No abstract available.
Nitric Oxide* ; Oxidative Stress* ; Reactive Oxygen Species*

No abstract available
Hemodynamics*

Dextran is a highly viscous polysaccharide liquid used for uterine distention during hysteroscopic surgery. Although generally safe, this agent has been recognized to cause non-cardiogenic pulmonary edema, intravascular coagulopathy, renal insufficiency, and anaphylactic reaction. We report the case of pulmonary edema following hysteroscopic surgery with dextran 40 and discuss the major side effects and the possible etiologies of the reported complication.
Anaphylaxis ; Dextrans* ; Hysteroscopy* ; Pulmonary Edema* ; Renal Insufficiency

PURPOSE: To analyze hemodynamic parameters of electrical bioimpedance on increased blood pressure induced by pneumoperitoneum and compare hemodynamic effects of propofol and isoflurane during laparoscopic cholecystectomy. METHODS: Systemic vascular resistance index(SVRI), index of contractility(IC), end diastolic index(EDI), mean arterial pressure(MAP) and heart rate(HR) were measured after anesthetic induction, 5, 10, 15 and 30 minutes after CO2 insufflation and after CO2 removal. RESULTS: In isoflurane group, MAP, IC, SVRI were increased but EDI was decreased after induction of pneumoperitoneum. In propofol group, MAP, SVRI were increased but IC was decreased after induction of pneumoperitoneum. HR was not changed during operartion. CONCLUSION: After induction of pneumoperitoneum, MAP is increased by increased IC and SVRI in isoflurane. In case of propofol, the MAP is increased by increased SVRI. It seems that increased transmural pressure of lymphatics and splanchnic vasculatures rather than sympathetic stimulation increases SVRI after pneumoperitoneum.
Blood Pressure* ; Cholecystectomy, Laparoscopic* ; Heart ; Hemodynamics* ; Insufflation ; Isoflurane ; Pneumoperitoneum* ; Propofol ; Vascular Resistance

No abstract available.
Fascioliasis* ; Humans*

No abstract available.

BACKGROUND: Postoperative nausea and vomiting (PONV) is the major complication related to general anesthesia, occurring in 60–80% of patients after thyroidectomy. The objective of this study was to compare the effects of an intraoperative dexmedetomidine infusion with remifentanil, as anesthetic adjuvants of balanced anesthesia, on PONV in patients undergoing thyroidectomy. METHODS: Eighty patients scheduled for thyroidectomy were randomized into the following two groups: 1) The dexmedetomidine group (Group D), who received an initial loading dose of dexmedetomidine (1 µg/kg over 10 min) during the induction of anesthesia, followed by a continuous infusion at a rate of 0.3–0.5 µg/kg/h; 2) the remifentanil group (group R), who received remifentanil at an initial target effect site concentration of 4 ng/ml during the induction of anesthesia, followed by a target effect site concentration of 2–3 ng/ml. PONV was assessed during the first 24 hours in 2 time periods (0–2 h and 2–24 h). The pain intensity, sedation score, extubation time, and hemodynamics were also assessed. RESULTS: During the 2 time periods, the incidence and severity of PONV in group D were significantly lower than in group R. In addition, the need for rescue antiemetics was significantly lower in group D than in group R. The effect of dexmedetomidine on postoperative pain relief (2–24 h) was superior to that of remifentanil. The hemodynamics were similar in both groups, whereas eye opening and extubation time were delayed in group D. CONCLUSIONS: Adjuvant use of intraoperative dexmedetomidine infusion may be effective for the prevention of PONV.
Adjuvants, Anesthesia ; Anesthesia ; Anesthesia, General ; Antiemetics ; Balanced Anesthesia* ; Dexmedetomidine* ; Hemodynamics ; Humans ; Incidence ; Pain, Postoperative ; Postoperative Nausea and Vomiting* ; Thyroidectomy*

BACKGROUND: Pneumoperitoneum for a laparoscopic cholecystectomy induces hemodynamic changes. The present study investigated the effect of preventive nicardipine on the hemodynamics induced by pneumoperitoneum during a laparoscopic cholecystectomy. METHODS: Forty five patients, scheduled to undergo laparoscopic cholecystectomy, were selected, and divided into three groups; the control group (C; normal saline infusion), the nicardipine bolus injection group (NB; 20microgram/kg nicardipine infusion, 1 min before skin incision) and the nicardipine continuous infusion group (NI; 2microgram/kg/min continuous infusion, from the time of endotracheal intubation to pneumoperitoneum). The blood pressure, heart rate, cardiac output and systemic vascular resistance were measured; at preincision, and at 5, 10 and 15 min after insufflation and at 5 min after exsufflation. RESULTS: Nicardipine injection attenuated increases in the blood pressure, systemic vascular resistance after pneumoperitoneum, and didn't attenuate decrease in the cardiac output. CONCLUSIONS: A preventive nicardipine injection is effective in attenuating the hemodynamic change after pneumoperitoneum during a laparoscopic cholecystectomy, especially attenuated the systemic vascular resistance and blood pressure increase.
Blood Pressure ; Cardiac Output ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Heart Rate ; Hemodynamics* ; Humans ; Insufflation ; Intubation, Intratracheal ; Laparoscopy ; Nicardipine* ; Pneumoperitoneum* ; Skin ; Vascular Resistance

BACKGROUND: To analyze hemodynamic changes during single catheter technique of hepatic venous isolation and extracorporeal charcoal hemoperfusion for malignant liver tumor. METHODS: Drugs for chemotherapy were infused to the liver through hepatic artery. With 4-lumen- 2-balloon (4L-2B) catheter, hepatic venous blood was circulated to the extracorporeal charcoal system. During extracorporeal charcoal system circulation, drugs were eliminated and the blood was reinfused to supra-hepatic vein-IVC. At the same time, IVC was clamped. Systemic vascular resistance index (SVRI), cardiac index (CI), stroke volume index (SVI), mean arterial pressure (MAP), heart rate (HR) and arterial blood gas were measured after 4L-2B catheter insertion (T1), during test circulation (T2), after 20min chemotherapy (T3) and after 10min reperfusion (T4). RESULTS: MAP was decreased at T3 compared to T1 and increased at T4 compared to T3. CI was decreased at T3 and increased at T4 compared to T1. SVRI was decreased at T4 compared to T1. HR was increased at T2 and T3 compared to T1. SVI was decreased at T2 and T3 compared to T1. CONCLUSIONS: During clamping of IVC, MAP is decreased by decreased SVI in spite of increased HR. After IVC is released and the stagnated blood of lower extremity is recirculated, the MAP is returned to the value of after catheter insertion by increased SVI in spite of decreased SVRI.
Arterial Pressure ; Blood Pressure ; Carcinoma, Hepatocellular* ; Catheters ; Charcoal ; Constriction ; Drug Therapy ; Heart Rate ; Hemodynamics* ; Hemoperfusion* ; Hepatic Artery ; Liver* ; Lower Extremity ; Reperfusion ; Stroke Volume ; Vascular Resistance

Massive air leakage through a lacerated lung produces inadequate ventilation and hypoxemia. Tube exchange from a single to double lumen endotracheal tube (DLT), and lung separation to maintain oxygenation, are challenging for seriously injured patients. In this case report, we aim to describe how a bronchial blocker (BB) makes it easier to perform a lung separation in this situation; it also increases the overall safety of the procedure. A 35-year-old female (163 cm, 47 kg) suffered from blunt chest trauma due to a traffic accident; the accident caused right-sided lung laceration with massive air leakage. Paradoxically, positive ventilation worsened SaO2 and leakage increased through a chest tube. We introduced BB while the patient was still awake: Left-side one-lung ventilation (OLV) was established and anesthesia was induced. After PaO2 was maximized with OLV, we changed the endotracheal tube to DLT without a hypoxic event. By BB placement, we maintained PaO2 at a secure level, conducted mechanical ventilation and exchanged the tube without deterioration.
Accidents, Traffic ; Adult ; Anesthesia ; Anoxia ; Chest Tubes ; Female ; Humans ; Lacerations ; Lung ; One-Lung Ventilation ; Oxygen ; Pneumothorax* ; Respiration, Artificial ; Thorax ; Ventilation