No Abstract Available.
Surgical Procedures, Minor*

Dermatologists frequently perform a number of procedures without the aid of an assistant and have sometimes difficulty to obtain hemostasis during the biopsy or other minor surgery. A flat plastic cylinder made of a disposable syringe effectively stops bleeding and procedures are easily carried out with a clean surgical field. It is believed to be inexpensive, durable and easy to be sterilized.
Biopsy ; Hemorrhage ; Hemostasis* ; Plastics* ; Surgical Procedures, Minor ; Syringes*

BACKGROUND: The purpose of this study was to determine the incidence of side effects, rate of recovery, and maintenance of anesthesia when using a mixture of propofol and thiopentone as compared with propofol alone. METHODS: Fifty ASA Physical Status I or II patients aged between 12 and 60 years scheduled for minor surgical procedures were randomly allocated to group P (propofol) or group PT (propofol mix with thiopentone) in which a loading dose of propofol 2 mg/kg (group P) or propofol 1 mg/kg and thiopentone 2.5 mg/kg (group PT) was applied. At induction of anesthesia, an independent anesthesiologist graded the incidence and severity of pain. After administering the induction dosage, he also checked spontaneous movements. The duration of operation time and the duration of anesthesia were also noted. RESULTS: There was a significant decrease of the incidence of pain on injection and spontaneous movements in group PT compared with group P (P < 0.05). The propofol maintenance dose was also significantly decreased (P < 0.05). There were no significant differences in recovery indexes between the two groups except delay in time to eye opening. CONCLUSIONS: Our data indicate that a propofol-thiopentone mixture for induction, maintenance and recovery are satisfactory during anesthesia undergoing minor surgery. In addition, there were significant reductions in pain on injection, spontaneous movement, and cost-effectiveness.
Anesthesia ; Humans ; Incidence ; Propofol* ; Surgical Procedures, Minor ; Thiopental

BACKGROUND: Surgical procedures carried out under local anesthesia are associated with patient discomfort and apprehension. The purpose of this study is to compare propofol and midazolam with regard to their suitability for the patient controlled sedation (PCS) technique during local anesthesia. METHODS: Forty unpremedicated, ASA physical status I day surgery patients undergoing elective minor surgery were randomly divided into two equal groups of patients who self-administered either propofol or midazolam intraoperatively. All patients initially received 0.5 g.kg-1 fentanyl. The bolus dose was either 20 mg (2 ml over 25 sec) of self-administered propofol or 0.5 mg (2 ml over 25 sec) of midazolam and lock-out period was 1 min. RESULTS: The onset of sedation following propofol was significantly faster than midazolam (p<0.05) and demands of propofol was significantly less than midazolam (p<0.05). There were no significant differences for postoperative recovery, sedation and comfort scale. CONCLUSIONS: Propofol was judged the more suitable agent for PCS than midazolam, because of its more rapid onset of sedation and less demands of drug.
Ambulatory Surgical Procedures ; Anesthesia, Local* ; Anesthetics ; Fentanyl ; Humans ; Midazolam* ; Propofol* ; Surgical Procedures, Minor

BACKGROUND: Recently, the value of routine preoperative screening tests has been questioned, especially in healthy children scheduled for elective minor surgery. We have assumed that sufficient history taking and physical examination could replace these tests. We prepared child health check lists for the parents to answer. Then, we compared the usefulness between preoperative screening tests and child health check lists. METHODS: Group A included 67 children, the parents of whom had answered the child health check list, and group B included 63 children who underwent routine preoperative screening tests. Each group was divided into ambulatory surgery patients (groups A1, B1) and patients admitted for surgery (group A2, B2). Comparison values between the two groups included preoperative evaluation time, operation time, anaesthesia time and recovery time. Also, clinical side effects were evaluated. RESULTS: The operation time, anaesthesia time and recovery time in each group showed no statistical differences. However, there were statistical differences of preoperative evaluation time. Preoperative evaluation time was significantly decreased in groups A1 (4.0 +/- 1.2), and A2 (5.4 +/- 1.3) compared to groups B1 (7.6 +/- 1.7), and B2 (8.6 +/- 1.8). CONCLUSIONS: The use of a child heath check list saved time in the preoperative evaluation and saved the effort of the anaesthesiologist. It also decreased the discomfort of the children by omitting the invasive procedure and it reduced the medical costs.
Ambulatory Surgical Procedures ; Child ; Child Health ; Humans ; Mass Screening ; Parents ; Physical Examination ; Surgical Procedures, Minor

Ketamine is a rapidly acting dissociative anesthetic that can be administered as a sole agent, an induction agent, or a supplement to low potency anesthetic agents.It is usually used for the minor surgery or outpatient surgery in pediatric anesthesia because of the undesirable psychotomimetic side effects of ketamine are less common in the children. We report that a pediatric patient had experienced a profound paralytic ileus after ventilation tube insertion with ketamine anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Child ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Ketamine ; Surgical Procedures, Minor ; Ventilation

Ketamine is a rapidly acting dissociative anesthetic that can be administered as a sole agent, an induction agent, or a supplement to low potency anesthetic agents.It is usually used for the minor surgery or outpatient surgery in pediatric anesthesia because of the undesirable psychotomimetic side effects of ketamine are less common in the children. We report that a pediatric patient had experienced a profound paralytic ileus after ventilation tube insertion with ketamine anesthesia.
Ambulatory Surgical Procedures ; Anesthesia ; Child ; Humans ; Ileus ; Intestinal Pseudo-Obstruction ; Ketamine ; Surgical Procedures, Minor ; Ventilation

BACKGROUND: Recent studies suggest that additional use of alfentanil could provide the best condition for the laryngeal mask airway (LMA) insertion. The aim of this study is to compare the median effective dose (ED50) of propofol for the classic LMA insertion and the insertion condition following between fentanyl and alfentanil adjuvant. METHODS: We enrolled 53 patients scheduled for minor surgery under general anesthesia. Patients were randomly allocated to the fentanyl group (n = 24) and the alfentanil group (n = 29) in double blind manner. For fentanyl group, 1microgram/kg of fentanyl was injected intravenously 90 sec before propofol. The afentanil group received 4microgram/kg of alfentanil and propofol coincidently. The insertion of LMA was attempted 90 sec after propofol administration. In accordance with Dixon's up-and-down method, the dose of propofol for consecutive patients in each group was varied with increments or decrements of 0.5 mg/kg based on the previous insertion results of patients. RESULTS: In the fentanyl and alfentanil group, the ED50 of propofol for LMA insertion according to Dixon's method was 2.0 +/- 0.3 mg/kg and 1.8 +/- 0.3 mg/kg, respectively. In addition, the ED50 of propofol of the fentanyl and alfentanil group according to probit regression model, 1.7 mg/kg (95% confidence interval, 1.2-2.2) and 1.7 mg/kg (1.3-2.0) were calculated respectively. There is no significant difference between the two groups. CONCLUSIONS: There was no significant difference in propofol ED50 for insertion of LMA and insertion condition between the alfentanil and the fentanyl group.
Alfentanil* ; Anesthesia, General ; Fentanyl* ; Humans ; Laryngeal Masks ; Propofol* ; Surgical Procedures, Minor

Surgical excision or undermining of the affected skin in patients with postherpetic neuralgia (PHN) has been introduced as an optional treatment when other treatment failed to reduce the pain. Such peripheral operation is rarely performed due to its limited effects and invasiveness. There were few reports about long-term outcome regarding surgical excision of PHN skin. We had experienced a case of PHN patient, who underwent surgical excision 10 years ago and suffered with returned pain and severe allodynia. The pain subsided markedly after a treatment with intercostal nerve block and topical lidocaine patch.
Humans ; Hyperalgesia ; Intercostal Nerves ; Lidocaine ; Neuralgia, Postherpetic ; Skin ; Surgical Procedures, Minor

BACKGROUND: Recently, it was reported that bupivacaine-induced spinal block significantly reduced the hypnotic requirements for thiopentone, midazolam and propofol. We evaluated the hypnotic effect and requirements for intravenous propofol when pretreated with intravenous lidocaine. METHODS: Fifty patients, ASA I or II, undergoing minor surgical procedures were randomly divided into five groups according to anesthetic pretreatment (group N: 0.9% normal saline; group 0.5: lidocaine 0.5 mg/kg; group 1.0: lidocaine 1.0 mg/kg; group 1.5: lidocaine 1.5 mg/kg; group 2.0 lidocaine 2.0 mg/kg). Ninty seconds after the administration of normal saline or lidocaine, propofol was administered intravenously over 5 sec in bolus doses of 0.2 mg/kg every 30 sec. The inability of patients respond to a simple command ("Open your eyes," said twice) was used as the end point for hypnosis. Responses to verbal commands were evaluated 25 sec after each bolus. The total dose required to achieve complete loss of response in each patient was recorded in mg/kg. The time of the loss of response was from the adminstration of propofol to the loss of response. Mean arterial pressures and heart rates were measured before induction, after loss of response, and immediately after induction. RESULTS: The time and total dose required to achieve loss of response was significantly reduced in groups 1.0, 1.5 and 2.0. Heart rates in groups 2.0 and mean arterial pressure in groups 0.5, 1.0, 1.5, 2.0 were significantly decreased after the loss of response. CONCLUSIONS: We suggest that lidocaine pretreatment significantly enhances the hypnotic effect and reduces the dose requirement for propofol during the induction period.
Anesthesia* ; Arterial Pressure ; Heart Rate ; Humans ; Hypnosis ; Hypnotics and Sedatives* ; Lidocaine* ; Midazolam ; Propofol* ; Surgical Procedures, Minor ; Thiopental