Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Jun 2005
Randomized Controlled Trial Clinical TrialStarting dose of gabapentin for patients with post-herpetic neuralgia--a dose-response study.
Gabapentin has been shown to provide pain relief for post-herpetic neuralgia at dosage of 1200 to 2400 mg/day. However, the initial dosing strategy has not been thoroughly investigated. The purpose of this study was to establish the initial dosing strategy in the treatment of the gabapentin-naive patients with post-herpetic neuralgia. ⋯ This study shows that elderly gabapentin-naive subjects no matter whether receiving 200, 400 or 600 mg/day of gabapentin benefited a moderate pain relief with minimal side effects at the first three days of treatment. Since starting with a minimal dose of 200 mg/day did not offer a better reduction of side effects, we suggest that 600 mg/day gabapentin could be a safe and effective starting dose for patients with post-herpetic neuralgia.
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Acta Anaesthesiol Taiwan · Jun 2005
Randomized Controlled Trial Clinical TrialEvaluation of the effects of caudal or cephalic epidural catheterization on the characteristics of lumbar epidural anesthesia.
The delayed and incomplete sensory block of the sacral roots in epidural anesthesia often results from too huge the size of the first sacral nerve root. To overcome the problem, the enhancement of anesthetic effect on the sacral segment by injecting the local anesthetic toward the caudal direction has been reported. Thus, in this study, we compared the anesthetic effects of epidural anesthesia by catheterization toward caudal direction with that toward cephalic direction on the areas innervated by the sacral nerve roots. ⋯ Epidural injection of local anesthetic via catheter oriented caudad or cephalad did not change the characteristics of epidural anesthesia including onset time, duration, anesthetic level, and analgesic effect on the surgical areas innervated by the sacral roots.
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Acta Anaesthesiol Taiwan · Mar 2005
Randomized Controlled Trial Clinical TrialThe optimal injection time of alfentanil for blunting circulatory responses to tracheal intubation.
The aim of this study is to investigate the optimal injection time of alfentanil during induction of anesthesia to blunt the circulatory responses induced by laryngoscopy and tracheal intubation. ⋯ Considering equal effectiveness and fewer side effects, one minute before intubation is the optimal injection time of alfentanil to blunt the circulatory responses induced by laryngoscopy and tracheal intubation.
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsAcute cardiovascular collapse after pericardial drainage in a patient with aortic dissection.
Proximal aortic dissection is frequently associated with cardiac tamponade. The treatment sometimes is difficult. We present a 69-year-old female patient who after repeated episodes of syncope received an open drainage of pericardial effusion that ended in a fatal outcome. ⋯ She developed sudden cardiovascular collapse following drainage of pericardial effusion to which she succumbed in spite of vigorous resuscitation. We suggest that the patients with cardiac tamponade complicated by aortic dissection must receive direct aortic repair together with intraoperative pericardial drainage. Selective or single pericardiocentesis should better be avoided.
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Acta Anaesthesiol Taiwan · Mar 2005
Case ReportsDelayed recovery of radial nerve function after axillary block in a patient receiving ipsilateral ulnar nerve transposition surgery.
A 68-year-old female who underwent right ulnar nerve transposition surgery under axillary block (AB) by dual-technique (paresthesia and axillary artery penetration techniques) developed postoperative wristdrop. Physical examination showed local hematoma formation with ecchymosis at her right axillary region. ⋯ Fortunately, she was completely restored to her right hand function 20 h after anesthesia, and was discharged without sequelae 17 days later. In this case, delayed recovery of radial nerve function after AB was suspected and the mechanism which led to this unusualness is discussed.