Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effect of two different doses of 0.75% glucose-free ropivacaine for spinal anesthesia for lower limb and lower abdominal surgery.
We compared the clinical efficacy and safety of two doses of ropivacaine for spinal anesthesia in Chinese patients undergoing lower limb and lower abdominal surgery. In this randomized, open-label study, 40 patients were divided into two groups: group A received 3.5 mL (26.25 mg) of 0.75% glucose-free ropivacaine, and group B received 4.5 mL (33.75 mg). Sensory and motor blocks were assessed during and after surgery through to complete recovery. ⋯ While shivering was more frequent in group B during the operation, the difference was not significant. Otherwise, there were no differences in adverse effects during and after surgery. We conclude that both doses of 0.75% glucose-free ropivacaine, 26.25 mg (3.5 mL) and 33.75 mg (4.5 mL), have the same efficacy and safety in Chinese patients undergoing spinal anesthesia for lower limb and lower abdominal surgery.
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Kaohsiung J Med Sci · Mar 2004
Case ReportsMultiple symmetric lipomatosis (Madelung's disease): report of two cases.
Multiple symmetric lipomatosis (Madelung's disease) is a rare disease characterized by non-encapsulated adipose deposits in the neck, the superior part of the trunk and, very rarely, in the limbs. It is common in middle-aged Caucasian Mediterranean males but very rare in Chinese people. ⋯ Both underwent incisional biopsies that revealed benign adipose tissue characterizing Madelung's disease. We discuss the clinical presentation, associated morbidity, and treatments for Madelung's disease.
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Kaohsiung J Med Sci · Dec 2003
Case ReportsExercise-induced acute spinal subdural hematoma: a case report.
A 63-year-old woman developed acute back pain and sciatica after playing hula-hoop. Urinary incontinence was also noted. ⋯ After emergency surgical decompression and evacuation of the spinal subdural hematoma, the patient had good recovery without any postoperative neurologic deficit. In this article, we describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of spinal subdural hematoma.
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Kaohsiung J Med Sci · Nov 2003
Spinal process landmark as a predicting factor for difficult epidural block: a prospective study in Taiwanese patients.
Although epidural anesthesia is a common practice in neuraxial blockade, difficult access to the epidural space is a frequent problem in operating theaters. We designed this study of epidural blocks to determine if the spinal landmark grading system is valuable in predicting a difficult epidural block. Before the epidural block, we collected the following data: demographics, body habitus (normal, thin, obese, pregnant), spinal anatomy (normal, deformed), spinal level (lumbar, thoracic), and spinal landmark grade (grade 1: spinous processes visible; grade 2: spinous processes not seen but easily palpated; grade 3: spinous processes not seen and not palpated but the interval between them is palpated as a low landmark under the thumb; grade 4: other). ⋯ Deformed spinal anatomy and body habitus both correlated with difficulty, merely from the total numbers of attempts (attempts-S and attempts-L). Thoracic epidurals were more difficult than lumbar epidurals by all three measures of difficulty. We concluded that this spinal landmark grading system is valuable in predicting a difficult epidural block and advocate its use as a predictor by anesthesiologists.
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Kaohsiung J Med Sci · Sep 2003
Randomized Controlled Trial Clinical TrialRopivacane 0.1 % with or without fentanyl for epidural postoperative analgesia: a randomized, double-blind comparison.
Epidural analgesia is often considered optimal postoperative analgesia for certain surgical procedures. Ropivacaine is a new local anesthetic that is less toxic than its homologue, bupivacaine. Epidural infusions usually comprise a local anesthetic, an opioid, or a combination of the two to improve analgesic efficacy and reduce unwanted side effects. ⋯ However, pain relief was significantly better in the ropivacaine/fentanyl group after the first hour and this difference lasted for the remaining time. There was no significant difference in adverse events between the two groups during 24 hours of assessment. In conclusion, the quality of analgesia was significantly improved by the addition of fentanyl 1 microg/mL to ropivacaine.