Korean journal of anesthesiology
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Korean J Anesthesiol · Dec 2012
Cardiac arrest with pulmonary edema in a non-parturient after ergonovine administration recovered with extracorporeal membrane oxygenation -A case report-.
Ergonovine have been used for the prevention and treatment of postpartum or postabortion hemorrhage. Although this modality has been considered relatively safe in the obstetric patients, there were a few cardiac events associated with this drug in the post-delivery or post-abortion patients, especially in patients with cardiovascular risk factors. We experienced cardiac arrest in a non-parturient with no discernible risk factors. ⋯ To manage the patient, extracorporeal membrane oxygenation was used and she recovered successfully without cardiopulmonary complications. Therefore, we recommend that when ergonovine is chosen as a modality, special caution should be paid to the pulmonary events, as well as cardiac, especially when administered by intravenously even in patients with no cardiovascular risk factors. If cardiac events occur, extracorporeal membrane oxygenation or other measures, such as intra-aortic balloon pump can be helpful when conventional cardiopulmonary resuscitation is not effective.
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Korean J Anesthesiol · Dec 2012
Intrathecal morphine in two patients undergoing deep hypothermic circulatory arrest during aortic surgery -A case report-.
We retrospectively report the first use of intrathecal morphine prior to incision in two male patients undergoing a complex aortic reconstruction, who required complete circulatory arrest under deep hypothermia for intraoperative and postoperative pain control. We administered intrathecal morphine to two male patients undergoing circulatory arrest and deep hypothermia. Patients were fully heparinized prior to cardiopulmonary bypass. ⋯ During the first 24 hours after surgery, we observed excellent analgesia without the associated side effects, thus, reducing the time required for pain control by the nursing staff. A successful analgetic strategy not only enhances the patient satisfaction, but may improve the postoperative outcome. However, complications, such as increased risk of epidural hematoma formation, are of special concern in cardiac surgery.
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Korean J Anesthesiol · Dec 2012
Ankle-brachial blood pressure differences in the beach-chair position of the shoulder surgery.
During shoulder surgery, blood pressure is frequently measured at the ankle. Anesthetic complications may result when ankle blood pressure is higher than brachial blood pressure and anesthesiologists misinterpret ankle blood pressure as brachial blood pressure. Therefore, we investigated whether ankle blood pressure is significantly higher than brachial blood pressure before anesthesia induction, during induction, after tracheal intubation, before beach chair position, and in the beach chair position. ⋯ These results suggest that anesthesiologists should consider these ankle-brachial blood pressure differences when monitoring anesthesia in the beach chair position.
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Korean J Anesthesiol · Dec 2012
The effect of gender on EC(50) of remifentanil to prevent pain during injection of microemulsion propofol.
Propofol injection pain is an unpleasant experience to patients and its prevalence can be influenced by age and gender. We determined the half maximal effective concentration (EC(50)) of remifentanil for preventing the microemulsion propofol injection pain in the male and female adult groups. ⋯ The remifentanil EC(50) for preventing the moderate to severe injection pain of propofol was higher in males than in females.
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Korean J Anesthesiol · Dec 2012
The safety and efficacy of minimal-flow desflurane anesthesia during prolonged laparoscopic surgery.
Minimal-flow anesthesia can meet the demands of a modern society that is more sensitive to environmental protection and economic burdens. This study compared the safety and efficacy of minimal-flow desflurane anesthesia with conventional high-flow desflurane anesthesia for prolonged laparoscopic surgery. ⋯ In prolonged laparoscopic surgery, no significant differences were found in safety and efficacy between minimal-flow and high-flow desflurane anesthesia.