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Original article
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
  • 2,651 View
  • 103 Download
AbstractAbstract 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.
Case reports
Reverse Takotsubo cardiomyopathy with left bundle branch block after anesthesia induction in a patient with subarachnoid hemorrhage: a case report
Eun Kyung Choi, Jong-Hoon Kim, Minhyun Kim
J Yeungnam Med Sci. 2022;39(2):172-178.   Published online October 25, 2021
DOI: https://doi.org/10.12701/yujm.2021.01354
  • 4,087 View
  • 76 Download
  • 1 Web of Science
AbstractAbstract PDF
Cardiac dysfunction after subarachnoid hemorrhage (SAH) is described as Takotsubo or reverse Takotsubo cardiomyopathy that shows transient left ventricular wall motion abnormalities with electrocardiogram (ECG) changes. ST change followed by T inversion is a common ECG finding complicated with these disorders, left bundle branch block (LBBB) may be a potential ECG pattern which is seen. In this case, we describe the clinical profile and outcomes of a patient with LBBB and reverse Takotsubo cardiomyopathy after anesthetic induction, which was scheduled as an emergent external ventricular drainage after SAH. This is the first report of an LBBB pattern in reverse Takotsubo cardiomyopathy.
Anesthetic management during whole-lung lavage using lung ultrasound in a patient with pulmonary alveolar proteinosis: a case report
Jae Wan Jung, Hyunho Lee, Jimi Oh
Yeungnam Univ J Med. 2021;38(4):374-380.   Published online September 6, 2021
DOI: https://doi.org/10.12701/yujm.2021.01284
  • 3,972 View
  • 98 Download
AbstractAbstract PDF
Pulmonary alveolar proteinosis (PAP) is an uncommon disease characterized by progressive accumulation of lipoprotein material in the lungs due to impaired surfactant clearance. Whole-lung lavage (WLL) is the current standard treatment and consists of sequential lavage of each lung to mechanically remove the residual material from the alveoli. Although WLL is considered safe, unexpected complications can occur. Moreover, due to the rarity of the disease itself, this procedure is unknown to many physicians, and management of intraoperative complications can be challenging for anesthesiologists. Lung ultrasound (LUS) provides reliable and valuable information for detecting perioperative pulmonary complications and, in particular, quantitation of lung water content. There have been reports on monitoring the different stages of controlled deaeration of the non-ventilated lung during WLL using LUS. However, it has been limited to non-ventilated lungs. Therefore, we report the use of LUS in WLL to proactively detect pulmonary edema in the ventilated lung and implement a safe and effective anesthesia strategy. Given the limited diagnostic tools available to anesthesiologists in the operating room, LUS is a reliable, fast, and noninvasive method for identifying perioperative pulmonary complications in patients with PAP undergoing WLL.
Review article
Drug selection for sedation and general anesthesia in children undergoing ambulatory magnetic resonance imaging
Sung Mee Jung
Yeungnam Univ J Med. 2020;37(3):159-168.   Published online April 17, 2020
DOI: https://doi.org/10.12701/yujm.2020.00171
  • 11,707 View
  • 378 Download
  • 17 Crossref
AbstractAbstract PDF
The demand for drug-induced sedation for magnetic resonance imaging (MRI) scans have substantially increased in response to increases in MRI utilization and growing interest in anxiety in children. Understanding the pharmacologic options for deep sedation and general anesthesia in an MRI environment is essential to achieve immobility for the successful completion of the procedure and ensure rapid and safe discharge of children undergoing ambulatory MRI. For painless diagnostic MRI, a single sedative/anesthetic agent without analgesia is safer than a combination of multiple sedatives. The traditional drugs, such as chloral hydrate, pentobarbital, midazolam, and ketamine, are still used due to the ease of administration despite low sedation success rate, prolonged recovery, and significant adverse events. Currently, dexmedetomidine, with respiratory drive preservation, and propofol, with high effectiveness and rapid recovery, are preferred for children undergoing ambulatory MRI. General anesthesia using propofol or sevoflurane can also provide predictable rapid time to readiness and scan times in infant or children with comorbidities. The selection of appropriate drugs as well as sufficient monitoring equipment are vital for effective and safe sedation and anesthesia for ambulatory pediatric MRI.

Citations

Citations to this article as recorded by  
  • Prioritisation of data-poor pharmaceuticals for empirical testing and environmental risk assessment
    Cristiana Cannata, Thomas Backhaus, Irene Bramke, Maria Caraman, Anna Lombardo, Rhys Whomsley, Caroline T.A. Moermond, Ad M.J. Ragas
    Environment International.2024; 183: 108379.     CrossRef
  • Review of pediatric sedation and anesthesia for radiological diagnostic and therapeutic procedures
    Mohammed Ageel
    Journal of Radiation Research and Applied Sciences.2024; 17(1): 100833.     CrossRef
  • Comparison of airway collapsibility following single induction dose ketamine with propofol versus propofol sedation in children undergoing magnetic resonance imaging: A randomised controlled study
    Pooja Bhardwaj, Sakthirajan Panneerselvam, Priya Rudingwa, Kirthiha Govindaraj, M.V.S. Satya Prakash, Ashok S. Badhe, Krishnan Nagarajan
    Indian Journal of Anaesthesia.2024; 68(2): 189.     CrossRef
  • Comparison of oral triclofos and intranasal midazolam and dexmedetomidine for sedation in children undergoing magnetic resonance imaging (MRI): an open-label, three-arm, randomized trial
    Shyam Chandrasekar, Bhagirathi Dwibedi, Rashmi Ranjan Das, Biswa Mohan Padhy, Bikram Kishore Behera
    European Journal of Pediatrics.2023; 182(3): 1385.     CrossRef
  • Correlation between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients in South Korea: a prospective cohort study
    Mijung Park, Ji Um, So Hyun Kim, Jiseon Yoon, Yeonjae Lee, Jiyeong Kwon, Seonhee Baek, Dong Yeon Kim
    Child Health Nursing Research.2023; 29(1): 51.     CrossRef
  • COMPARISON OF INTRAMUSCULAR VERSUS INTRAVENOUS KETAMINE FOR SEDATION IN CHILDREN UNDERGOING MAGNETIC RESONANCE IMAGING EXAMINATION
    Jasim M. Salman, Jasim N. Al-Asadi, Husham H. Abdul-Ra’aoof, Jawad H. Ahmed, Ali H Reshak
    Wiadomości Lekarskie.2023; 76(1): 198.     CrossRef
  • Does sevoflurane sedation in pediatric patients lead to “pseudo” leptomeningeal enhancement in the brain on 3 Tesla magnetic resonance imaging?
    Kiran Hilal, Kumail Khandwala, Saima Rashid, Faheemullah Khan, Shayan Sirat Maheen Anwar
    World Journal of Radiology.2023; 15(4): 127.     CrossRef
  • Intranasal dexmedetomidine versus intranasal midazolam as sole sedative agents for pelviabdominal magnetic resonance imaging in pediatrics: A randomized double-blind trial
    TaysserM Abdelraheem, HamdyA Hendawy, AmiraM Elkeblawy
    Bali Journal of Anesthesiology.2023; 7(2): 99.     CrossRef
  • Prospective, randomized, double-blind, double-dummy, active-controlled, phase 3 clinical trial comparing the safety and efficacy of intranasal dexmedetomidine to oral midazolam as premedication for propofol sedation in pediatric patients undergoing magnet
    Olivia Nzungu Wabelo, Denis Schmartz, Mario Giancursio, Françoise De Pooter, Giulia Caruso, Jean-François Fils, Philippe Van der Linden
    Trials.2023;[Epub]     CrossRef
  • The effect of age on outpatient pediatric procedural sedation with intranasal dexmedetomidine and oral midazolam
    Xiaqing Zhou, Jialian Zhao, Haiya Tu, Kunwei Chen, Yaoqin Hu, Yue Jin
    European Journal of Pediatrics.2023; 183(1): 169.     CrossRef
  • Determination of the normal conus medullaris level in term infants: the role of MRI in early infancy
    Mengchun Sun, Benzhang Tao, Gan Gao, Hui Wang, Aijia Shang
    Journal of Neurosurgery: Pediatrics.2022; 29(1): 100.     CrossRef
  • Patient background related to success and adverse event in pediatric sedated MRI
    Yutaka Konda, Hajime Mihira, Louis Akiyama, Yuki Shiko, Yoshihito Ozawa, Yohei Kawasaki, Katsunori Fujii, Ryugo Hiramoto
    Pediatrics International.2022;[Epub]     CrossRef
  • Analysis of Risk Factors for Chloral Hydrate Sedative Failure with Initial Dose in Pediatric Patients: a Retrospective Analysis
    Yu Cui, Langtao Guo, Qixia Mu, Lu Kang, Qin Chen, Qunying Wu, Yani He, Min Tang
    Pediatric Drugs.2022; 24(4): 403.     CrossRef
  • Using intranasal dexmedetomidine with buccal midazolam for magnetic resonance imaging sedation in children: A single-arm prospective interventional study
    Bi Lian Li, Hao Luo, Jun Xiang Huang, Huan Huan Zhang, Joanna R. Paquin, Vivian M. Yuen, Xing Rong Song
    Frontiers in Pediatrics.2022;[Epub]     CrossRef
  • A Novel Propofol Dosing Regimen for Pediatric Sedation during Radiologic Tests
    Ji-Young Min, Jeong-Rim Lee, Hye-Mi Lee, Ho-Jae Nam, Hyo-Jin Byon
    Journal of Clinical Medicine.2022; 11(17): 5076.     CrossRef
  • Psychiatric outcomes following ketamine administration for orthopedic surgical anesthesia
    Alec E. Mansour, Elijah W. Hale, Daniel S. Saks
    Frontiers in Anesthesiology.2022;[Epub]     CrossRef
  • Artificial intelligence in paediatric radiology: Future opportunities
    Natasha Davendralingam, Neil J Sebire, Owen J Arthurs, Susan C Shelmerdine
    The British Journal of Radiology.2021; 94(1117): 20200975.     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
  • 5,492 View
  • 134 Download
  • 3 Crossref
AbstractAbstract 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
Original Articles
Comparison of sevoflurane and propofol anesthesia on the incidence of hyperglycemia in patients with type 2 diabetes undergoing lung surgery
Hyuckgoo Kim, Jisoo Han, Sung Mee Jung, Sang-Jin Park, Nyeong Keon Kwon
Yeungnam Univ J Med. 2018;35(1):54-62.   Published online June 30, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.1.54
  • 6,498 View
  • 99 Download
  • 4 Crossref
AbstractAbstract PDF
Background
The type and regimen of anesthesia may affect perioperative hyperglycemia following major surgical stress. This study compared the effects of sevoflurane and propofol on the incidence of hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.
Methods
This retrospective study included 176 patients with type 2 diabetes mellitus who had undergone lung surgery. Blood glucose levels and clinical outcomes from the preoperative period to the first 2 postoperative days (PODs) were retrospectively examined in patients who received sevoflurane (group S, n= 87) and propofol (group P, n=89) for maintenance of general anesthesia. The primary endpoint was the incidence of persistent hyperglycemia (2 consecutive blood glucose levels >180 mg/dL [10.0 mmol/L]) during the perioperative period. The secondary composite endpoint was the incidence of major postoperative complications and 30-day mortality rate after surgery.
Results
Blood glucose levels similarly increased from the preoperative period to the second POD in both groups (p=0.857). Although blood glucose levels at 2 hours after surgery were significantly lower in group P than in group S (p=0.022; 95% confidence interval for mean difference, -27.154 to -2.090), there was no difference in the incidence of persistent hyperglycemia during the perioperative period (group S, 70%; group P, 69%; p=0.816). The composite of major postoperative complications and all-cause in-hospital and 30-day mortality rates were also comparable between the two groups.
Conclusion
Sevoflurane and propofol were associated with a comparable incidence of perioperative hyperglycemia and clinical outcomes in diabetic patients undergoing lung surgery.

Citations

Citations to this article as recorded by  
  • Strategies for intraoperative glucose management: a scoping review
    Nathaniel Morin, Sarah Taylor, Danae Krahn, Leyla Baghirzada, Michael Chong, Tyrone G. Harrison, Anne Cameron, Shannon M. Ruzycki
    Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2023; 70(2): 253.     CrossRef
  • Impact of total intravenous anesthesia and total inhalation anesthesia as the anesthesia maintenance approaches on blood glucose level and postoperative complications in patients with type 2 diabetes mellitus: a double-blind, randomized controlled trial
    Xinghui Xiong, Yong He, Cheng Zhou, Qin Zheng, Chan Chen, Peng Liang
    BMC Anesthesiology.2023;[Epub]     CrossRef
  • Current trends in management of hyperglycaemia in surgical patients with diabetes mellitus: a review
    Vladimir N. Kuklin, J. Matri, N. P. Barlow, S. H. Tveit, J. E. Kvernberg, E. -M. Ringvold, V. Dahl
    Annals of Critical Care.2022; (4): 33.     CrossRef
  • Effects of sevoflurane anesthesia and abdominal surgery on the systemic metabolome: a prospective observational study
    Yiyong Wei, Donghang Zhang, Jin Liu, Mengchan Ou, Peng Liang, Yunxia Zuo, Cheng Zhou
    BMC Anesthesiology.2021;[Epub]     CrossRef
Ultrasound-guided superficial cervical plexus block under dexmedetomidine sedation versus general anesthesia for carotid endarterectomy: a retrospective pilot study
Wangseok Do, Ah-Reum Cho, Eun-Jung Kim, Hyae-Jin Kim, Eunsoo Kim, Heon-Jeong Lee
Yeungnam Univ J Med. 2018;35(1):45-53.   Published online June 30, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.1.45
  • 6,541 View
  • 85 Download
  • 7 Crossref
AbstractAbstract PDF
Background
Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA.
Methods
Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay.
Results
There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group (13.3±4.6 days in the GA group vs. 8.5±2.4 days in the RA group, p<0.001).
Conclusion
In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.

Citations

Citations to this article as recorded by  
  • Outcomes of Dexmedetomidine with Local Regional Anesthesia in Carotid Endarterectomy
    Samik H. Patel, Vikram L. Sundararaghavan, Amber M. Pawlikowski, Jeremy Albright, Jason M. Adams, Michael J. Heidenreich, Robert J. Beaulieu, Abdulhameed Aziz
    Annals of Vascular Surgery.2023; 89: 174.     CrossRef
  • Anesthetic Management of a Patient Undergoing Cochlear Implantation With Superficial Cervical Plexus Block and Sedation: A Case Report
    Natsuki Takemura, Tetsuya Miyashita, Yasuko Baba
    A&A Practice.2022; 16(1): e01555.     CrossRef
  • Ultrasound-guided intermediate cervical plexus block for postoperative analgesia in patients undergoing carotid endarterectomy under general anesthesia: a case-control study
    Onat BERMEDE, Volkan BAYTAŞ
    Journal of Contemporary Medicine.2022; 12(2): 261.     CrossRef
  • Relationship between annular calcification of plaques in the carotid sinus and perioperative hemodynamic disorder in carotid angioplasty and stenting
    Qingjie Chi, Zhuo Chen, Li Zhu, Ruifan Yuan, Kaixuan Ren, Tianle Wang, Wenbin Ding
    Journal of Stroke and Cerebrovascular Diseases.2022; 31(10): 106634.     CrossRef
  • Cardiac output and cerebral blood flow during carotid surgery in regional versus general anesthesia: A prospective randomized controlled study
    Helmuth Tauber, Werner Streif, Jennifer Gebetsberger, Lukas Gasteiger, Eve Pierer, Michael Knoflach, Gustav Fraedrich, Maria Gummerer, Josef Fritz, Corinna Velik-Salchner
    Journal of Vascular Surgery.2021; 74(3): 930.     CrossRef
  • Cerebral and Systemic Stress Parameters in Correlation with Jugulo-Arterial CO2 Gap as a Marker of Cerebral Perfusion during Carotid Endarterectomy
    Zoltán Kovács-Ábrahám, Timea Aczél, Gábor Jancsó, Zoltán Horváth-Szalai, Lajos Nagy, Ildikó Tóth, Bálint Nagy, Tihamér Molnár, Péter Szabó
    Journal of Clinical Medicine.2021; 10(23): 5479.     CrossRef
  • Plexus anesthesia versus general anesthesia in patients for carotid endarterectomy with patch angioplasty: Protocol for a systematic review with meta-analyses and Trial Sequential Analysis of randomized clinical trials
    M. S. Marsman, J. Wetterslev, F. Keus, D. van Aalst, F. G. van Rooij, J. M.M. Heyligers, F. L. Moll, A. Kh. Jahrome, P. W.H.E Vriens, G. G. Koning
    International Journal of Surgery Protocols.2020; 19: 1.     CrossRef
Case Reports
Suddenly fixed upward ocular deviation under general anesthesia
Won Jae Kim, Sang Jin Park, Myung Mi Kim
Yeungnam Univ J Med. 2017;34(2):290-292.   Published online December 31, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.2.290
  • 1,765 View
  • 10 Download
AbstractAbstract PDF
Various changes in ocular position are possible during general anesthesia as opposed to the awakening state. However, unexpected ocular deviation under general anesthesia is a disconcerting event as it can lead to difficult complications intraoperatively. To date, sudden fixed upward ocular deviation has been rarely reported previously. This phenomenon was observed in an 8-year-old boy during strabismus surgery. Suddenly fixed upward ocular deviation occurred when the speculum was inserted into the right eye. When the eyeball was pulled down, using forceps, there was some resistance, such as contracture of superior rectus. The eyeball sprang back into the upward position when the forceps was released. These changes could hamper the good exposition of the surgical field, leading to significant intraoperative difficulties and complications. Surgeons should be aware of this possibility, despite general anesthesia; if it occurs, proceed with the surgery as planned preoperatively, and both ophthalmic and anesthetic interventions should be used to solve this problem.
An Unexpected Vapor Leakage from Locked Vaporizer.
Hyun Seok Seong, Sang Jin Park, In Seong Kim
Yeungnam Univ J Med. 2011;28(1):94-98.   Published online June 30, 2011
DOI: https://doi.org/10.12701/yujm.2011.28.1.94
  • 1,408 View
  • 1 Download
AbstractAbstract PDF
One of the most popular types of vaporizer mounting sytems is Selectatec, as it possesses a simple detachment mechanism. Detachable units can loosen between the vaporizer and anesthetic machine, which can cause vapor leakage. A locking system was subsequently developed to prevent this issue; however, we report a case of an unexpected vapor leakage from a locked vaporizer.
Anesthesia for Cesarean Section in a Parturient with Dilated Cardiomyopathy: A Case Report.
Sae Yeon Kim, Su Jeong Heo, Sun Ok Song
Yeungnam Univ J Med. 2010;27(1):52-56.   Published online June 30, 2010
DOI: https://doi.org/10.12701/yujm.2010.27.1.52
  • 1,536 View
  • 12 Download
AbstractAbstract PDF
Idiopathic peripartum cardiomyopathy is an uncommon malady disease. Making the diagnosis is often difficult and it is always necessary to exclude other prior heart disease and other causes of left ventricular dysfunction in pregnant women. Heart failure in these women ensues when the cardiovascular demands of normal pregnancy are further amplified when the common complications of pregnancy complications superimposed upon these underlying conditions that cause compensated ventricular hypertrophy. This may be aggravated by making a late diagnosis and providing inappropriate treatment. We experienced a 38-year-primigravida who has diagnosed with idiopathic peripartum cardiomyopathy and underwent elective cesarean section with general anesthesia.
Anesthetic Management of a Patient with Alexander's Disease: Case Report.
Bum Soo Kim, Dae Lim Jee, Sun Ok Song
Yeungnam Univ J Med. 2010;27(1):47-51.   Published online June 30, 2010
DOI: https://doi.org/10.12701/yujm.2010.27.1.47
  • 1,640 View
  • 43 Download
AbstractAbstract PDF
We present here the case of a 13-year-old male patient with Alexander's disease who underwent surgical correction of a femur fracture. Alexander's disease is a rare and fatal disorder that affects the white matter in the brain and it causes developmental delay, psychomotor regression, spasticity, megaloencephaly and seizure. The patient had the possibility of a seizure attack during the perioperative period. We discuss the anesthetic management of a patient with Alexander's disease and we review the relevant literature.
Anesthetic Experience for Trans-Sphenoidal Surgery of Pituitary Adenoma on a Patient with Brugada Syndrome: A Case Report.
Min Jung Heo, Sae Yeon Kim
Yeungnam Univ J Med. 2009;26(2):148-155.   Published online December 31, 2009
DOI: https://doi.org/10.12701/yujm.2009.26.2.148
  • 1,408 View
  • 1 Download
AbstractAbstract PDF
Brugada syndrome is characterized by an ECG pattern of right bundle branch block and ST segment elevation in the right precordial leads (V(1)-V(3)) without structural heart disease. It is also characterized by sudden cardiac death that's caused by ventricular fibrillation. This is a familial syndrome with an autosomal dominant inheritance pattern and it may be considerably more common in Southeast Asia. Many factors during anesthesia can precipitate malignant dysrrhythmia in these patients, so careful choice of anesthetics is required. We experienced a case of Brugada syndrome in a 59-year-old male patient who was under general anesthesia for trans-sphenoidal surgery to treat a pituitary adenoma, and the patient was diagnosed as having Brugada syndrome without any untoward cardiovascular events.
Anesthetic Induction in a Sitting Position for a Patient with Congestive Heart Failure.
Seung Dong Kim, Gul Jung, Dae Lim Jee
Yeungnam Univ J Med. 2008;25(2):150-153.   Published online December 31, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.2.150
  • 1,503 View
  • 2 Download
AbstractAbstract PDF
A 67-year-old woman with severe congestive heart failure (New York Heart Association, NYHA class IV) was set to receive general anesthesia for cardiac surgery. For several months, she had been in a constant sitting position from which the slightest change evoked dyspnea. A patient in such a condition is rarely considered a candidate for general anesthesia, because such patients are never eligible for any type of surgery other than that used to fix the heart problem itself. We report this case to explain how anesthesia was induced with the patient sitting in a crouching position and discuss other methods of induction that can probably be used in similar situations.
General Anesthesia for Extracorporeal Shockwave Lithotripsyin Child with Lesch-Nyhan Syndrome.
Sang Jin Park, Il chi Kwon, Won Ki Lee, Deok Hee Lee
Yeungnam Univ J Med. 2008;25(1):78-83.   Published online June 30, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.1.78
  • 1,468 View
  • 6 Download
AbstractAbstract PDF
Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.
Review Article
Delayed Complications of Regional Anesthesia
Sun Ok Song
Yeungnam Univ J Med. 2007;24(2 Suppl):S96-107.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S96
  • 1,188 View
  • 3 Download
AbstractAbstract PDF
Regional anesthesia, an attractive choice of anesthesia for the patients with systemic illness such as pulmonary/heart diseases or endocrine dysfunctions, is generally accepted as a safe anesthetic method. However, there are various kinds of complication annoying the physician and the patient following a regional anesthesia. Therefore, physicians and patients must understand the risks in addition to the benefits of regional anesthesia to make an informed consent of anesthetic technique. 1) This review will give an overview of delayed complications following a regional anesthesia.

JYMS : Journal of Yeungnam Medical Science