International journal of clinical and experimental medicine
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Sedation with propofol is widely used for the outpatient examination. Although anaphylaxis to propofol is rare, there were some reports of anaphylaxis following propofol administration. We present a case of female patient under sedation for lower gastrointestinal endoscopy with possible propofol anaphylaxis. ⋯ Propofol is widely used for the sedation of outpatient with lower gastrointestinal endoscopy. But it may cause some allergic reaction. Inhaled sevoflurane may provide a satisfactory and safe alternative for adult outpatients' endoscopy.
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To compare the cost-effectiveness of inhalation of sevoflurane, target-controlled infusion (TCI) of propofol, intravenous (IV) propofol for induction-inhalation of sevoflurane, and IV propofol for induction-inhalation of desoflurane for anesthesia maintenance in day surgery. ⋯ Induction with intravenous injection of propofol and maintenance with inhalation of desoflurane is the most cost-effective method of anesthesia for day surgery.
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To introduce a new modified technique for radial artery catheterization. ⋯ The authors suggested the use of 1 ml hollow tube-assisted radial artery cannulation technique rather than a direct technique. This modified technique provided easy, safe, quick and less cost cannulation.
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Case Reports
Surgical treatment and radiotherapy of epidermoid cyst with malignant transformation in cerebellopontine angle.
We report surgical treatment and radiotherapy of an extremely rare case of malignant epidermoid cyst located in cerebellopontine angle. MRI and CT demonstrated the lesion with partial enhancement and calcification. During operation, we found the tumor attached tightly to surrounding tissue. ⋯ With adjuvant radiotherapy, the patient underwent excellent recovery, and follow-up MRI demonstrated no obvious residue or recurrence of the tumor. Malignant epidermoid cyst can be diagnosed radiologically in combination with clinical presentation. Maximal removal plus adjuvant radiotherapy is the treatment of choice, although the general prognosis of it is poor.
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Managing ventilation and oxygenation during laparoscopic procedures in severely obese patients undergoing weight loss surgery presents many challenges. Pressure-controlled ventilation, volume-guaranteed (PCV-VG) is a dual-control mode of ventilation and an alternative to pressure (PC) or volume (VC) controlled ventilation. PCV-VG features a user-selected tidal volume target, that is auto-regulated and pressure controlled. We hypothesized that PCV-VG ventilation would provide improved oxygenation and ventilation during laparoscopic bariatric surgery with a lower peak inflating pressure (PIP) than either PC or VC ventilation. ⋯ In adolescents and young adults undergoing laparoscopic bariatric surgery, PCV-VG and PC were superior to VC ventilation in their ability to provide ventilation with the lowest PIP.