Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Dec 2001
Case ReportsA modified method for intubation of a patient with ankylosing spondylitis using intubating laryngeal mask airway (LMA-Fastrach)--a case report.
We present an instance of successful use of an intubating laryngeal mask airway (LMA-Fastrach) and a Cook airway exchanger (CAE) for ventilation and intubation in a patient with severe ankylosing spondilitis (AS) receiving total hip arthroplasty. This measure may serve as an effective alternative for airway management in patients with difficult airway. A 61-year-old male was scheduled for right total hip arthroplasty because of degenerative osteoarthritis. ⋯ The whole procedure was uneventful and smooth. In sum, the modified Fastrach intubation method may facilitate tracheal intubation in patients with severe ankylosing spondilitis. It may be an alternative way for successful airway management in patients with difficult airway.
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Acta Anaesthesiol. Sin. · Dec 2001
Randomized Controlled Trial Clinical TrialPremedication with low-dose oral midazolam reduces the incidence and severity of emergence agitation in pediatric patients following sevoflurane anesthesia.
Sevoflurane is a volatile anesthetic agent with low pungency, non-irritating odor, and low blood/gas partition coefficient that makes it an attractive alternative to halothane. However, a high incidence of emergence agitation (EA) has been reported in pediatric patients after sevoflurane anesthesia. The underlying mechanism of sevoflurane-induced EA remains unclear. Rapid recovery of consciousness (emergence) from sevoflurane anesthesia has been proposed as one possible mechanism. We, therefore, hypothesized that sedatives such as midazolam may counteract sevoflurane's rapid emergence and thus reduce the incidence and the severity of sevoflurane-induced EA. ⋯ Premedication with oral midazolam is safe, convenient and effective in decreasing the occurrence of sevoflurane-induced EA. It does not delay discharge from PACU and is suitable for outpatient surgery.
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Acta Anaesthesiol. Sin. · Dec 2001
Randomized Controlled Trial Clinical TrialReversal of mivacurium chloride: edrophonium of spontaneous recovery in microscopic laryngeal surgery.
A double-blind, randomized study was designed to compare the recovery manner of mivacurium infusion with or without edrophonium reversal in microscopic laryngeal surgery. Neuromuscular blockade was quantified using the train-of-four stimuli to the ulnar nerve and quantification of the ratio of the fourth twitch to the first twitch. ⋯ Mivacurium, a short-acting nondepolarizing agent, is a suitable muscle relaxant for patients receiving microscopic laryngeal surgery. Recovery time with the use of edrophonium as reversal agent was shorter than with placebo, but extubation and discharge time did not differ in two groups. The time which could be saved by the use of edrophonium for reversal of mivacurium to hasten the maximal recovery appears to be less than a few minutes. Therefore, clinically, the value of routine use of edrophonium to obtain a faster recovery does not outweigh its demerits of cost and risk and is not worthy of recommendation.
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Acta Anaesthesiol. Sin. · Dec 2001
Randomized Controlled Trial Clinical TrialPrevention of PONV with dexamethasone in female patients undergoing desflurane anesthesia for thyroidectomy.
Desflurane is associated with a higher incidence of 24-h postoperative nausea and vomiting (PONV) as compared with sevoflurane or isoflurane. Dexamethasone 5 mg i.v. is suggested to be the minimum effective dose for prophylaxis of PONV in women undergoing thyroidectomy with isoflurane anesthesia. The objective of this study was to investigate whether a 5 mg dose of dexamethasone could be enough for, or a larger dose at 8 mg, could be more capable of preventing PONV in women undergoing desflurane anesthesia for thyroidectomy. ⋯ The results of this study showed that in PONV prophylaxis, in female patients undergoing desflurane anesthesia for thyroidectomy, the effect of dexamethasone 8 mg was superior to that of dexamethasone 5 mg.
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Acta Anaesthesiol. Sin. · Dec 2001
Incidence of oral tissue trauma after the administration of general anesthesia.
Administration of general anesthesia necessitates certain amounts of manipulation or instrumentation within the mouth that may cause some oral tissue injuries. The purpose of this study was to determine the incidence of oral tissue trauma after receiving general anesthesia. Some possible risk factors were explored. ⋯ Oral tissue trauma as it seems to be a common anesthetic complication that should be considered as a recognized hazard of general anesthesia. Understanding and recognizing oral anatomical condition and pathological change before anesthesia may help the anesthesiologists in preventing oral and dental complications and thus to avoid legal suits.