Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2005
Randomized Controlled Trial Comparative StudyProphylactic versus therapeutic administration of intravenous lidocaine for suppression of post-extubation cough following cataract surgery: a randomized double blind placebo controlled clinical trial.
Post-extubation cough causes considerable patient discomfort and in certain surgical procedures may lead to postoperative surgical complication. Different drugs and techniques have been used for the prevention of post-extubation cough with variable success rates. Prophylactic administration of lidocaine has been tried for the prevention of post-extubation cough with controversial results. No previous study has been performed to evaluate the therapeutic effect of intravenous lidocaine for treatment of post-extubation cough. This study was designed to compare the prophylactic effect of intravenous lidocaine with that of the therapeutic lidocaine in a sample of adult patients undergoing general anesthesia for cataract surgery. ⋯ The outcome of this study shows that prophylactic administration of lidocaine prior to tracheal extubation may be ineffective to prevent post-extubation cough. Based on the results of this study it can be recommended that post-extubation cough should be treated upon occurrence instead of routine prophylactic administration of lidocaine.
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Acta Anaesthesiol Taiwan · Sep 2005
Randomized Controlled Trial Clinical TrialIntrathecal midazolam combined with low-dose bupivacaine improves postoperative recovery in diabetic mellitus patients undergoing foot debridement.
Intrathecal midazolam acts synergically with other anesthetics to relieve surgical pain, and the drug combination may decrease complications attributable to each component drug. This prospective study was to determine the spinal effects of low-dose of bupivacaine (5 mg) combined with intrathecal midazolam (2 mg) in diabetes mellitus (DM) patients undergoing foot debridement. ⋯ The combination of intrathecal midazolam and bupivacaine was a safe and effective anesthetic technique, and it also provided early recovery of motor function and reduced the requirement of analgesics postoperatively.
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Acta Anaesthesiol Taiwan · Sep 2005
Randomized Controlled Trial Clinical TrialClinical trial of nitroglycerin-induced controlled hypotension with or without acupoint electrical stimulation in microscopic middle ear surgery under general anesthesia with halothane.
Transcutaneous electrical stimulation (ES) has been shown to produce long-lasting fall of arterial blood pressure in animal or human models. Previous reports have shown that ES of acupuncture points (acupoints) enhances the hypotensive effect of isoflurane anesthesia. This study was designed to investigate the combined effect of acupoint ES and different infusion rates of nitroglycerin on controlled hypotension. ⋯ The result of this study shows that ES of ST36 combined with nitroglycerin infusion facilitates lowering of blood pressure and produces a bloodless surgical field. The mechanism of blood pressure lowering effect of acupoint ES may be reducing of norepinephrine and other sympathomimetic substances in the blood.
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Acta Anaesthesiol Taiwan · Sep 2005
Case ReportsClipping of the appendix induced cardiac arrest during appendectomy under spinal anesthesia.
Bradycardia is commonly seen in high spinal anesthesia, however, evolution of cardiac arrest from sudden onset of severe bradycardia is infrequent. Prompt recognization and resuscitative measures are of paramount importance because they may insure a complete recovery without sequela as an aftermath. ⋯ Cardiac massage, manual ventilation with oxygen and low-dose epinephrine successfully resuscitated the patient. The possible mechanisms and management of this complication are also discussed.
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Overactive inflammatory responses that destroy rather than protect are the crucial issues in the development of a spectrum of septic disease states, such as adult respiratory distress syndrome, systemic inflammatory response syndrome, septic shock, and multiple organ failure. This review focuses on an area in which alternative actions of intravenous anesthetics show much promise for sepsis: their effects on the inflammatory response and on inflammatory cells in vitro and in vivo. ⋯ Different intravenous anesthetics, such as propofol, ketamine, benzodiazepine and barbiturates, which produce different levels of inhibition of inflammatory effects, are discussed in this article. In addition, such modulations of inflammatory responses may be of great relevance to the practice of intensive care, and intravenous anesthetics may play significant roles in this regard.