1.Delayed Recovery of Motor Block Following Radiofrequency Ablation of Varicose Veins with Femoral Nerve Block and Tumescent Anesthesia.
Mi Roung JUN ; Young Eun KIM ; Sang Chul YOON ; Mun Gyu KIM
Soonchunhyang Medical Science 2017;23(1):74-76
Femoral nerve block with tumescent anesthesia is used to perform the radiofrequency ablation of varicose veins. The surgery can be done as day-case. But if recovery from motor block is delayed, it can make hospital discharge difficult. Prolonged femoral nerve blocks with motor blockade of the quadriceps have been noted after the use of bupivacaine. The motor blockade lasted up to 30–40 hours when 15–30 mL of 0.5% bupivacaine was used. However, it was rarely reported in ropivacaine. We report that femoral nerve block with 15 mL of 0.375% ropivacaine induced prolonged motor blockade up to 30 hours.
Anesthesia*
;
Bupivacaine
;
Catheter Ablation*
;
Femoral Nerve*
;
Sodium Bicarbonate
;
Varicose Veins*
2.Loop Formation and Malposition of Subclavian Vein Catheter.
Mi Roung JUN ; Sang Ho KIM ; Jae Hwa YOO ; Doyeon KIM
Soonchunhyang Medical Science 2017;23(2):152-154
Central venous catheterization is a useful procedure for administrating fluids and drugs as well as monitoring central venous pressure in the operating room. The internal jugular vein and the subclavian vein are preferred as catheter insertion sites because of the low risk of infection and mechanical complications. However, the risk of venous malposition is higher in subclavian vein. The loop formation of the central venous catheter accompanied by its malposition increases the risk of thrombosis. If the procedure is to be performed with any difficulty, early radiologic examination should be required to detect and avoid complications. We report a case of malposition and loop formation of central venous catheter located in subclavian vein confirmed by chest X-ray after transferred to the intensive care unit.
Catheterization, Central Venous
;
Catheters*
;
Central Venous Catheters
;
Central Venous Pressure
;
Intensive Care Units
;
Jugular Veins
;
Operating Rooms
;
Subclavian Vein*
;
Thorax
;
Thrombosis
3.Suspected anaphylactic reaction associated with sugammadex: a case report.
Jae Hwa YOO ; Soon Im KIM ; Si Young OK ; Sun Young PARK ; Ana CHO ; Yoo Mi HAN ; Mi Roung JUN
Korean Journal of Anesthesiology 2016;69(4):413-416
We describe a case of a 35-year-old male patient who was scheduled for laparoscopic cholecystectomy and developed a life-threatening anaphylactic reaction 2 min after the administration of sugammadex. He manifested erythematous wheals on the entire body, dyspnea, hypotension, and tachycardia. These symptoms disappeared after the administration of epinephrine. The patient recovered and was discharged at postoperative day 5 without any complications. After 7 weeks, we performed a skin prick test, and there was a weakly positive reaction for sugammadex. This case is suspected anaphylaxis associated with sugammadex, and we need to be aware that the use of sugammadex is associated with a serious risk of anaphylaxis.
Adult
;
Anaphylaxis*
;
Cholecystectomy, Laparoscopic
;
Dyspnea
;
Epinephrine
;
Humans
;
Hypotension
;
Male
;
Skin
;
Tachycardia
4.Aprepitant in combination with palonosetron for the prevention of postoperative nausea and vomiting in female patients using intravenous patient-controlled analgesia.
Jae Hwa YOO ; Soon Im KIM ; Ji Won CHUNG ; Mi Roung JUN ; Yoo Mi HAN ; Yong Jik KIM
Korean Journal of Anesthesiology 2018;71(6):440-446
BACKGROUND: The aim of this study was to evaluate aprepitant in combination with palonosetron as compared to palonosetron alone for the prevention of postoperative nausea and vomiting (PONV) in female patients receiving fentanyl- based intravenous patient-controlled analgesia (IV-PCA). METHODS: In this randomized single-blinded study, 100 female patients scheduled for elective surgery under general anesthesia were randomized to two groups: Group AP (80 mg aprepitant plus 0.075 mg palonosetron, n = 50) and Group P (0.075 mg palonosetron, n = 50). The patients in group AP received 80 mg aprepitant per oral 1–3 h before surgery, while all patients received 0.075 mg palonosetron after induction of standardized anesthesia. All patients had postoperative access to fentanyl-based IV-PCA. The incidence of nausea and vomiting, use of rescue medication, and severity of nausea were evaluated at 6 and 24 h after surgery. RESULTS: The incidence of nausea (54%) and vomiting (2%) in group AP did not differ significantly from that in group P (48% and 14%, respectively) during the first 24 h after surgery (P > 0.05). Patient requirements for rescue medication in group AP (29%) were similar to those in group P (32%) at 24 h after surgery (P > 0.05). There was no difference between the groups in severity of nausea during the first 24 h after surgery (P > 0.05). CONCLUSIONS: Aprepitant combined with palonosetron did not reduce the incidence of PONV as compared to palonosetron alone within 24 h of surgery in women receiving fentanyl-based IV-PCA.
Analgesia, Patient-Controlled*
;
Anesthesia
;
Anesthesia, General
;
Female*
;
Humans
;
Incidence
;
Nausea
;
Postoperative Nausea and Vomiting*
;
Vomiting
5.Anesthetic considerations of Joubert syndrome in patients with mitochondrial disease - A case report -
Jeong Yeon KIM ; Koun JEONG ; Ki Seob HAN ; Ji Eun PARK ; Mun Gyu KIM ; Mi Roung JUN
Anesthesia and Pain Medicine 2021;16(2):158-162
Background:
Joubert syndrome and mitochondrial disease are rare congenital diseases in which a wide range of symptoms affects multiple organs. Patients with these diseases present characteristic symptoms related to the musculoskeletal, respiratory, and neurological systems, which make it difficult for anesthesiologists to manage the patient’s airway and choose appropriate anesthetic drugs. Case A 13-year-old male patient with Joubert syndrome and mitochondrial disease underwent elective surgery to insert a continuous ambulatory peritoneal dialysis catheter. Anesthesia was induced and maintained with propofol, remifentanil, and rocuronium. An I-gel was inserted to secure the airway; however, the fitting did not work properly, so the patient was intubated. The operation was completed without any major problems, and the intubated patient was transferred to the intensive care unit.
Conclusions
Anesthesiologists should determine the method of anesthesia and prepare for unintended complications based on a full understanding of these congenital diseases.
6.Assessment of phase-lag entropy, a new measure of electroencephalographic signals, for propofol-induced sedation
Mi Roung JUN ; Jae Hwa YOO ; Sun Young PARK ; Sojin NA ; Hyerim KWON ; Jae Hwi NHO ; Soon Im KIM
Korean Journal of Anesthesiology 2019;72(4):351-356
BACKGROUND:
Phase-lag entropy (PLE) was recently described as a measurement of temporal pattern diversity in the phase relationship between two electroencephalographic signals from prefrontal and frontal montages. This study was performed to evaluate the performance of PLE for assessing the depth of sedation.
METHODS:
Thirty adult patients undergoing upper limb surgery with a brachial plexus block were administered propofol by target-controlled infusion. The depth of sedation was assessed using the Observer's Assessment of Alertness/Sedation (OAA/S) scale. The effect-site concentration (Ce) of propofol was initially started at 0.5 μg/ml and was increased in increments of 0.2 μg/ml until an OAA/S score of 1 was reached. Three minutes after the target Ce was reached, the PLE, bispectral index (BIS), and level of sedation were assessed. Correlations between the OAA/S score and PLE or BIS were determined. The prediction probabilities (P(k)) of PLE and BIS were also analyzed.
RESULTS:
The PLE values were closely correlated with the OAA/S scores (Spearman's Rho = 0.755; P < 0.001) to an extent comparable with the correlation between the BIS and OAA/S score (Spearman's Rho = 0.788; P < 0.001). The P(k) values of PLE and BIS were 0.731 and 0.718, respectively.
CONCLUSIONS
PLE is a new and reliable consciousness monitoring system for assessing the depth of sedation induced by propofol, which is comparable with the BIS.
7.Anesthetic considerations of Joubert syndrome in patients with mitochondrial disease - A case report -
Jeong Yeon KIM ; Koun JEONG ; Ki Seob HAN ; Ji Eun PARK ; Mun Gyu KIM ; Mi Roung JUN
Anesthesia and Pain Medicine 2021;16(2):158-162
Background:
Joubert syndrome and mitochondrial disease are rare congenital diseases in which a wide range of symptoms affects multiple organs. Patients with these diseases present characteristic symptoms related to the musculoskeletal, respiratory, and neurological systems, which make it difficult for anesthesiologists to manage the patient’s airway and choose appropriate anesthetic drugs. Case A 13-year-old male patient with Joubert syndrome and mitochondrial disease underwent elective surgery to insert a continuous ambulatory peritoneal dialysis catheter. Anesthesia was induced and maintained with propofol, remifentanil, and rocuronium. An I-gel was inserted to secure the airway; however, the fitting did not work properly, so the patient was intubated. The operation was completed without any major problems, and the intubated patient was transferred to the intensive care unit.
Conclusions
Anesthesiologists should determine the method of anesthesia and prepare for unintended complications based on a full understanding of these congenital diseases.
8.Assessment of phase-lag entropy, a new measure of electroencephalographic signals, for propofol-induced sedation
Mi Roung JUN ; Jae Hwa YOO ; Sun Young PARK ; Sojin NA ; Hyerim KWON ; Jae Hwi NHO ; Soon Im KIM
Korean Journal of Anesthesiology 2019;72(4):351-356
BACKGROUND: Phase-lag entropy (PLE) was recently described as a measurement of temporal pattern diversity in the phase relationship between two electroencephalographic signals from prefrontal and frontal montages. This study was performed to evaluate the performance of PLE for assessing the depth of sedation. METHODS: Thirty adult patients undergoing upper limb surgery with a brachial plexus block were administered propofol by target-controlled infusion. The depth of sedation was assessed using the Observer's Assessment of Alertness/Sedation (OAA/S) scale. The effect-site concentration (Ce) of propofol was initially started at 0.5 μg/ml and was increased in increments of 0.2 μg/ml until an OAA/S score of 1 was reached. Three minutes after the target Ce was reached, the PLE, bispectral index (BIS), and level of sedation were assessed. Correlations between the OAA/S score and PLE or BIS were determined. The prediction probabilities (P(k)) of PLE and BIS were also analyzed. RESULTS: The PLE values were closely correlated with the OAA/S scores (Spearman's Rho = 0.755; P < 0.001) to an extent comparable with the correlation between the BIS and OAA/S score (Spearman's Rho = 0.788; P < 0.001). The P(k) values of PLE and BIS were 0.731 and 0.718, respectively. CONCLUSIONS: PLE is a new and reliable consciousness monitoring system for assessing the depth of sedation induced by propofol, which is comparable with the BIS.
Adult
;
Brachial Plexus Block
;
Consciousness Monitors
;
Electroencephalography
;
Entropy
;
Humans
;
Propofol
;
Upper Extremity