International journal of clinical and experimental medicine
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Case Reports
Serious anaphylactic shock induced by hemocoagulase agkistrodon during anesthesia in a 5-year-old child.
We report a case of serious anaphylactic shock in a 5-year-old child undergoing scheduled surgery blank space of a right femoral intramedullary nail removal. The boy had undergone right femoral elastic intramedullary nail fixation surgery 14 months prior, but had no history of allergies. Within 5 minutes of intravenous bonus injection of hemocoagulase agkistrodon (HCA) 1 unit, a widespread transient diffuse erythema was seen on the front of his chest. ⋯ Total amount of dexamethasone sodium phosphate 14 mg was used. To the best of our knowledge, few case reports of HCA-induced anaphylactic shock in children exist. Our report will, therefore, increase awareness of the allergic potential of HCA among pediatric anesthesiologists.
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To estimate the efficacy and safety of adding bevacizumab to cetuximab- or panitumumab-based therapy in the treatment of patients with metastatic colorectal cancer (mCRC), using a meta-analysis of randomized controlled trials. ⋯ The addition of bevacizumab to cetuximab- or panitumumab-based therapy did not improve PFS and OS resulting in better ORR. Thus, the combined therapy of bevacizumab with cetuximab or panitumumab is not recommended for the treatment of mCRC. However, larger scale RCTs are needed to confirm these findings.
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There has been a large series in the literature reporting on results of osteotomy for the correction of kyphotic deformity secondary to post-traumatic thoracolumbar fracture. However, there are few reports on using intraoperative, full rotation, three dimensional image (O-arm)-based navigation, transpedicular wedge osteotomy for the correction of kyphotic deformity in old thoracolumbar fracture. A 45-year-old woman with L1 old fracture, presented to us with a Cobb angle of 45 degrees. ⋯ The location, angle and depth of osteotomy, as well as screw fixation were performed using a guide tube while referring to the reconstructed 3D-anatomical views. The surgery was successful without nervous and vascular injuries. Using intraoperative, full rotation, three dimensional image (O-arm)-based navigation, the transpedicular wedge osteotomy is a safe and effective treatment for kyphosis after the thoracolumbar fracture, which can insert the pedicular screw accurately, trace the real-time wedge osteotomy and reduce the loss of correction of kyphotic deformity.
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Sufentanil-induced cough is a common phenomenon during the induction of anesthesia. This double-blind, randomized, and placebo-controlled study was designed to investigate the effects of prophylactic magnesium sulfate (MgSO4) on the incidence and severity of sufentanil-induced cough. A total of 165 patients who were scheduled for elective surgery under general anesthesia were allocated into three groups (I, II, and III; n = 55 each) that were injected with either 50 ml of normal saline, 30 or 50 mg/kg of MgSO4 (diluted with normal saline into 50 ml). ⋯ Compared with group I, group III had the lowest incidence of mild cough and both groups II and III had lower incidence of moderate and severe cough (P < 0.05). There were no differences in the hemodynamic data at three timepoints among the three groups. In conclusion, sufentanil-induced cough may be suppressed effectively and safely by prophylactic use of 30 mg/kg of MgSO4 during anesthetic induction.
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This study is to investigate the predictive factors of blood loss in ankylosing spondylitis (AS) patients. Retrospective analysis was performed in patients with thoracolumbar kyphotic deformity secondary to ankylosing spondylitis who underwent PSO from 2008 through 2013. Patient's demographics, preoperative and postsurgical global kyphosis (GK) angle, preoperative hematologic tests and other factors related to PSO were analyzed. ⋯ Multiple stepwise analysis identified male sex (P = 0.000), and two-level osteotomy (P = 0.016) to be predictive factors of increased EBL/EBV percentage in AS patients undergoing PSO for thoracolumbar kyphosis. Male and two-level osteotomy are the two most significant factors predicting increased EBL/EBV percentage in AS patients undergoing PSO for thoracolumbar kyphosis. These predictors can provide more adequate preoperative preparations.