A Successful Tracheostomy under General Anesthesia with Blind Intubation via ILMA in a Sitting Position / 대한마취과학회지

The intubating laryngeal masK airway is a newly available device designed to allow for blind endotracheal intubation and treatment of patients with difficult airways. Emergency tracheostomies are required for oropharyngeal, hypopharyngeal, and laryngeal tumors acutely obstructing the airway. Patients with an airway obstructive tumor maintain their airway by a very active inspiratory effort in a sitting position. In these patients, it may be impossible to position them for a tracheostomy with shoulder extension. We report a case where a patient was tracheostomized successfully under general anesthesia with blind intubation via ILMA insertion in a sitting position.

Differential Analgesic and Adverse Effects of 0.125% Bupivacaine vs. Ropivacaine Coadministered Epidurally with Morphine / 대한마취과학회지

BACKGROUND: This study aimed to compare analgesic efficacy and occurance of motor block and other side effects of a 48 hr postoperative continuous epidural infusion of 0.125% bupivacaine or ropivacaine with morphine. METHODS: Forty patients undergoing a Cesarean section were allocated randomly into two groups. Both groups received an epidural injection of 2.0% lidocaine 18 20 ml and 0.5% bupivacaine 2 5 ml with fentanyl 50microgram 20 minutes before surgical incision and received 2 mg of epidural morphine by bolus 40 minutes after surgical incision. For post-operative pain control, a continuous epidural infusion was started using a two day infusor containing 6 mg of morphine in 100 ml of 0.125% bupivacaine (Group 1, n = 20) or 100 ml of 0.125% ropivacaine (Group 2, n = 20). Visual analog scale (VAS) for pain during rest and movement, sensory change and motor blockade were assessed for 48 hrs. after surgery. RESULTS: There were no significant differences in VAS for pain during rest and movement. The incidences of side effect were similar in both groups. CONCLUSIONS: Using 0.125% bupivacaine with morphine via the epidural route provided similar pain relief and side effects as 0.125% ropivacaine with morphine.