No abstract available.
Humans

BACKGROUND: Subhypnotic doses of propofol have been demonstrated to possess a direct antiemetic property. The present study was designed to assess the antiemetic efficacy of propofol mixed the reservoir bag of an intravenous patient-controlled analgesia (PCA) in patients using an intravenous PCA after a thoracotomy. METHODS: One-hundred seventy five subjects were allocated to two groups. Propofol was added to the PCA regimen to a concentration of 5 mg/ml in group P. The same volume of normal saline were substituted for propofol in group C. The PCA regimen was composed of ketorolac, fentanyl and morphine. The dosages of drugs were adjusted according to the patient's age and sex. The PCA was set at a basal rate of 0.5 ml/hr, bolus dose of 1 ml and a lockout interval of 10 min. The incidence and severity of PONV, sedation, pain and other side effect was assessed at 1, 4, 8, 12, 18, 24, 36, 48, 60 and 72 hr postoperatively. RESULTS: There was no significant difference in the incidence and the severity of postoperative nausea and vomiting (PONV) between the two groups. Overall pain scores were not different between the two groups. The occurrence and the severity of sedation was significantly higher in group P compared to group C (P < 0.05). CONCLUSIONS: Propofol added to a concentration of 5 mg/ml in a PCA regimen, composed of ketorolac, fentanyl and morphine, used for postoperative pain control is not effective in decreasing PONV in patients undergoing a thoracotomy.
Analgesia, Patient-Controlled* ; Fentanyl ; Humans ; Incidence ; Ketorolac ; Morphine ; Nausea* ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Propofol* ; Thoracotomy ; Vomiting*

No abstract available.

No abstract available.

No abstract available.
Prostate

No abstract available.

Neuroleptic malignant syndrome (NMS) is a rare but potentially lethal outcome caused by sudden discontinuation or dose reduction of dopaminergic agents. We report an extremely rare case of NMS after deep brain stimulation (DBS) surgery in a cerebral palsy (CP) patient without the withdrawal of dopaminergic agents. A 19-year-old girl with CP was admitted for DBS due to medically refractory dystonia and rigidity. Dopaminergic agents were not stopped preoperatively. DBS was performed uneventfully under monitored anesthesia. Dopaminergic medication was continued during the postoperative period. She manifested spasticity and muscle rigidity, and was high fever resistant to anti-pyretic drugs at 2 h postoperative. At postoperative 20 h, she suffered cardiac arrest and expired, despite vigorous cardiopulmonary resuscitation. NMS should be considered for hyperthermia and severe spasticity in CP patients after DBS surgery, irrespective of continued dopaminergic medication.
Anesthesia ; Cardiopulmonary Resuscitation ; Cerebral Palsy* ; Deep Brain Stimulation* ; Dopamine Agents ; Dystonia ; Female ; Fever ; Globus Pallidus* ; Heart Arrest ; Humans ; Muscle Rigidity ; Muscle Spasticity ; Neuroleptic Malignant Syndrome ; Postoperative Period ; Young Adult

Background: The prognostic nutritional index (PNI) reflects systemic inflammation and nutritional status. This study aimed to evaluate the effect of preoperative PNI on postoperative cancer-specific survival in patients with endometrial cancer (EC). Methods: Demographic, laboratory, and clinical data were retrospectively collected from 894 patients who underwent surgical resection of EC. Preoperative PNIs were determined from the serum albumin concentration and total lymphocyte count, which were measured within 1 month before surgery. Patients were classified into high PNI (n = 619) and low PNI (n = 275) groups according to the preoperative PNI cut-off value of 50.6. The stabilized inverse probability of treatment weighting (IPTW) method was used to reduce bias: a weighting cohort divided into high PNI (n = 615.4) and low PNI (n = 272.3) groups. The primary outcome measure was postoperative cancer-specific survival. Results: The postoperative cancer-specific survival rate was higher in the high PNI group than the low PNI group in the unadjusted cohort (93.1% vs. 81.5%; proportion difference [95% confidence interval; 95% CI], 11.6% [6.6–16.6%]; P < 0.001) and in the IPTW- adjusted cohort (91.4% vs. 86.0%; 5.4% [0.8–10.2%]; P = 0.021). In the multivariate Cox proportional hazard regression model in the IPTW-adjusted cohort, high preoperative PNI (hazard ratio [95% CI], 0.60 [0.38–0.96]; P = 0.032) was an independent determinant of postoperative cancer-specific mortality. The multivariate-adjusted restricted cubic spline curve for the Cox regression model showed a significant negative association between preoperative PNI and postoperative cancer-specific mortality (P < 0.001). Conclusion High preoperative PNI was associated with improved postoperative cancerspecific survival in patients undergoing surgery for EC.