Effects of sugammadex on the coronary circulation: direct effects on coronary vessels or hypersensitivity (Kounis syndrome)? / 대한마취과학회지

No abstract available.

Encountering unexpected difficult airway: relationship with the intubation difficulty scale / 대한마취과학회지

BACKGROUND: An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. METHODS: We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. RESULTS: For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. CONCLUSIONS: Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation.

Intravenous non-opioid analgesia for peri- and postoperative pain management: a scientific review of intravenous acetaminophen and ibuprofen / 대한마취과학회지

Pain is a predictable consequence following operations, but the management of postoperative pain is another challenge for anesthesiologists and inappropriately controlled pain may lead to unwanted outcomes in the postoperative period. Opioids are indeed still at the mainstream of postoperative pain control, but solely using only opioids for postoperative pain management may be connected with risks of complications and adverse effects. As a consequence, the concept of multimodal analgesia has been proposed and is recommended whenever possible. Acetaminophen is one of the most commonly used analgesic and antipyretic drug for its good tolerance and high safety profiles. The introduction of intravenous form of acetaminophen has led to a wider flexibility of its use during peri- and postoperative periods, allowing the early initiation of multimodal analgesia. Many studies have revealed the efficacy, safety and opioid sparing effects of intravenous acetaminophen. Intravenous ibuprofen has also shown to be well tolerated and demonstrated to have significant opioid sparing effects during the postoperative period. However, the number of randomized controlled trials confirming the efficacy and safety is small and should be used in caution in certain group of patients. Intravenous acetaminophen and ibuprofen are important options for multimodal postoperative analgesia, improving pain and patient satisfaction.

Survey of Institutional Review Board Approval and Informed Consent in Clinical Research of Korean Anesthetic Society / 대한마취과학회지

BACKGOUND: All medical research requires approval of the institutional review board ( IRB ) and informed consent from the research participants in advance. But there are reports of low rates of IRB approval in major anesthesia journals. The purpose of the study is to investigate IRB approval and informed consent rates of Korean anesthetic field researches and provide suggestion. METHODS: We reviewed 11 years data from Korean journal of anesthesiology and obtained the number and percentage of IRB approved papers, informed consents and verbal consents. RESULTS: The total number and percentage of IRB approved papers has increased to 60% and so as cases with informed consents over the past 11 years. But the ratio is still under 25%. The ratio of informed consent against verbal consent is also increasing. CONCLUSIONS: The number of IRB approved and informed consented papers have increased. But the proportion is still not satisfying or low. Changes in understandings of the clinical researchers with education of research ethics and systemic establishment are needed.