Korean journal of anesthesiology
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Korean J Anesthesiol · Apr 2017
Reversal with sugammadex for rocuronium-induced deep neuromuscular block after pretreatment of magnesium sulfate in rabbits.
Magnesium sulfate (MgSO4) has been used in the treatment of pre-eclampsia, hypertension and arrhythmia. Magnesium enhances the neuromuscular block of rocuronium. This study has been conducted to evaluate the reversal efficacy of sugammadex from deep rocuronium-induced neuromuscular block (NMB) during consistent pretreatment of MgSO4 in rabbits. ⋯ The reversal of sugammadex from a deep rocuronium-induced NMB during large pretreatment of MgSO4 was not affected. However, we should consider that the reversal effect of sugammadex varied depending on the dose.
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Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. ⋯ Various other prophylactic and treatment interventions have been suggested. However, due to a lack of conclusive evidence supporting their use, the potential benefits of such interventions should be weighed carefully against the risks. This article reviews the current literature on the diagnosis, risk factors, pathophysiology, prevention, and treatment of PDPH.
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Korean J Anesthesiol · Apr 2017
Learning curves for three specific procedures by anesthesiology residents using the learning curve cumulative sum (LC-CUSUM) test.
The learning curve cumulative sum (LC-CUSUM) test is an innovative tool that allows quantitative monitoring of individual medical performance during the learning process by determining when a predefined acceptable level of performance is reached. This study used the LC-CUSUM test to monitor the learning process and failure rate of anesthesia residents training for specific subspecialty anesthesia procedures. ⋯ A single 6-month rotation in a reference teaching center may not be sufficient to train residents to perform specific or sub-specialty procedures as required. A regional learning network may be useful. More patient-based data are necessary to conduct a risk adjustment analysis for such specific procedures.
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Korean J Anesthesiol · Apr 2017
Thoracic interfascial nerve block for breast surgery in a pregnant woman: a case report.
Regional anesthesia for non-obstetric surgery in parturients is a method to decrease patient and fetal risk during general anesthesia. Thoracic interfascial nerve block can be used as an analgesic technique for surgical procedures of the thorax. ⋯ Pecto-intercostal fascial block (PIFB) targets the anterior cutaneous branch of the intercostal nerve. The authors successfully performed a modified Pecs II block and PIFB without complications in a parturient who refused general anesthesia for breast surgery.