Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2004
A survey for prevention and treatment of malignant hyperthermia in Taiwan.
Malignant hyperthermia (MH) is a hypermetabolic disorder with high mortality. Intravenous administration of dantrolene is the specific treatment. However, the only means to lower mortality rate are early detection and suitable treatment. Therefore, properly monitoring and handy availability of dantrolene are essential to lower the mortality of MH. This study was designed to evaluate the capabilities in prevention and treatment of MH of the hospitals in Taiwan. ⋯ This study has revealed that in some hospitals in Taiwan intraoperatively (anesthetic) monitoring is inadequate and there is no stockpile of dantrolene for immediate treatment of MH. We recommend that appropriate anesthetic monitoring equipment should be strictly applied and a stock of initial dose of dantrolene (6 vials) should be kept, which are necessary for early diagnosis and treatment of MH.
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Acta Anaesthesiol Taiwan · Sep 2004
Nitrous oxide uptake in man: a new concept of uptake of inhalation anesthetics.
With proper recognition of the functional residual capacity (FRC) and the existence of the alveolar membrane in consideration of gas uptake, the uptake of nitrous oxide does not follow the previously described power function of time, 1,000 ml x t(-1/2). ⋯ In contrast to previous publications, in which the time course of FA/FI was used to express the uptake of nitrous oxide, in spite of the area under the curve of FA/FI should not be used to express uptake, instead, the area above the curve, (1-FA/FI), fits the results and should be considered as representing uptake.
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Acta Anaesthesiol Taiwan · Sep 2004
Frequent use of alternative airway techniques makes difficult intubations less and easier.
This study is to evaluate how alternative airway techniques work at different scenarios of difficult airways in our department where those techniques are popularized in daily practice. ⋯ In elective general anesthesia, frequent use of the alternative airway techniques, such as LMA for a surgical procedure of short duration and lighting stylet for a possibly difficult airway, will decrease the events of difficult intubations. Lighting stylet seems more advantageous than laryngoscope in management of difficult intubation caused by poor laryngoscopic view.
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Acta Anaesthesiol Taiwan · Sep 2004
Case ReportsOccurrence of the Bezold-Jarisch reflex during Cesarean section under spinal anesthesia--a case report.
We report a 35-year-old parturient with gestational diabetes mellitus (GDM) history who sustained a nearly fatal Bezold-Jarisch reflex during Cesarean section under spinal anesthesia. A high spinal block combined with acute massive hemorrhage may produce life-threatening Bezold-Jarisch reflex which should be treated prophylactically and aggressively during surgery. Additionally, the autonomic disturbance associated with GDM might exaggerate the reflex in this episode. The patient survived after successful resuscitation and was discharged without any sequela.
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Acta Anaesthesiol Taiwan · Jun 2004
Case ReportsSuccessful detection and management of unexpected endotracheal tube kinking during neurosurgery--a case report.
Kinking of endotracheal tube (ETT) is not an infrequent problem during general anesthesia. However, failure to secure free airway following airway obstruction due to kinking of endotracheal tube or other tube problems may lead to lethality instead of lifesaving. We describe a case of unexpected kinking of ETT intraorally while craniotomy was underway. ⋯ In this case report we would like to highlight how to accurately and quickly diagnose and manage the ETT kinking intraorally while craniotomy was in process under anesthesia. Emphasis is also laid on the importance of properly positioning of the head and neck prior to any operation especially in craniotomy. Besides, the flexometallic (FM) or armoured endotracheal tubes may be good substitutes for the polyvinyl chloride (PVC) ones in preventing the ETT kinking during general anesthesia.