1.Neuromuscular blockade reversal with sugammadex versus pyridostigmine/ glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility
Jihyun AN ; Heeyun NOH ; Eunju KIM ; Jihyang LEE ; Kyeongyoon WOO ; Hyunkyum KIM
Korean Journal of Anesthesiology 2020;73(2):137-144
Background:
Acetylcholinesterase inhibitors (e.g., pyridostigmine bromide) are used for neuromuscular blockade (NMB) reversal in patients undergoing surgery under general anesthesia (GA). Concurrent use of anticholinergic agents (e.g., glycopyrrolate) decreases cholinergic side effects but can impede bowel movements. Sugammadex has no cholinergic effects; its use modifies recovery of gastrointestinal (GI) motility following laparoscopic cholecystectomy compared to pyridostigmine/glycopyrrolate. This study evaluated the contribution of sugammadex to the recovery of GI motility compared with pyridostigmine and glycopyrrolate.
Methods:
We conducted a prospective study of patients who underwent laparoscopic cholecystectomy. Patients were randomly allocated to the experimental group (sugammadex, Group S) or control group (pyridostigmine-glycopyrrolate, Group P). After anesthesia (propofol and rocuronium, and 2% sevoflurane), recovery was induced by injection of sugammadex or a pyridostigmine-glycopyrrolate mixture. As a primary outcome, patients recorded the time of their first passage of flatus (‘gas-out time’) and defecation. The secondary outcome was stool types.
Results:
One-hundred and two patients participated (Group S, 49; Group P, 53). Mean time from injection of NMB reversal agents to gas-out time was 15.03 (6.36–20.25) h in Group S and 20.85 (16.34–25.86) h in Group P (P = 0.001). Inter-group differences were significant. Time until the first defecation as well as types of stools was not significantly different.
Conclusions
Sugammadex after laparoscopic cholecystectomy under GA resulted in an earlier first postoperative passage of flatus compared with the use of a mixture of pyridostigmine and glycopyrrolate. These findings suggest that the use of sugammadex has positive effects on the recovery of GI motility.
2.The experience of infection prevention for coronavirus disease 2019 (COVID-19) during general anesthesia in an epidemic of COVID-19: including unexpected exposure case- Two cases report -
Hyunkyum KIM ; Jeongmin OH ; Sang-Gon LEE ; Kwang-Seok SHIM
Anesthesia and Pain Medicine 2020;15(3):388-396
Background:
Coronavirus disease 2019 (COVID-19) has been an epidemic in the Republic of Korea since the first patient who came in China was confirmed as having the disease on January 19, 2020. Therefore, surgery for COVID-19-related patients is expected to increase.Case: We experienced two cases of COVID-19-related patients who underwent surgery for femur fracture under general anesthesia. In one case, infection control to prevent transmission was achieved, while in the second case, healthcare workers were exposed to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
Conclusions
In areas where there is COVID-19 epidemic, SARS-CoV-2 RT-PCR should be performed before surgery in patients with symptoms of respiratory infection such as fever, cough, and sputum, or for those in whom the possibility of COVID-19 cannot be completely excluded. Efforts should be made to prevent healthcare worker’s exposure and the contamination of the operating room.
3.Infection control of operating room and anesthesia for cesarean section during the COVID-19 outbreak in Daegu, the Republic of Korea -a case series-
Jeongmin OH ; Eunju KIM ; Hyunkyum KIM ; Sang-Ah LEE ; Kyeong Hee LEE ; Mi Hyae YU ; Jihyun AN
Korean Journal of Anesthesiology 2021;74(2):169-174
Background:
The coronavirus disease-19 (COVID-19) was first reported in Wuhan, China, with Korea being subsequently exposed. In Korea, COVID-19 screening guidelines have been established in every hospital as an attempt to prevent its spread. There has been a previous report of a successful cesarean section of a confirmed mother; however, there remain no guidelines for suspected mothers. Cesarean section is often urgently operated without sufficient infection evaluations. We would like to suggest anesthetic management guidelines for cesarean section patients suspected of COVID-19.Case: Our hospital, which is located in Daegu, Korea, was designated as a quarantine and delivery facility for suspected mothers. We performed the cesarean section on seven suspected mothers and one confirmed mother.
Conclusions
This case report presents guidelines for infection control during surgery and anesthesia for cesarean section of mothers with suspected COVID-19 involving operating room preparation and protection strategy.
4.Infection control of operating room and anesthesia for cesarean section during the COVID-19 outbreak in Daegu, the Republic of Korea -a case series-
Jeongmin OH ; Eunju KIM ; Hyunkyum KIM ; Sang-Ah LEE ; Kyeong Hee LEE ; Mi Hyae YU ; Jihyun AN
Korean Journal of Anesthesiology 2021;74(2):169-174
Background:
The coronavirus disease-19 (COVID-19) was first reported in Wuhan, China, with Korea being subsequently exposed. In Korea, COVID-19 screening guidelines have been established in every hospital as an attempt to prevent its spread. There has been a previous report of a successful cesarean section of a confirmed mother; however, there remain no guidelines for suspected mothers. Cesarean section is often urgently operated without sufficient infection evaluations. We would like to suggest anesthetic management guidelines for cesarean section patients suspected of COVID-19.Case: Our hospital, which is located in Daegu, Korea, was designated as a quarantine and delivery facility for suspected mothers. We performed the cesarean section on seven suspected mothers and one confirmed mother.
Conclusions
This case report presents guidelines for infection control during surgery and anesthesia for cesarean section of mothers with suspected COVID-19 involving operating room preparation and protection strategy.
5.Venous Sinus Thrombosis and Dural Arteriovenous Fistula after Herpes Simplex Encephalitis in a Patient with Protein S, Protein C Deficiency
Yujin SONG ; Hwajin CHOI ; Yunyoung CHOI ; Hyunkyum CHO ; Dongyu KIM ; Yo Han JUNG
Journal of the Korean Neurological Association 2024;42(2):162-165
Herpes simplex encephalitis is known to cause intracranial hypertension and cerebral edema. When cerebral edema occurs, venous sinuses are compressed, resulting in congestion and thrombosis. An arteriovenous fistula may form as a result, particularly in conjunction with superior sagittal sinus thrombosis. In this report, the authors describe a patient with protein S and C deficiency who developed venous sinus thrombosis and dural arteriovenous fistula after experiencing herpes simplex encephalitis.