Korean journal of anesthesiology
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Dubowitz syndrome is a rare autosomal recessive disorder that leads to growth retardation (intrauterine, postnatal), mental retardation, a peculiar face, microcephaly, behavioral problems and eczema. The peculiar face of individuals with Dubowitz syndrome includes sparse hair and eyebrows, low-set ears, blepharophimosis, bilateral ptosis, a flat nasal bridge with a broad nasal root and micrognathia. ⋯ We report the uneventful anesthetic management of a 16-year-old girl with Dubowitz syndrome who underwent a total abdominal hysterectomy after a pelvic examination under general anesthesia. We report this case of Dubowitz syndrome with a review of the relevant literature.
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Anesthesiologists have been aware of the importance of optimal drug combination long ago and performed many investigations about the combined use of anesthetic agents. There are 3 classes of drug interaction: additive, synergistic, and antagonistic. These definitions of drug interaction suggest that a zero interaction model should exist to be used as a reference in classifying the interaction of drug combinations. ⋯ Akaike information criterion (AIC) is the most popular approach to choosing the best model among the aforementioned models. Whatever the good qualities of a chosen model, it is uncertain whether the chosen model is the best model. A more robust inference can be extracted from averaging several models that are considered relevant.
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Korean J Anesthesiol · May 2010
Comparison of a supraclavicular block showing upper arm twitching response with a supraclavicular block showing wrist or finger twitching response.
Although an ultrasound-guided brachial plexus block has become the standard, conventional brachial plexus blocks with a paresthesia or muscle twitch are still performed. However despite eliciting a paresthesia or muscle twitch, there are some cases in whom the brachial plexus block fails. This has been attributed to the difference between the proximal response (PR) and distal response (DR). Therefore, this study compared a supraclavicular block showing a PR with that showing a DR. In addition, clinical data such as success rate, onset time, and complications were examined. ⋯ The elicitation of a DR was more effective in increasing the success rate and reducing the onset time than the elicitation of a PR in a single-injection supraclavicular block.
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Korean J Anesthesiol · May 2010
Intravascular ultrasound catheter for transesophageal echocardiography in congenital heart surgery -A case report-.
Transesophageal echocardiography (TEE) has an important role during congenital heart surgery. TEE in small infants is associated with complications, including an inability to pass the TEE probe, esophageal trauma, airway compression, aortic compression, and interference with ventilation. Recently, a monoplane intravascular ultrasound catheter (IVUC) has been developed for intracardiac echocardiography. ⋯ We examined 15 pediatric patients undergoing congenital cardiac surgery using an 8-Fr AcuNav IVUC probe. We checked the cardiac anatomy, cardiac function pre-operatively and de-aeration before weaning from CPB; the surgical repairs were evaluated post-operatively. Although the IVUC probe has limitations associated with the monoplane, we found the IVUC probe to be useful in small infants and safer than the TEE.
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Korean J Anesthesiol · May 2010
Combination of nitrous oxide and lidocaine to prevent withdrawal after rocuronium in children.
Pain at the site of rocuronium injection is a common side-effect in pediatric patients. This prospective, randomized, double-blind study evaluated the efficacy of a combination of nitrous oxide and lidocaine pretreatment on withdrawal response during rocuronium injection in children. ⋯ This study demonstrated that a combination of inhaled 50% N(2)O in O(2) and 1 mg/kg lidocaine pretreatment significantly reduced the incidence of rocuronium-induced withdrawal movements in pediatric patients compared with lidocaine pretreatment alone.