is seldom practiced. We herein report two cases of MH with excellent response to small doses of dantrolene and then discuss the way of practicable management and debate on the question of whether fewer stock of dantrolene is an alternative way for hospitals of smaller scale.
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Acta Anaesthesiol Taiwan · Dec 2004
Randomized Controlled Trial Clinical TrialThe efficacy and safety of transnasal butorphanol for postoperative pain control following lower laparoscopic surgery.
The aim of the study was to evaluate the efficacy and safety of transnasal butorphanol for postoperative analgesia in adult female patients undergoing lower laparoscopic surgery. ⋯ In contrast with placebo transnasal butorphanol was effective in the treatment of postoperative pain in female patients undergoing lower laparoscopic surgery. It had minimum side effects.
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Acta Anaesthesiol Taiwan · Dec 2004
Case ReportsAnesthetic management of a patient undergoing segmental resection of trachea with an endotracheal neurofibroma and nearly total occlusion of trachea.
We report a case of endotracheal (ET) neurofibroma with resultant severe airway obstruction undergoing segmental resection of the trachea. After the extracorporeal membrane oxygenation system (ECMO) was set up handily for use and comprehensive monitoring system was established, ET intubation under fiberoptic bronchoscopy (FOB) was performed under mild sedation. ⋯ Thorough preoperative evaluation, comprehensively anesthetic planning, FOB-assisted ET intubation before induction of anesthesia were mandatory to achieve a safe and delicate anesthesia for such a patient. In critical situation, conduction of anesthesia after establishment of ECMO support would be another choice.
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Acta Anaesthesiol Taiwan · Sep 2004
Randomized Controlled Trial Clinical TrialSupplementing epidural lidocaine with midazolam: effect on sensorymotor block level.
Midazolam, the only clinically available water-soluble benzodiazepine, has been reported to have an antinociceptive effect through neuroaxial pathway. Also it can be used epidurally for postoperative analgesia and chronic pain management. In a recent study it was disclosed that when midazolam was added to intrathecal bupivacaine it improved the duration and quality of the spinal anesthesia. In this study the effects of this drug on intraoperative motor and sensory blocks were evaluated. ⋯ Midazolam can improve the durations of sensory and motor blocks of lidocaine in a single epidural administration. It seems that the 5 mg dosage works better than the lower one.