BACKGROUND: As undergoing general anesthesia for Cesarean Section, we usually maintain a light anesthesia until delivery. It provokes the high incidence of waketulness for the mothers. We surveyed the incidence of maternal wakefulness when thiopental was used as an induction agent. METHODS: Forty pregnant women (ASA class I or II) at term who underwent general anesthesia and cesarean section received thiopental, 4mg/kg. As the 'isolated forearm technique', a pressure cuff was inflated to isolate one arm from the the effects of succinylcholine so that wakefulness during anesthesia could be assessed by asking the patient to move her hand. To assess wakefulness,the patient was commanded to squeeze the investigator's hand a specified number of times. If the patient promptly squeezed the investigator's hand the appropriate number of times, the command was repeated but a different number of times specified. Only if the patient responded correctly both times, then we noted as a positive response. This test was repeated at 1 minute intervals beginning 1 minute after thiopental injection through the delivery. RESULTS: Five of the forty patients (12.5%) showed wakefulness. Twenty nine of the forty patients showed 'reaching movements'. One patient showed both wakefulness and 'reaching movements'. CONCLUSIONS: When we undergo general anesthesia for Cesarean Section, especially using thiopental as an induction agent, we should consider the maternal wakefulness seriously.
Anesthesia ; Anesthesia, General ; Anesthesia, Obstetrical ; Arm ; Cesarean Section* ; Female ; Forearm* ; Hand ; Humans ; Incidence ; Mothers ; Pregnancy ; Pregnant Women ; Succinylcholine ; Thiopental ; Wakefulness*

No abstract available.
Sepsis*

No abstract available.
Hematoma*

No abstract available.
Animals ; Medulla Oblongata* ; Putrescine* ; Rats*

Voice changes developing after endotracheal intubation during right hemicolectomy with endotracheal intubation have been found to be due to a right recurrent laryngeal nerve palsy in 43-years-old male patient. It was likely that the inflated cuffed tube rode up to the level of the cricoid cartilage during the course of surgery as traction was placed on the endotracheal tube because the condenser humidifier and breathing circuit weighed heavy. Cuff overexpansion, in addition to muscle relaxation and decreased tracheal elasticity were considered as contributing factors of vocal cord palsy. We believe that tube traction and cuff overexpansion were the mechanism of vocal cord palsy in our patient. So we recommend the routine use of tube stand so that weigh of the breathing circuit does not transmit traction to the endotracheal tube. Concurrently, filling the cuff with a sample of the inspired mixture of gases, saline and 4% lidocaine in special cases or regular deflation of the cuff must be considered.
Cricoid Cartilage ; Elasticity ; Gases ; Humans ; Intubation, Intratracheal* ; Lidocaine ; Male ; Muscle Relaxation ; Respiration ; Traction ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice

No abstract available.
Choanal Atresia*

No abstract available.
Pulmonary Edema*

No abstract available.
Diagnosis* ; Pyloric Stenosis, Hypertrophic*

No abstract available.
Estradiol* ; Female ; Menstrual Cycle* ; Superovulation*

OBJECTIVE: There are various surgical approaches to far-lateral lesions in the L5-S1 intervertebral space. Of these is the validity of a paramedian tangential approach is being investigated in this study. METHODS: A retrospective study was conducted on 25 patients who had been diagnosed as having a far-lateral L5-S1 disc herniations, osteophyte, costal process hypertrophy, and had undergone a paramedian tangential approach from November 1999 through December 2003. The degree of symptoms and improvement were compared via the visual analog pain scale, before and after surgery. RESULTS: This study included 4 males and 21 females with a mean age of 62+/-11.8 years old. The average follow-up period after surgery was 8.2+/-2.7 months. The visual analog pain scale taken before surgery was 6.7+/-1.1 points, while the post-surgical scale was 2.4+/-0.9 points showing a significant decrease (p<0.05). There were no complications that developed during surgery. CONCLUSION: A paramedian tangential approach is less invasive in the soft tissue than that of the median approach. This approach may effectively reduce nerve root compression and expand intervertebral foramens, and is devoid of the risk of spinal instability after surgery. The authors suppose that a paramedian tangential approach is quite an effective technique to relieve compression in the far-lateral L5-S1 intervertebral space.
Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Male ; Osteophyte ; Pain Measurement ; Radiculopathy ; Retrospective Studies