ABSTRACT
Dexmedetomidine is a highly selective α2-adrenoceptor agonist that demonstrates anxiolytic and analgesic properties without inducing respiratory compromise, which makes it a suitable agent for procedural sedation and imaging studies. In our current case reports, intravenous dexmedetomidine infusion was used to provide sedation to 2 pediatric patients over more than 20 sessions of radiation therapy. On both occasions, dexmedetomidine provided adequate sedation without respiratory depression. However, the required dosage increased with repeated radiation therapy sessions.
Subject(s)
Humans , Dexmedetomidine , Pediatrics , Radiotherapy , Respiratory InsufficiencyABSTRACT
Interventional neuroradiology (INR) has been a rapidly expanding and advancing clinical area during the past few decades. As the complexity and diversity of INR procedures increases, the demand for anesthesia also increases. Anesthesia for interventional neuroradiology is a challenge for the anesthesiologist due to the unfamiliar working environment which the anesthesiologist must consider, as well as the unique neuro-interventional components. This review provides an overview of the anesthetic options and specific consideration of the anesthesia requirements for each procedure. We also introduce the anesthetic management for interventional neuroradiology performed in our medical institution.
Subject(s)
Anesthesia , International Normalized RatioABSTRACT
Case 1:A 59-year-old man underwent mitral valve replacement and Maze operation.Under general anesthesia, a pulmonary artery catheter (PAC) and superior vena cava (SVC) cannula were inserted.There were no complications during surgery.However, when the surgeons attempted to remove the PAC the next day there was resistance that caused the catheter to break during removal.A chest X ray revealed that the distal portion of the PAC remained in his heart.Therefore, the patient underwent surgery to remove the remnant catheter.Case 2:A 62-year-old man underwent mitral valvuloplasty.A PAC was inserted under general anesthesia.After the procedure, the patient was weaned off his cardiopulmonary bypass (CPB).However, his pulmonary artery pressure could not be measured and an abnormal wave was observed. We attempted to re-insert the catheter, but were unsuccesful.An operation was conducted and the catheter was found to be tied at the septum of the right atrium.
Subject(s)
Humans , Middle Aged , Anesthesia, General , Cardiopulmonary Bypass , Catheters , Mitral Valve , Pulmonary Artery , Thorax , Vena Cava, SuperiorABSTRACT
Case 1:A 59-year-old man underwent mitral valve replacement and Maze operation.Under general anesthesia, a pulmonary artery catheter (PAC) and superior vena cava (SVC) cannula were inserted.There were no complications during surgery.However, when the surgeons attempted to remove the PAC the next day there was resistance that caused the catheter to break during removal.A chest X ray revealed that the distal portion of the PAC remained in his heart.Therefore, the patient underwent surgery to remove the remnant catheter.Case 2:A 62-year-old man underwent mitral valvuloplasty.A PAC was inserted under general anesthesia.After the procedure, the patient was weaned off his cardiopulmonary bypass (CPB).However, his pulmonary artery pressure could not be measured and an abnormal wave was observed. We attempted to re-insert the catheter, but were unsuccesful.An operation was conducted and the catheter was found to be tied at the septum of the right atrium.
Subject(s)
Humans , Middle Aged , Anesthesia, General , Cardiopulmonary Bypass , Catheters , Mitral Valve , Pulmonary Artery , Thorax , Vena Cava, SuperiorABSTRACT
BACKGROUND: We examined the effects of varying inspiratory to expiratory (I : E) ratio on gas exchange and hemodynamics during high frequency partial liquid ventilation (HFPLV), a combination of high frequency ventilation (HFV) and partial liquid ventilation (PLV), in a rabbit model of acute lung injury. METHODS: Twelve rabbits treated with repeated saline lavage were divided into two groups. In the HFPL group (n = 6), 6 ml/kg of perfluorodecaline was administered through the endotracheal tube. Rabbits in this group and in the HFJ group (n = 6) were treated with high frequency jet ventilation (HFJV) at I : E ratios of 1 : 1, 1 : 2, and 1 : 3 for 15 minutes, and arterial blood gas, mixed venous blood gas and hemodynamic parameters were measured. RESULTS: We observed no significant respiratory and hemodynamic differences between the two groups. At an I : E ratio of 1 : 1, the PaO2 was significantly higher, and the shunt rate and PaCO2 were significantly lower in both groups, compared with I : E ratios of 1 : 2 and 1 : 3. Cardiac output at the 1 : 3 I : E ratio was significantly higher than at 1 : 1. CONCLUSIONS: These findings indicate that, in this model, a 1 : 1 I : E ratio was superior for oxygenation and ventilation than I : E ratios of 1 : 2 or 1 : 3, while having no detrimental effects on hemodynamics.
Subject(s)
Rabbits , Acute Lung Injury , Cardiac Output , Hemodynamics , High-Frequency Jet Ventilation , High-Frequency Ventilation , Liquid Ventilation , Oxygen , Therapeutic Irrigation , VentilationABSTRACT
The purposes of this study were to investigate the satisfaction of use of removable denture elated to general, functional and esthetic factors among dental patients in national sorokdo hospital, and to establish the structure relationships of dental treatment satisfaction. Two hundred fifty hansen`s patients who consented with this survey were selected and examined their oral status. Satisfaction degree was estimated by means of self-developed questionarires, filled out by face-to-face interview. Collected data were analyzed by t-tast The obtained results were as follow : 1. The satisfaction degree of four subscales was highest in esthetic actor (3.17+/-0.36), denture retention factor(3.10+/-0.60), general treatment satisfaction factor(2.94+/-0.56), and masticatory function factor (2.90+/-0.68) in descending order. It was appeared that patients was generally satisfied with all four factor. 2. On the comparison between proportion of denture satisfaction and satisfactio 02n of subscales, as the satisfaction of general treatment, masticatory function and denture retention were increased, the proportion of denture satisfaction of esthetic function and proportion of denture satisfaction. 3. The masticatiory function factor, denture retention factor and genernal satisfaction of treatment factor were directly affected on the denture satisfaction, but esthetic factor was affected indirectly on the denture satisfaction as a result of path analysis
Subject(s)
Humans , Dental Prosthesis , Denture Retention , DenturesABSTRACT
BACKGROUND: The effects of propofol-rocuronium on the conditions of tracheal intubation, maternal hemodynamic changes and status of neonates were evaluated in 28 parturients undergoing an elective caesarean section. METHODS: Anesthesia was induced with propofol 2 mg/kg and rocuronium 0.6 mg/kg and maintained with O2-N2O-Propofol. Neuromuscular transmission was assessed using the electromyographic response to the train-of-four stimulation of the ulnar nerve at the wrist every 10 s. Intubation was begun at the disappearance of the T3 of the TOF or 80 s from the administration of rocuronium, whichever occurred first. The conditions for tracheal intubation were classified into four grades as excellent, good, poor and inadequate. The time to the T1 disappearance (onset time) and the time to the reappearance of T2 (duration of the effect) were recorded. The maternal arterial blood pressure and heart rates were measured before and after propofol-rocuronium administration. The neonates were evaluated by the 1-5 min Apgar scores and the acid-base status of the umbilical cord blood. RESULTS: The mean intubation time was 74.4 +/- 10.1 s and the onset time of rocuronium was 100.8 +/- 31.8 s. The intubation conditions were excellent or good in 26 patients (93%) but poor in 2 patients. The maternal arterial blood pressure decreased and the heart rate increased after administering the propofol-rocuronium. The neonatal Apgar scores and blood gas parameters were within the normal range. CONCLUSIONS: Rapid sequence intubation using propofol-rocuronium is clinically acceptable as a caesarean section anesthetic.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Anesthesia , Arterial Pressure , Cesarean Section , Fetal Blood , Heart Rate , Hemodynamics , Intubation , Propofol , Reference Values , Ulnar Nerve , WristABSTRACT
BACKGROUND: The effect of arterial carbon dioxide tension (PaCO2) during ischemia and reperfusion has been a controversial issue. In this study, the effect of PaCO2 during ischemia and reperfusion was evaluated by 31P magnetic resonance spectroscopy (MRS). METHODS: Incomplete global cerebral ischemia was induced by ligation of carotid artery under lowered mean blood pressure (mean blood pressure= 40 mmHg) for 30 minutes followed by 2 hours of reperfusion. Eighteen cats were divided into 3 groups: For group 1 (n=6) (control group), animals were subjected to normocarbia (PaCO2=28~33 mmHg) during ischemia and reperfusion, for group 2 (n=6), animals were subjected to hypocarbia (PaCO2=18~23 mmHg) during ischemia and reperfusion, and for group 3 (n=6), animals were subjected to normocarbia during ischemia and hypocarbia during reperfusion. RESULTS: For group 1, the energy metabolism measured by [PCr/Pi] was recovered about 74.7 6.4%. For group 2, the energy metabolism failed to be completely recovered by 120 minutes of reperfusion (69.3 7.3%), whereas for group 3, the energy matabolism was completely recovered by 120 minutes of reperfusion (97.6 2.4%). There were statistically significant differences between group 1 and group 3 (p<0.05). The changes in pH were not significantly different among the groups. CONCLUSION: In this study, a condition of hypocarbia during reperfusion seems better for the energy metabolism after incomplete global ischemia of cats.