Anaphylaxis is a type I allergic reaction and its clinical features occur after re-exposure to the same allergen. Numerous types of drugs can cause anaphylaxis during general anesthesia. Topical bovine thrombin (TBT) is usually used for hemostasis during surgery. However, TBT can cause interruption of the normal blood coagulation pathways, delay wound repair, and lead to uncontrolled bleeding, anaphylaxis, or death. Anaphylaxis caused by TBT during the perioperative period is very rare. We report the case of a patient who developed severe hypotension, tachycardia, and bronchospasm while undergoing discectomy for herniated nucleus pulposus. Based on the symptoms and signs, anaphylaxis was considered most likely. Identification of the causative agents is important in these cases because it can be very helpful for the management and prevention of anaphylaxis.
Anaphylaxis* ; Anesthesia, General ; Blood Coagulation ; Bronchial Spasm ; Diskectomy ; Epinephrine ; Hemorrhage ; Hemostasis* ; Humans ; Hypersensitivity ; Hypotension ; Perioperative Period ; Tachycardia ; Thrombin* ; Wounds and Injuries

Polyphenol (-)-epigallocatechin gallate (EGCG), the most abundant catechin of green tea, appears to attenuate myocardial ischemia/reperfusion injury. We investigated the involvement of ATP-sensitive potassium (K(ATP)) channels in EGCG-induced cardioprotection. Isolated rat hearts were subjected to 30 min of regional ischemia and 2 hr of reperfusion. EGCG was perfused for 40 min, from 10 min before to the end of index ischemia. A nonselective K(ATP) channel blocker glibenclamide (GLI) and a selective mitochondrial K(ATP) (mK(ATP)) channel blocker 5-hydroxydecanoate (HD) were perfused in EGCG-treated hearts. There were no differences in coronary flow and cardiodynamics including heart rate, left ventricular developed pressure, rate-pressure product, +dP/dt(max), and -dP/dt(min) throughout the experiments among groups. EGCG-treatment significantly reduced myocardial infarction (14.5+/-2.5% in EGCG 1 micrometer and 4.0+/-1.7% in EGCG 10 micrometer, P<0.001 vs. control 27.2+/-1.4%). This anti-infarct effect was totally abrogated by 10 micrometer GLI (24.6+/-1.5%, P<0.001 vs. EGCG). Similarly, 100 micrometer HD also aborted the anti-infarct effect of EGCG (24.1+/-1.2%, P<0.001 vs. EGCG ). These data support a role for the K(ATP) channels in EGCG-induced cardioprotection. The mK(ATP) channels play a crucial role in the cardioprotection by EGCG.
Animals ; Anti-Arrhythmia Agents/pharmacology ; Antioxidants/*pharmacology ; Catechin/*analogs & derivatives/pharmacology ; Decanoic Acids/pharmacology ; Glyburide/pharmacology ; Heart/*drug effects/physiology/physiopathology ; Hemodynamics ; Humans ; Hydroxy Acids/pharmacology ; KATP Channels/*metabolism ; Male ; Mitochondria, Heart/*drug effects/metabolism ; Myocardial Infarction/*pathology ; Myocardial Ischemia/*pathology ; Potassium Channel Blockers/pharmacology ; Rats ; Rats, Wistar

Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.
Airway Management ; Child ; De Lange Syndrome ; Humans ; Intubation ; Laryngoscopes

Management of airway in a child with Cornelia de Lange Syndrome (CdLS) should be given due consideration because most of them have the problems related to difficult airway. The GlideScope video laryngoscope can be attempted during routine intubation, however it is mostly used in case of difficulty. With adequate preoperative airway assessment, we used the pediatric video laryngoscope as useful alternative airway device in a child with CdLS and orotracheal intubation proceeded uneventfully.