Korean journal of anesthesiology
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Korean J Anesthesiol · Sep 2012
Effect of timing of morphine administration during propofol - remifentanil anesthesia on the requirements of post-operative analgesia.
An important concern of intra-operative infusion of remifentanil is the possible development of acute opioid tolerance, which manifests as an increased postoperative analgesia requirement. We have examined the effect of the timing of intra operative morphine administration on the need for morphine consumption for pain control during the first 24 hours after operation. ⋯ Early intra-operative administration of morphine compared to that of morphine in the end of surgery did not affect postoperative morphine consumption and pain scores during the first 24 hours after surgery for open nephrolithotomy. Newer pharmacologic interventions for prevention of acute tolerance of opioids seems rational (Clinical trial registration No. ACTRN: 12609000570280).
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Korean J Anesthesiol · Sep 2012
Cesarean section in spinal anesthesia on a patient with mesencephalic tumor and ventriculoperitoneal drainage -A case report-.
A seventeen-year-old pregnant woman with a mesencephalic tumor and ventriculoperitoneal (VP) drainage was admitted to the hospital at full term pregnancy to give birth. Elective cesarean section was performed because of her prime disease (mesencephalic tumor), breech position of the baby, gestational diabetes and expected weight of the baby of more than 4 kg. The operation was performed under spinal anesthesia. ⋯ The patient was hemodynamically stabile during the anesthesia and the procedure was uneventful. The woman developed no neurologic symptoms, and a healthy female child was born. This is the first case of a pregnant woman with a cerebral tumor and VP drainage on whom a successful delivery was performed with C-section under spinal anesthesia.
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Korean J Anesthesiol · Sep 2012
The effect of ketamine on the separation anxiety and emergence agitation in children undergoing brief ophthalmic surgery under desflurane general anesthesia.
Emergence agitation (EA) frequently occurs after desflurane anesthesia in children. Ketamine, because of its sedative and analgesic properties, might be useful for the management of separation anxiety and EA. We investigated the preventive effect of ketamine on separation anxiety and EA after desflurane anesthesia in children for brief ophthalmic surgery. ⋯ In children undergoing brief ophthalmic surgery with desflurane anesthesia, ketamine 1.0 mg/kg administered before entering the operating room reduced separation anxiety, postoperative pain, and incidence of EA without delay in recovery.
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Korean J Anesthesiol · Sep 2012
The effect of aprepitant for the prevention of postoperative nausea and vomiting in patients undergoing gynecologic surgery with intravenous patient controlled analgesia using fentanyl: aprepitant plus ramosetron vs ramosetron alone.
The purpose of this study was to evaluate the effect of an aprepitant, neurokinin-1(NK1) receptor antagonist, for reducing postoperative nausea and vomiting (PONV) for up to 24 hours in patients regarded as high risk undergoing gynecological surgery with intravenous patient-controlled analgesia (IV PCA) using fentanyl. ⋯ In patients regarded as high risk undergoing gynecological surgery with IV PCA using fentanyl, the aprepitant plus ramosetron ware more effective than ramosetron alone to decrease the incidence of PONV, use of rescue antiemetics and nausea severity for up to 24 hours postoperatively.
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Korean J Anesthesiol · Sep 2012
Seizure and delayed emergence from anesthesia resulting from remote cerebellar hemorrhage after lumbar spine surgery -A case report-.
A patient with remote cerebellar hemorrhage (RCH) who was presented at the authors' hospital with seizure and delayed emergence from anesthesia after loss of cerebrospinal fluid (CSF) through a dural tear during lumbar spine surgery is described. RCH is a rare and unpredictable complication after spinal surgery. ⋯ Its mechanism is still disputed, but is probably venous bleeding secondary to significant intra- or post-operative loss of CSF. Therefore, RCH must be considered in patients with unexplained mental deterioration or disturbance upon emergence and seizure from general anesthesia after spine surgery.