Journal of anesthesia
-
Journal of anesthesia · Dec 2010
Back massage therapy promotes psychological relaxation and an increase in salivary chromogranin A release.
Massage therapy promotes psychosocial relaxation, reduces stress and has been reported to improve the immune function. As such, massage therapy is currently used in palliative care for the relief of anxiety and pain. Although psychosocial status has been evaluated using subjective psychological tests, such as State-Trait Anxiety Inventory (STAI), subjective psychological tests are of limited value if the subjects fail to report reliably. ⋯ In contrast, the level of salivary chromogranin A significantly increased. We therefore conclude that changes in the salivary biomarkers tested here may not indicate changes in psychological status following massage therapy. However, the increase in chromogranin A release may contribute to the immunologically beneficial effects of massage therapy as chromogranin A has antibacterial and antifungal activity.
-
Journal of anesthesia · Dec 2010
Case ReportsComplications with massive sacrococcygeal tumor resection on a premature neonate.
Resection of large sacrococcygeal teratomas (SCT) in neonates can pose many anesthetic challenges. The pathophysiology of the SCT determines the varying management. We present a case report of a 34-week newborn with a massive Altman type 3 SCT. ⋯ We also had difficulty in maintaining the temperature. This patient did well after the surgery and was discharged home. We address here the anesthetic issues involved in the perioperative care management of a premature infant with a massive SCT.
-
Journal of anesthesia · Dec 2010
Case ReportsDexmedetomidine was safely used for sedation during spinal anesthesia in a very elderly patient.
We safely administered dexmedetomidine (DEX) for sedation during spinal anesthesia in a very elderly patient. The patient was a 98-year-old woman who had hypertension, renal failure, and first-grade atrioventricular block. She was scheduled to undergo internal fixation for fracture of the femoral neck. ⋯ Percutaneous oxygen saturation was maintained at 98% or more; respiratory rate was within 15-21 tpm, and no ventilatory assistance was required. The maximum predicted plasma concentration (pCp) of DEX was 1.56 ng/mL, and the mean pCp of DEX during surgery was approximately 0.45 ng/mL. We found that DEX can be safely used for sedation during spinal anesthesia in a very elderly patient.
-
Journal of anesthesia · Dec 2010
Gentle chest compression relieves extubation laryngospasm in children.
Extubation laryngospasm is frequently encountered in children undergoing upper airway surgery. Different drugs and techniques have been used for its treatment. The objective of this study was to examine gentle chest compression as an alternative to standard practice for relief of laryngospasm. ⋯ Gentle chest compression with 100% oxygen is a simple and effective technique for immediate management of post extubation laryngeal spasm in children.
-
Journal of anesthesia · Dec 2010
Case ReportsAnesthesia for a 16-month-old patient with Prader-Willi syndrome.
Prader-Willi syndrome (PWS) is a rare disorder of chromosome abnormalities in which the paternal genes in chromosome 15 are lacking. The clinical course is characterized by hypotonia, hyperphagia, and morbid obesity. ⋯ The clinical course of the patient was uneventful during the procedure and postoperative period. However, arrangements with a pediatric intensive care setting for the postoperative period are recommended for patients with PWS undergoing surgery.