Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Sep 2000
Randomized Controlled Trial Clinical TrialIntra-articular ketamine for pain control following arthroscopic knee surgery.
In an attempt to demonstrate the peripheral effect of ketamine on the synovia of knee joint and to smoothen the recovery from arthroscopic knee surgery, this study was designed to evaluate the analgesic effect of intra-articular ketamine injection after knee arthroscopy. ⋯ Ketamine had been reported to have peripheral analgesic effects with variable duration on measurements of pain and hyperalgesia. However, in the present study, we failed to demonstrate that ketamine could provide a clinically relevant peripheral analgesic effect for postoperative arthroscopic pain.
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Acta Anaesthesiol. Sin. · Sep 2000
Comparative Study Clinical TrialIs total knee replacement more painful than total hip replacement?
During its use in pain management the patient-controlled analgesia (PCA) devices are capable of registering the course of treatment at patient request, the condition of drug delivery and total amount of drug being given. The patients could determine the need of medication to their own satisfaction while forced treatment by the bias of the health care personnel is avoided and the safety of patients is further warranted. In pain relief with this device, the number of requests for analgesia and the dose of analgesic used can be easily measured. Therefore, it is more objective to compare the pain intensity among different types of operation when PCA device is used. Using PCA morphine consumption as a parameter, we attempted to elucidate the difference of intensity of pain associated with total hip and total knee replacements by comparing their morphine requirement. ⋯ Using PCA morphine consumption as parameter, we can distinguish the magnitude of pain intensity between 2 major orthopedic surgeries. The deeper and more extensive operation would in total hip replacement does not mean that it is a more painful procedure than total knee replacement. Several speculations are proposed.
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Acta Anaesthesiol. Sin. · Jun 2000
Case ReportsConvulsions during superior laryngeal nerve block--a case report.
Complications following local anesthesia for fiberoscope-assisted intubation are rare. We report a case with surgical condition indicating awake endotracheal intubation for general anesthesia, suffering from convulsions after receiving left superior laryngeal nerve block to facilitate the procedure. The possible cause may be accidental injection of the local anesthetic into the vertebral artery. ⋯ The central nervous system toxicity of local anesthetic depends not only on the dosage used, but also on the rate of injection, as well as the site at which it is injected. Starting from a small dose together with careful monitoring of patient's response is advised when nerve block in the neck is performed. Here, we also emphasize the importance of availability of resuscitation equipment for maintaining adequate ventilation and circulation in case of emergency.
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Acta Anaesthesiol. Sin. · Jun 2000
Case ReportsAwareness due to disconnection from the fresh gas supply: why could ventilation be achieved in spite of disconnection from the fresh gas supply?
An anaesthesia ventilator of to-and-fro type incorporated into the anesthesia machine was used for mechanical ventilation in a patient undergoing plastic surgery under sevoflurane anaesthesia. During operation, elevation of blood pressure and tachycardia, which suggested inadequate anesthesia could not be managed by adjustment of sevoflurane to higher concentrations. However, the patient's lungs could be well ventilated without problems. ⋯ As a result, anaesthetic gas is replaced by a driving gas. A ventilator of to-and-fro type is still used in clinical anesthesia due to its simple design. The phenomenon reflects the pitfall in the design of a to-and-fro type anaesthesia ventilator.
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Acta Anaesthesiol. Sin. · Jun 2000
Randomized Controlled Trial Comparative Study Clinical TrialComparison of inhalation induction with 2%, 4%, 6%, and 8% sevoflurane in nitrous oxide for pediatric patients.
Sevoflurane is almost the idealest volatile anesthetic agent regarding inhalation induction of general anesthesia. Previous studies have established a role of sevoflurane in high concentration primed in the circuit for inhalation induction in pediatric patients. However, which concentration of sevoflurane is suitable has not yet been reported. This study was designed to compare the efficiency of different concentration of sevoflurane i.e. 2%, 4%, 6%, and 8% and with N2O in 50% oxygen for induction of anesthesia in pediatric patients and at the same time to evaluate the tolerance of patients. ⋯ Sevoflurane 6% for inhalation induction apparently caused low incidence of adverse effects and hastened induction. We suggest that 6% sevoflurene is a concentration more practical for inhalation induction in pediatric patients.