摘要
Erythromelalgia is a rare disease characterized by palmar and plantar erythema, burning pain and local increase in temperature. Secondary erythromelalgia most commonly appears secondary to myeloproliferative disorders, essential thrombocytosis and polycythemia vera. The pain associated with erythromelalgia is often severe and recalcitrant. So far no properly performed therapeutic trials have been published. We present a case of erythromelalgia of both hands and feet in a 52 year old man. A twice daily cervical and lumbar epidural block of mepivacaine 0.5% and mexiletine 100 mg given orally resuletd in complete resolution of the syndrome. After 3 months, the symptom recurred mildly.
Subject(s)
Humans , Middle Aged , Bupivacaine , Burns , Erythema , Erythromelalgia , Foot , Hand , Mepivacaine , Mexiletine , Myeloproliferative Disorders , Polycythemia Vera , Rare Diseases , Thrombocytosis摘要
BACKGROUND: Although post operative pain has been reduced significantly since the advent of laparoscopic surgery, many patients still complain of moderate abdominal and shoulder pain after surgery. METHOD: Patients scheduled for elective laparoscopic cholecystectomy were assigned to three groups by simple randomization(12 patients per group). Group I patients(control) had no specific treatment, group II patients had 10 ml of normal saline instillation, and group III patients had 10 ml of 0.5% bupivacaine instillation. Instillation was made directly into the gallbladder bed and right subdiaphragmatic space under direct vision by the surgeon at the end of the procedure and before evacuating the pneumoperitoneum. RESULT: Compared to that of the group I, VAS of group II and III did not show any statistically significant difference. Compared to the group I, group II & III showed no significant difference in numbers of requests of Tiaprofenic acid during the 36hours after the surgery. CONCLUSION: Topical instillation of 0.5% bupivacaine 10 ml to the gallbladder bed and right subdiaphragmatic space after laparoscopic cholecystectomy is not effective for the post operative pain control.
Subject(s)
Humans , Bupivacaine , Cholecystectomy, Laparoscopic , Gallbladder , Laparoscopy , Pain, Postoperative , Pneumoperitoneum , Shoulder Pain摘要
BACKGROUND: Many studies have demonstrated that nitrous oxide diffuses into the cuffs of endotracheal tubes and increases cuff volumes and pressures. Such increments of cuff pressure maybe result in damage to the trachea. We evaluated the increase of intracuff pressure, volume and the statistical significance was analyzed with personal computer. METHODS: Fourty-nine patients ranging in age 37+/-15 years, in ASA physical status class 1~2 , they were 26 males and 23 females. They divided into two groups, group I(n=25) were anesthesia with nitrous oxide : oxygen (2 L/min : 2 L/min), group II were(n=24) anesthesia with nitrous oxide : oxygen (4 L/min : 2 L/min). The cuff pressure was measured every 30 minutes and compared with each others and group I and II. RESULTS: Our results suggest that a significant intracuff volume and pressure changes developed between two groups (p<0.05), more significant intracuff pressure changes occured at group II than group I (p=0.001) and significant increment changes according to time and different concentration of nitrous oxide between two groups (p<0.05). CONCLUSIONS: This study was conducted to determine the degree of intracuff pressure and volume changes during general inhalation anesthesia with different concentration of nitrous oxide. These results suggest that a nitrous oxide significantly increases cuff pressure and volume in a concentration and time related fashion.