Korean journal of anesthesiology
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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 · Apr 2010
Anaphylaxis with angioedema by rocuronium during induction of general anesthesia -A case report-.
Perioperative anaphylaxis is characterized by severe respiratory and cardiovascular manifestations. Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anesthesiologist. A 34-year-old woman was scheduled to undergo endo venous laser therapy of varicose veins. ⋯ The patient received ephedrine and hydrocortisone with hydration. After achieving stable vital signs and symptom relief, surgery was performed without complications. A postoperative skin dermal test performed to identify the agent responsible revealed a positive skin test for rocuronium.
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Korean J Anesthesiol · Apr 2010
Comparison of coagulation factors and blood loss between O and non-O blood types following hydroxyethyl starch infusion.
Individuals with type O blood are more likely to have reduced factor VIII and von Willebrand factor levels compared to their non-O counterparts. Hydroxyethyl starch (HES), which is widely used for blood volume replacement, can induce coagulopathy. Therefore, we tested whether blood type O patients show more coagulopathy and blood loss than non-O patients after infusion of 6% HES. ⋯ Despite inborn low factor VIII which further decreased shortly after HES infusion, blood type O patients did not show more blood loss than non-O blood type after 15 ml/kg of HES infusion in PLIF surgery.
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Korean J Anesthesiol · Apr 2010
The change of T-wave on electrocardiogram after epinephrine test dose in spinal anesthetized adults.
This study evaluated the efficacy of a T-wave change after the IV administration of low dose epinephrine containing the test dose during spinal anesthesia. ⋯ These results suggest that a change in the T-wave amplitude is useful for detecting the unintentional IV administration of low dose epinephrine during CSEA.