Journal of Yeungnam Medical Science

Case report

Intra-abdominal hypertension during hip arthroscopy: a case report: Saeyoung Kim, Hyun-Su Ri, Ji Hyun Kim, Jiyong Yeom; J Yeungnam Med Sci. 2023;40(1):102-105. Published online September 23, 2022; DOI: https://doi.org/10.12701/jyms.2022.00430

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Abstract PDF: Symptomatic extravasation of irrigation fluid is a rare complication of hip arthroscopy. However, depending on the amount of fluid, intra-abdominal hypertension (IAH) may occur and even develop into abdominal compartment syndrome, which can seriously alter hemodynamic circulation. Therefore, it is important for anesthesiologists to promptly recognize the abnormal signs of IAH for early diagnosis and better clinical outcomes. Nevertheless, these signs are difficult to detect because they are usually obscured when the patient is under anesthesia and masked by surgical drapes. We report a case of IAH under general anesthesia during hip arthroscopy to highlight possible symptoms and signs.

Original articles

Effects of propofol-remifentanil versus sevoflurane-remifentanil on acute postoperative pain after total shoulder arthroplasty: a randomized trial: Eun Kyung Choi, Saeyoung Kim, Do young Kim; J Yeungnam Med Sci. 2023;40(3):247-251. Published online March 30, 2022; DOI: https://doi.org/10.12701/jyms.2022.00129

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Abstract PDF: Background
While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia.
Methods
Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed.
Results
No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery.
Conclusion
PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.

Digital subtraction angiography vs. real-time fluoroscopy for detection of intravascular injection during transforaminal epidural block: Kibeom Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(2):109-114. Published online January 24, 2019; DOI: https://doi.org/10.12701/yujm.2019.00122

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Abstract PDF

Background
Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF.
Methods
We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA.
Results
Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels.
Conclusion
During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

Citations

Citations to this article as recorded by

1. Lumbosacral radicular pain
Laurens Peene, Steven P. Cohen, Jan Willem Kallewaard, Andre Wolff, Frank Huygen, Antal van de Gaag, Steegers Monique, Kris Vissers, Chris Gilligan, Jan Van Zundert, Koen Van Boxem
Pain Practice.2024; 24(3): 525. CrossRef
Safety of local anesthetics in cervical nerve root injections: a narrative review
Zachary E. Stewart
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An update on technical and safety practice patterns in transforaminal epidural steroid injections
Ashley E. Gureck, Berkenesh Gebrekristos, Razvan Turcu, Dana Kotler, Alec L. Meleger
Interventional Pain Medicine.2023; 2(4): 100286. CrossRef
Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes
Josh Levin, John Chan, Lisa Huynh, Matt Smuck, Jayme Koltsov, Bilge Kesikburun, Graham E. Wagner, Marc Caragea, Keith Kuo, Zachary L. McCormick, Byron Schneider, Evan Berlin, D.J. Kennedy, Serdar Kesikburun
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The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain
Mansoor M Aman, Ammar Mahmoud, Timothy Deer, Dawood Sayed, Jonathan M Hagedorn, Shane E Brogan, Vinita Singh, Amitabh Gulati, Natalie Strand, Jacqueline Weisbein, Johnathan H Goree, Fangfang Xing, Ali Valimahomed, Daniel J Pak, Antonios El Helou, Priyanka
Journal of Pain Research.2021; Volume 14: 2139. CrossRef

Case report

Awareness during general anesthesia despite simultaneous bispectral index and end-tidal anesthetic gas concentration monitoring: Jungwon Lee, Chorong Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(1):50-53. Published online December 14, 2018; DOI: https://doi.org/10.12701/yujm.2019.00010

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3 Crossref

Abstract PDF

Awareness during general anesthesia occurs in approximately 0.1–0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0–5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7–1.3 MAC, awareness during anesthesia occurred.

Citations

Citations to this article as recorded by

Depth of anaesthesia monitoring: updated evidence. Comment on Br J Anaesth 2023; 131: 196–9
Paul S. Myles
British Journal of Anaesthesia.2023; 131(5): e145. CrossRef
Impact of bispectral index monitoring on critical incidents rate in high-risk patients: a randomised controlled trial
N. V. Trembach
Kuban Scientific Medical Bulletin.2022; 29(1): 48. CrossRef
A Crossover Comparison of the Sensitivity and the Specificity between BIS and AEP in Predicting Unconsciousness in General Anesthesia
Haitao Yang, Guan Wang, Jinxia Gao, Jie Liu, Liang Zhao
Scientific Programming.2020; 2020: 1. CrossRef

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