Child ; Child, Preschool ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities ; Consensus ; Humans ; Infant ; Leukocyte Count ; Male ; Palate ; Surgery, Oral

We present a case of acquired tracheoesophageal fistula (TEF) which was found during induction of general anesthesia for clipping of aneurysm. The patient had been intubated with endotracheal tube for 10 days and then done tracheotomy for 45 days. Thereafter, TEF was confirmed by MRI and treated with fistula repair and tracheal fenestration. Acquired TEF can occur under the condition of prolonged tracheal intubation with high cuff pressure (>30 mmHg) and can also result from intratracheal neoplasm, mediastinitis, and other tracheal or esophageal damages. If unrecognized during anesthetic induction, TEF can cause gastric dilatation and rupture, pulmonary aspiration and respiratory failure. So early diagnosis and proper management is very important whenever TEF is suspected during anesthetic induction.
Anesthesia, General ; Aneurysm ; Early Diagnosis ; Fistula ; Gastric Dilatation ; Humans ; Intubation ; Magnetic Resonance Imaging ; Mediastinitis ; Respiratory Insufficiency ; Rupture ; Tracheoesophageal Fistula* ; Tracheotomy

Alveolar Process ; Maxilla ; Osteotomy

Bile* ; Choledochal Cyst* ; Humans ; Infant* ; Peritonitis*

No abstract available.
Burns* ; Humans

BACKGROUND: The nature of operation alters the volume of distribution at steady state (Vdss) of drug. The hepatic extraction ratio of midazolam (0.3~0.7) could be influenced by hepatic blood flow (HBF), and hepatic enzyme activity. The pharmacokinetics of intravenous midazolam were determined in patients undergoing lung surgery. METHODS: Midazolam, 0.2 mg/kg, was administered to five patients undergoing lung surgery at 30 minutes after induction of anesthesia. Anesthesia was maintained with O2-enflurane for one lung ventilation. Blood samples from artery were drawn at increasing intervals for 12 h. Plasma midazolam concentrations were measured by gas chromatography. Computer simulations of the times required for 20%, 50%, and 80% decreases in midazolam concentrations were performed. RESULTS: A three compartment model best described the concentration versus time data. The volume of the central compartment (Vc) and volume of distribution at steady state (Vdss) were 4.3 2.8 l and 59.9 20.1 l, respectively. The elimination half-life was 3.4 2.2 h. Simulations indicate that under all the situations, the concentrations would decrease more rapidly in our patients in spite of similar Vdss and elimination half-life of patients undergoing minor gynecological surgery. CONCLUSION: The elimination half-life was in the range of previously reported values. The shorter recovery time is apparently due to relatively faster redistrubution, and relatively greater capacity for redistribution.
Anesthesia ; Arteries ; Chromatography, Gas ; Computer Simulation ; Female ; Gynecologic Surgical Procedures ; Half-Life ; Humans ; Lung* ; Midazolam* ; One-Lung Ventilation ; Pharmacokinetics* ; Plasma

No abstract available.
Cisplatin* ; Hearing Loss* ; Hearing*

The purpose of this study is to examine the change of enzymeimmuno-assay for prostaglandinE2 in the synovial fluid lavage specimen of patients with mandibular fracture patients without condylar fracture. For this study, fourteen patients (eight males, six females) with mandibular fractures without condylar fracture was investigated to analyse the synovial fluid from upper temporomandibular joint cavities. Synovial fluid was collected from TMJ cavities of mandibular fracture patients before open reduction and after one week of open reduction, and then stored in liquid nitrogen tank after centrifuge. Two synovial fluid lavage samples of TMJs of 2 asymptomatic served as normal controls referred from other data. The concentrations of PGE2 were measured by use of PGE2 EIA system (Amersham). The following results were obtained: 1) In nine patients, the concentrations of PGE2 are lower after open reduction than before. 2) In three patients, the concentrations of PGE2 are higher after open reduction than before. 3) There was no statistical significant between the preoperative group and postoperative 7 days (p>0.05), but there was some difference between the two groups. In conclusion, the results suggest that PGE2 probably does not play as important role in the harm of TMJ.
Dinoprostone* ; Humans ; Male ; Mandibular Fractures* ; Nitrogen ; Synovial Fluid* ; Temporomandibular Joint* ; Therapeutic Irrigation

No abstract available.
Pregnancy*

Central retinal artery occlusion occurs rarely as a complication of spine surgery in prone position, but is quite tragic. The suggested cause are hypotensive anesthesia and increased external ocular pressure by headrest, sand bag or others. We experienced a case of left central retinal artery occlusion(CRAO) after surgery of C4-5 fracture-dislocation using a horseshoe headrest and report this case.
Anesthesia ; Prone Position ; Retinal Artery Occlusion ; Retinal Artery ; Spine