International journal of clinical and experimental medicine
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To study the change of maternal pulmonary function when ropivacaine and bupivacaine were used in spinal anesthesia for cesarean section, 40 ASA physical status I and II parturient scheduled to undergo cesarean section were randomly divided into bupivacaine and ropivacaine groups. Bupivacaine 9 mg and ropivacaine 14 mg were intrathecal injected respectively. FVC, FEV1 and PEFR were measured with spirometry before anesthesia and 2 h after intrathecal injection. Anesthesia level, the degree of motor block and VAS were also recorded. ⋯ Decreases in maternal pulmonary function tests were similar following spinal anaesthesia with bupivacaine or ropivacaine for cesarean section. The clinical maternal effects of these alterations appeared negligible.
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Levosimendan (LS) is a new inotropic drug which belongs to the group of drugs known as calcium sensitizers. It is different from other inotropic agents by its inotropic and vasodilatory actions without an increase in myocardial oxygen consumption and considered as a good choice in high-risk patients undergoing cardiac surgery. We aimed to investigate the proper time of the administration and the effect of prophylactic usage of LS in patients with low left ventricular ejection fraction (LVEF) undergoing coronary artery bypass grafting (CABG). ⋯ Our study shows that the elective preoperative initiation of LS especially 12 hours before the operation onset is associated with better improvement on cardiac functions as well as with lower mortality and complication rates, lower use of additional inotropic and vasopressor drugs, less need for intra-aortic balloon pump support and shorter length of stay in the ICU in patients with high perioperative risk or compromised left ventricular function. As a result, patients who received an infusion of LS 12 hours before surgery showed an evidence of less myocardial damage which suggested the preconditioning effect of the drug.
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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.