Tearing of the Lingual Frenulum Caused by Insertion of the LMA-ProSeal by the Introducer: A case report / 대한마취과학회지

The LMA (laryngeal mask airway)-ProSeal introducer was developed for easy insertion and fewer PLMA related complications. We experienced tearing of the lingual frenulum incidentally caused by insertion of the PLMA with the introducer. We believe that the introducer may have some advantages concerning insertion PLMA but some disadvantages because it hinder patient tongue control.

Intrathecal Triamcinolone for Intractable Postherpetic Neuralgia / 대한마취과학회지

BACKGROUND: There is no effective treatment for intractable postherpetic neuralgia. Some reports noticed effectiveness of intrathecal steroid administration which was injected at L2/3, L3/4 interspace. We tried the same procedure but injection site was differed to reduce the steroid dose. And then we evaluated the effectiveness and neurologic complications. METHODS: We studied 9 patients with postherpetic neuralgia. The patients received intrathecal triamcinolone and mepivacaine (2ml of 0.5% mepivacaine with 15 mg of triamcinolone). Each weekly dose was injected into the lesion site or near the site. Pain was evaluated 1 week, 1 month and then more than 3 months after the treatment. RESULTS: We found that pain intensity was decreased by 69.7% one week after the treatment, by 70% 3-9 months after the treatment. During the treatment, all patients except two took analgesics but did not at the end of treatment. CONCLUSIONS: The results of this trial indicated that the intrathecal administration of triamcinolone was effective for postherpetic neuralgia pain management.

The Effect of Laryngeal Mask Airway ProSeal(TM) Cuff Inflation Prior to Insertion by the Inexperienced on the Success Rate of Inserting the PLMA(TM) and on Postoperative Sore Throat / 대한마취과학회지

Backgroud: The purpose of this study was to assess the effect of inflating a laryngeal mask airway ProSeal(TM) (PLMA(TM)) cuff, prior to insertion, on the degree of difficulty of inserting a PLMA(TM) by the inexperienced, and the incidence of postoperative sore throat. METHODS: Before induction, we measured the thyromental and sternomental distance. PLMA(TM) insertions were conducted by those with experience of less than 15 previous insertions. One hundred and five consecutive patients undergoing general anesthesia were randomized into 3 groups: In group 1, the PLMA(TM) was inserted with the cuff fully deflated, in group 2, the cuff was partially inflated (i.e., filled with half the recommended air), in group 3, the cuff was fully inflated. Successful insertion was judged primarily by the clinical function of the airway. The number of insertion attempts to achieve a satisfactory airway were recorded. Each patient was asked whether he had a sore throat, dysphonia, or dysphagia just before leaving the postanesthesia care unit (PACU) and again 24 hr after surgery. RESULTS: The number of insertion attempts required to achieve a satisfactory airway and the failure rate of insertion were not significantly different in the 3 groups. However, the 3 groups were significantly different in terms of the incidence of postoperative sore throat in the PACU. This was highest in group 3 (P<0.05). The incidences of other variables of laryngopharygeal morbidity in the PACU and 24 hrs after surgery were not significantly different in the 3 groups. CONCLUSIONS: Inflation of the cuff prior to insertion did not affect the success rate of inserting a PLMA(TM) by the inexperienced, and PLMA(TM) insertion after partial inflation was associated with higher incidence of postoperative sore throat in the PACU. Thus, in general anesthesia, it is desirable that the inexperienced insert the PLMA(TM) with the cuff fully deflated.