Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Jun 2000
Case ReportsSpinal anesthesia in MELAS syndrome: a case with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes.
MELAS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) is one of the classic mitochondrial encephalomyopathies with variable clinical presentation and multisystem involvement. Enhanced sensitivity to neuromuscular blockade or anesthetic agents and susceptibility to malignant hyperthermia in these patients have ever been reported, all of which complicate the management of general anesthesia. ⋯ Although there is little information about the application of regional anesthesia in MELAS patients, we demonstrate that it may be a satisfactory choice. However, it is suggested that regional anesthesia is performed only when neurological abnormalities of spinal cord or peripheral nerves are definitely ruled out.
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Acta Anaesthesiol. Sin. · Jun 2000
Case ReportsFatal anaphylactoid shock associated with protamine for heparin reversal during anesthesia.
A 19-year-old female was scheduled for elective surgery of repair of ventricular septal defect (VSD). She had no known previous food or drug allergy history. She was not previously exposed to protamine and did not have any of the risk factors pointing to protamine hypersensitivity reaction. ⋯ One was caused by intravenous (i.v.) administration of antibiotics, and the other happened following i.v. drip of protamine sulfate for reversal of systemic heparinization. She had none of the risk factors suggestive of hypersensitivity to drugs and was therefore considered not at risk for such severe adverse reactions which happened. This article was to discuss the anaphylactoid shock induced by antibiotics and protamine during anesthesia, and the prevention and management of such a reaction.
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Acta Anaesthesiol. Sin. · Jun 2000
Continuous epidural analgesia for painless labor does not increase the incidence of cesarean delivery.
Continuous epidural analgesia is a popular technique provided for labor pain relief. However, the possible association between epidural analgesia and increased rate of cesarean delivery is always a concern. The purpose of this study was to explore if epidural analgesia would affect the rate of cesarean delivery in healthy term parturient women. ⋯ The findings may support the conclusion that continuous epidural analgesia for pain relief during labor would not increase the rate of cesarean delivery. In contrast, it may reduce this risk in nulliparas.
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Acta Anaesthesiol. Sin. · Mar 2000
Randomized Controlled Trial Clinical TrialPropofol-sodium thiopental admixture reduces pain on injection.
Propofol injection associated with a high incidence of pain is well known. Propofol and sodium thiopental mixture has recently been reported to be used for cost saving and able to reduce pain on injection. ⋯ Sodium thiopental, when added to propofol, can significantly reduce propofol injection pain. This attenuation effect was noted even with as low as 10 volume % of sodium thiopental.
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Acta Anaesthesiol. Sin. · Mar 2000
Randomized Controlled Trial Clinical TrialEffect of oral clonidine premedication on perioperative hemodynamic response and postoperative analgesic requirement for patients undergoing laparoscopic cholecystectomy.
To investigate the clinical efficacy of oral clonidine premedication in anesthesia and analgesia in patients undergoing laparoscopic cholecystectomy (LC). ⋯ Oral clonidine premedication helped to provide perioperative hemodynamic stability, spared the use of isoflurane and reduced the requirement of postoperative analgesia so as to smoother the way to recovery in patients undergoing LC.