Boric acid(H BO) is a weak topical anti infective agent. It can cause acute borism due to the internal absorption. Although the frequency is very rare, boric acid can also induce contact dermat.itis after topical spplication. We present allergic contact dermatitis to boric acid. The patch test results showed a positive reaction to 2% boric acid solution.
Absorption ; Dermatitis, Allergic Contact* ; Patch Tests

BACKGROUND: Pelviscopic techniques have rapidly increased in therapeutic procedures as well as diagnostic procedures because of the many benefits associated with much smaller incisions than traditional open techniques. But the deliberate pneumoperitoneum with carbon dioxide during pelviscopic surgery may cause some problems-hypercarbia, pneumomentum, subcutaneous or mediastinal emphysema, pneumothorax, hypoxemia, hypotension, cardiovascular collapse and cardiac dysrhythmia. METHOD: We observed the changes of blood pressure (systolic, mean, diastolic), pulse rate, PaCO2, PaO2, peak inspiratory airway pressure and expired tidal volume at 10 minute after induction of general anesthesia (control value), 30 minutes and 60 minutes after insufflation of CO2 and Trendelenburg position. RESULTS: The blood pressure, PaCO2 and peak inspiratory airway pressure were increased significantly than control values (p<0.05). The changes of pulse rate and expired tidal volume were not statistically significant in comparison to control values. The PaO2 was decreased significantly (p<0.05). CONCLUSION: To minimize the risk of CO2 retension and unstability of cardiovascular system during pelviscopy under the Trendelenburg position, we must monitor the vital signs and the arterial blood gas status continuously and carefully.
Anesthesia, General* ; Anoxia ; Arrhythmias, Cardiac ; Blood Pressure ; Carbon Dioxide ; Cardiovascular System ; Head-Down Tilt* ; Heart Rate ; Hypotension ; Insufflation* ; Mediastinal Emphysema ; Pneumoperitoneum ; Pneumothorax ; Tidal Volume ; Vital Signs

Recently, continuous epidural catheter insertion is common practice not only in anesthesia but also in pain clinic. Meningitis is rare but serious complication of epidural analgesia. Acute bacterial meningitis occurred in a 82-year-old female patient with thoracic herpes zoster after continuous thoracic epidural analgeia. An MRI of thoracic region did not show an epidural abscess or granulation tissue. Gram stain and culture of the epidural catheter tip and the CSF yielded Staphylococcus aureus. Immediate treatment with antibiotics and supportive therapy was instituted and then the patient discharged without neurologic sequalae.
Aged, 80 and over ; Analgesia, Epidural* ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Epidural Abscess ; Female ; Granulation Tissue ; Herpes Zoster ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Pain Clinics ; Staphylococcus aureus

BACKGROUND: Perioperative hypothermia is a common problem during both laparotomy and laparoscopic surgery. Hypothermia during laparoscopic surgery is related to the use of irrigation fluid and the large volume of CO2 for maintaining pneumoperitoneum. The aim of this study is to estimate whether the use of warm irrigation fluid can reduce the incidence of hypothermia and the decrease of body temperature. METHODS: Forty-two female patients undergoing elective laparoscopic surgery were randomly divided into 2 groups. Group 1 (n = 20) was given an ambient temperature irrigation fluid and group 2 (n = 22) a warm irrigation fluid. The core esophageal body temperatures of all the patients were measured every 10 minutes for 70 minutes. Body temperature 10 minutes after induction was a control value. The degree of body temperature decrease was measured, and the incidence of hypothermia was recorded. RESULTS: The incidences of hypothermia in group 2 were decreased significantly 60 and 70 minutes after induction, compared with those of group 1. The degree of body temperature decrease was revealed to be significantly different between the two groups starting 50 minutes after induction. CONCLUSIONS: The use of warm irrigation fluid during laparoscopic surgery can reduce the incidence of hypothermia and degree of body temperature decrease.
Body Temperature* ; Female ; Humans ; Hypothermia ; Incidence ; Laparoscopy* ; Laparotomy ; Pneumoperitoneum

BACKGROUND: Perioperative hypothermia is a common problem during both laparotomy and laparoscopic surgery. Hypothermia during laparoscopic surgery is related to the use of irrigation fluid and the large volume of CO2 for maintaining pneumoperitoneum. The aim of this study is to estimate whether the use of warm irrigation fluid can reduce the incidence of hypothermia and the decrease of body temperature. METHODS: Forty-two female patients undergoing elective laparoscopic surgery were randomly divided into 2 groups. Group 1 (n = 20) was given an ambient temperature irrigation fluid and group 2 (n = 22) a warm irrigation fluid. The core esophageal body temperatures of all the patients were measured every 10 minutes for 70 minutes. Body temperature 10 minutes after induction was a control value. The degree of body temperature decrease was measured, and the incidence of hypothermia was recorded. RESULTS: The incidences of hypothermia in group 2 were decreased significantly 60 and 70 minutes after induction, compared with those of group 1. The degree of body temperature decrease was revealed to be significantly different between the two groups starting 50 minutes after induction. CONCLUSIONS: The use of warm irrigation fluid during laparoscopic surgery can reduce the incidence of hypothermia and degree of body temperature decrease.
Body Temperature* ; Female ; Humans ; Hypothermia ; Incidence ; Laparoscopy* ; Laparotomy ; Pneumoperitoneum

BACKGROUND: Epidural pain control has been used extensively for postoperative pain management, but nausea, vomiting and pruritus associated with morphine and fentanyl administration remain intractable problems. The aim of this study is to find the optimal epidural droperidol dosage for reducing the side effects of epidural morphine and fentanyl. METHODS: 140 patients randomly sampled and undergoing vaginal total hysterectomy were divided into 7 groups. Groups I and IV, and groups II and V, and groups III and VI, received 5 mg, 3.75 mg, 2.5 mg of droperidol by 2-day infusion pump through the indwelling epidural catheter, respectively. Group IV, V, VI patients received 1.25 mg of bolus droperidol through the indwelling epidural catheter at the time of peritoneal closure. As group VII was the control group, these patients received only epidural analgesics (morphine 10 mg, fentanyl citrate 300 microgram and 0.05% bupivacaine 100 ml) by 2-day infusion pump. RESULTS: Droperidol significantly reduced the incidence and severity of postoperative nausea, vomiting and itching sensation compared with the control group but verbal rating scale (VRS) of sedation was increased with the dosage of droperidol. There was no significant difference in the intensity of analgesia between the there groups. CONCLUSIONS: An effective epidural droperidol dosage for reducing postoperative nausea, vomiting and pruritus due to epidural pain control is 2.5 mg by 2-day infusion pump.
Analgesia ; Analgesics ; Bupivacaine ; Catheters ; Droperidol* ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Infusion Pumps ; Morphine* ; Nausea* ; Pain Management* ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Pruritus* ; Sensation ; Vomiting*

BACKGROUND: Epidural pain control has been used extensively for postoperative pain management, but nausea, vomiting and pruritus associated with morphine and fentanyl administration remain intractable problems. The aim of this study is to find the optimal epidural droperidol dosage for reducing the side effects of epidural morphine and fentanyl. METHODS: 140 patients randomly sampled and undergoing vaginal total hysterectomy were divided into 7 groups. Groups I and IV, and groups II and V, and groups III and VI, received 5 mg, 3.75 mg, 2.5 mg of droperidol by 2-day infusion pump through the indwelling epidural catheter, respectively. Group IV, V, VI patients received 1.25 mg of bolus droperidol through the indwelling epidural catheter at the time of peritoneal closure. As group VII was the control group, these patients received only epidural analgesics (morphine 10 mg, fentanyl citrate 300 microgram and 0.05% bupivacaine 100 ml) by 2-day infusion pump. RESULTS: Droperidol significantly reduced the incidence and severity of postoperative nausea, vomiting and itching sensation compared with the control group but verbal rating scale (VRS) of sedation was increased with the dosage of droperidol. There was no significant difference in the intensity of analgesia between the there groups. CONCLUSIONS: An effective epidural droperidol dosage for reducing postoperative nausea, vomiting and pruritus due to epidural pain control is 2.5 mg by 2-day infusion pump.
Analgesia ; Analgesics ; Bupivacaine ; Catheters ; Droperidol* ; Fentanyl* ; Humans ; Hysterectomy* ; Incidence ; Infusion Pumps ; Morphine* ; Nausea* ; Pain Management* ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Pruritus* ; Sensation ; Vomiting*

A 53-year-old female admitted for multiple rib fracture, hemoptysis and dyspnea due to traffic accident. High resonance CT of the chest revealed bronchiectasis in left lower lobe. She presented for left lower lobectomy with the consent of her. A day before the operation, right internal jugular vein catheter was placed using anterior approach, and free blood flow was achieved. 2 hours after the procedure, she complained of mild chest pain and dyspnea but it was thought to reflect the rib fracture, and then 2 liters of fluid was administered through internal jugular vein catheter. Conducting anesthesia, thiopental sodium and succinylcholine chloride was administered through this route. But loss of consciousness of the patient didn't occur. The chest x-ray taken in OR showed hydrothorax on right pleural cavity.
Accidents, Traffic ; Anesthesia ; Bronchiectasis ; Catheters* ; Chest Pain ; Dyspnea ; Female ; Hemoptysis ; Humans ; Hydrothorax* ; Jugular Veins* ; Middle Aged ; Pleural Cavity ; Rib Fractures ; Succinylcholine ; Thiopental* ; Thorax ; Unconsciousness

Takayasu's arteritis is a chronic, idiopathic occlusive inflammation of the aorta and its major branches, affecting females in over 85% of the cases. The major clinical finding is loss of palpable pulses in the upper limbs and neck. Several authors have cautioned against the use of regional anesthesia in Takayasu's arteritis, because of the dangers of hypotension and subsequent vasopressor use. However, regional anesthesia, with an awake patient, is the easiest way to monitor cerebral function and is the preferred technique in the parturient. We report on a case of Takayasu's arteritis associating renovascular hypertension during pregnancy with successful cesarean delivery under epidural anesthesia.
Anesthesia, Conduction ; Anesthesia, Epidural* ; Aorta ; Cesarean Section* ; Female ; Humans ; Hypertension, Renovascular ; Hypotension ; Inflammation ; Neck ; Pregnancy ; Takayasu Arteritis* ; Upper Extremity

PURPOSES: This study examined uncertainty and nursing need according to illness phases(phase I, II, III) in cancer patients, and investigated relationships between uncertainty and nursing need. METHODS: A cross-sectional descriptive study was conducted with a sample of 121 adult cancer patients treated in two hospitals. RESULTS: As for the total score, the uncertainty was not significantly different across the subgroups by illness phase. As for the subscale score, however, two sub-scales of the uncertainty were different across the subgroups. 'The unpredictability' was highest in illness phase I and II groups, while 'the lack of information' was highest in the illness phase III group. Nursing need as the total score was not significantly different across the subgroups by illness phase. However, all subscale scores of the nursing need were significantly different across the subgroups. Educational need was highest in the illness phase I group; physical and emotional needs were highest in the illness phase III group. Uncertainty and nursing need were not related to each other at any illness phase. CONCLUSION: The results suggest that nursing need and uncertainty may change across illness phases. Clinicians need to consider this pattern in caring for cancer patients.
Adult ; Humans ; Uncertainty