Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Comparative Study
Intraocular pressure changes during general anesthesia in children, comparing no mask, undermask and laryngeal mask airway.
In a before and after study of 35 children's eyes, we compared the intraocular pressure (IOP) during general anesthesia consisting of 6-8 per cent sevoflurane in 100 per centoxygen at induction. IOP measurement, blood pressure, oxygen saturation, and heart rate were recorded in patients with an applied face mask while the patient became unconscious and proceeded to surgery. ⋯ The IOP with an applied face-mask was significantly statistically different from that after insertion of a LMA (12.8 +/- 3.1 and 12.0 +/- 3.3, p < 0.05) but not significantly different cilnically. We concluded that clinically, the IOP does not change in children given general anesthesia with a correct size of face mask when compared with insertion of an LMA or no face mask.
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Case Reports
Kikuchi-Fujimoto's disease, histiocytic necrotizing lymphadenitis, mimicking systemic lupus erythematosus.
Kikuchi-Fujimoto's disease (KFD) or histiocytic necrotizing lymphadenitis is a self-limiting condition characterized by fever, neutropenia and lymphadenopathy. It is rarely associated with systemic lupus erythematosus (SLE). ⋯ The clinical symptoms resolved spontaneously within 3 months without any treatment. Because there is an association between KFD and SLE, great care should be taken with a patient who presents with either KFD or SLE.
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The routine plain-film abdominal series, consisting of supine and upright abdominal radiographs and upright chest radiograph of 246 patients, who presented with abdominal pain from the emergency room of Bangkok Metropolitan Administration Medical College and Vajira Hospital from January 2000 to May 2001 were reviewed. Each radiograph was independently interpreted to detect any radiographic abnormality. ⋯ Most of the detectable abnormalities in the upright views were pneumoperitoneums that were clearly demonstrated on the upright chest radiographs. So elimination of the upright abdominal view from the routine plain-film abdominal series in the screening of surgical cases from medical cases could result in cost-saving and a decrease in radiation exposure without significant loss of diagnostic information.
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To determine the occurrence and associated factors of awareness in the patients undergoing elective surgery under general anesthesia. ⋯ The occurrence of awareness was 0.62 per cent in the patients undergoing surgery under anesthesia. Inadequate anesthesia was the most likely cause of awareness. No postoperative sequelae of awareness occurred.
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Case Reports
Drug-induced hyperthermia and rhabdomyolysis during the perioperative period: report of three patients.
Drug-induced hyperthermia is one condition that anesthesiologists may meet even though it is uncommon, it is life threatening. We report 3 cases of patients at Siriraj Hospital, Mahidol University who developed drug-induced hyperthermia and rhabdomyolysis from different mechanisms. In two of them, the diagnosis was suspected malignant hyperthermia. ⋯ As a result of early detection and early manangement, these three patients survived without any permanent damage to vital organs. We conclude that Thai anesthesiologists should be more aware and alert to drug-induced hyperthermia especially as nowadays many teenagers abuse stimulant drugs and "triggering" drugs as antidepressant or serotonin reuptake inhibitors are prescribed more frequently. Early detection and management will decrease morbidity and mortality.