Korean journal of anesthesiology
-
Korean J Anesthesiol · Jun 2010
Breakage of a thoracic epidural catheter during its removal -A case report-.
The breakage of an epidural catheter is a rare complication during the removal of a thoracic epidural catheter. There are many causes to breakage of an epidural catheter, such as the characteristics of the catheter itself, patient's factors (anatomy, position during insertion and removal of the catheter, and the BMI), and the difficulty of the procedure. ⋯ To prevent the catheter breakage during its removal, the catheter should be withdrawn without excessive tension. In addition, an understanding of the patient's anatomy is essential.
-
Korean J Anesthesiol · Jun 2010
Prolonged paradoxical air embolism during intraoperative intestinal endoscopy confirmed by transesophageal echocardiography -A case report-.
Venous air embolism (VAE) during intestinal endoscopy is a rare complication. We report a case of cardiovascular collapse due to VAE confirmed by transesophageal echocardiography (TEE) during intraoperative intestinal endoscopy. ⋯ This case demonstrates that TEE can play an important role in diagnosing and managing an air embolism in anesthetized patients. In addition, this case demonstrates that PAEs may occur longer than expected after recovery from VAE-induced cardiovascular collapse.
-
Korean J Anesthesiol · Jun 2010
Caudal analgesia reduces the sevoflurane requirement for LMA removal in anesthetized children.
An anesthetic state can reduce adverse airway reaction during laryngeal mask airway (LMA) removal in children. However, the anesthetic state has risks of upper airway obstruction or delayed emergence; so possibly less anesthetic depth is advisable. Caudal analgesia reduces the requirement of anesthetic agents for sedation or anesthesia; it is expected to reduce the sevoflurane requirement for LMA removal. Therefore, we determined the EC(50) of sevoflurane for LMA removal with caudal analgesia and compared that to the EC(50) without caudal analgesia. ⋯ Caudal analgesia significantly reduced the sevoflurane concentration for a smooth LMA removal in anesthetized children.
-
Korean J Anesthesiol · Jun 2010
Spectral analysis of respiratory-related hemodynamic variables in simulated hypovolemia: a study in healthy volunteers with spontaneous breathing using a paced breathing activity.
A dynamic preload index such as stroke volume variation (SVV) is not as reliable in spontaneous breathing (SB) patients as in mechanically ventilated patients. This study examined the hypothesis that spectral analysis of hemodynamic variables during paced breathing (PB) activity may be a feasible index of volume changes and fluid responsiveness, despite insufficient respiratory changes in the preload index during SB activity. ⋯ These results suggest that RF spectral analysis of dynamic preload variables may enable the detection of volume change and fluid responsiveness in SB hypovolemic patients performing PB activity.
-
Korean J Anesthesiol · Jun 2010
Effects of anesthesia on fluid volume kinetics after infusion of colloid solution during blood donation.
The fluid kinetics of intravenously infused colloid during inhalation anesthesia and hemorrhage have not been investigated. We therefore assessed fluid space changes during infusion of hydroxyethyl starch solution after hemorrhage in conscious and desflurane-anesthetized individuals. ⋯ Infusion of colloid after mild hemorrhage resulted in similar expansions of plasma volume in desflurane-anesthetized and conscious individuals. During anesthesia, however, the expansion of plasma volume by colloid was decreased and of shorter duration than observed in conscious patients.