Evaluation of the Esthetic and Functional Outcomes of Extracorporeal Septoplasty for Rhinoplasty in Asian Patients

Objectives@#. In extracorporeal septoplasty (ECS), the entire septal cartilage is harvested, and a neo-L strut is built extracorporeally. Thus, ECS can simultaneously achieve septum straightening and tip projection. This study evaluated the functional and esthetic outcomes of the ECS technique for rhinoplasty in Asian patients. @*Methods@#. We conducted a retrospective review of 64 patients who underwent rhinoplasty using ECS between January 2016 and March 2018. Subjective patient satisfaction was assessed and objective surgical outcomes were evaluated. Improvement in nasal obstruction was rated using a visual analog scale (VAS). Anthropometric changes were compared between preoperative and postoperative facial photographs. Complications and revisions were also analyzed. @*Results@#. The participants comprised 64 patients (48 males and 16 females, with a mean age of 29.3 years). The mean operative time was 89.3 minutes. In total, 61 patients were satisfied with the esthetic outcome, and the overall objective rhinoplasty outcome score was 3.45. Preoperative nasal obstruction symptoms (7.9±1.2 on VAS) improved postoperatively (3.1±1.3, P<0.001), and significant improvements were also observed in the nasofrontal angle (152.3° to 148.1°, P<0.001), nasolabial angle (88.8° to 92.0°, P<0.001), and nasal tip projection (0.62 to 0.66, P<0.033). Recurrent deviation of the nasal septum and external nose or tip deprojection did not occur in any patients, and there were no cases of revision during the mean follow-up period of 13.3 months. @*Conclusion@#. ECS might be an esthetically and functionally satisfactory alternative rhinoplasty technique for Asian patients with a shortage of septal cartilage.

Increased Risk of Psychopathological Abnormalities in Subjects With Unilateral Hearing Loss: A Cross-Sectional Study

Objectives@#. Although unilateral hearing loss (UHL) has been proven to be associated with educational and behavioral problems, few studies have investigated psychopathological abnormalities in this population. The aim of this study was to evaluate the psychopathological influence of UHL among Korean 19-year-old males. @*Methods@#. The authors retrospectively compared the objective personality test profiles of 602 subjects with UHL with those of 23,790 peers with normal hearing. All participants in the current study were 19-year-old males who underwent a physical examination and completed the Korean Military Multiphasic Personality Inventory for conscription at the Military Manpower Administration from February 2015 to December 2016. @*Results@#. Significantly higher scores were found on neurosis scales in the UHL group than in the normal-hearing group (50.9± 10.8 vs. 44.9±6.0 for anxiety; 51.0±10.5 vs. 44.9±5.2 for depression; 51.1±10.4 vs. 45.1±6.81 for somatization, all P<0.001). The psychopathy scales were also significantly higher in the UHL group than in the normal-hearing group (49.3±9.4 vs. 46.3±5.7 for schizophrenia; 51.1±11.2 vs. 44.3±5.8 for personality disorders; 51.1±10.5 vs. 45.7±3.7 for paranoia, all P<0.001). @*Conclusion@#. Nineteen-year-old males with UHL tended to have more abnormal results on personality tests than controls with normal hearing, suggesting that UHL may be related with a higher risk of psychopathology.

Two Cases of Orbital Blowout Fractures with Extraocular Muscle Entrapment in Children / 대한이비인후과학회지

Orbital blowout fracture is a common result of facial trauma and with the expanded use of endoscopy in orbital blowout fracture surgery, otolaryngologists are participating more often blowout fracture surgery. Because orbital blowout fracture may result in sequelae such as diplopia and enophthalmos, proper diagnosis and timing of repair are crucial. Orbital blowout fracture with extraocular muscle entrapment is uncommon and almost exclusively seen in children. It needs emergent release of entrapped muscle to prevent permanent sequelae (e.g., diplopia). The authors experienced two cases of orbital blowout fracture with extraocular muscle entrapment and had good surgical results without any sequelae. We report these cases with a review of the literature.

Clinical Analysis of External Auditory Canal Osteoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#External auditory canal osteoma is an uncommon benign lesion and represents as unilateral solitary pedunculated mass. The aim of this study is to evaluate the clinical symptoms of osteoma and its treatment outcomes over a 10-year period in a tertiary hospital.SUBJECTS AND METHOD: Eight patients underwent operation to remove an external auditory canal osteoma at Chungbuk National University Hospital from 2008 to 2017. The medical records were retrospectively reviewed with regard to clinical characteristics, size and location of osteoma, method of surgery and treatment outcomes.@*RESULTS@#The average age of patients was 41.8 years with the male predominance of 6:2. All of the lesions in the osteoma were unilateral and solitary (average size 5.0 mm). All of the eight cases were pedunculated: in four cases, the stalks of the osteoma were found on the tympanomastoid suture line and in three cases, it was found on the tympanosquamous suture line. Four patients were asymptomatic, where the lesions were found incidentally during unrelated evaluations. No patients were found with conductive hearing loss in the pure tone audiometry. Transcanal and endaural approach were used in five and three cases, respectively. Most of the cases were removed by curettage only, except for the two who needed additional drilling. The average surgery time was 15.6 minutes. There was no postoperative complication or recurrence.@*CONCLUSION@#The external auditory canal osteoma was mostly unilateral and solitary. The removal of osteoma in the early stage was relatively easy with no recurrence or complication.

Clinical Analysis of External Auditory Canal Osteoma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: External auditory canal osteoma is an uncommon benign lesion and represents as unilateral solitary pedunculated mass. The aim of this study is to evaluate the clinical symptoms of osteoma and its treatment outcomes over a 10-year period in a tertiary hospital. SUBJECTS AND METHOD: Eight patients underwent operation to remove an external auditory canal osteoma at Chungbuk National University Hospital from 2008 to 2017. The medical records were retrospectively reviewed with regard to clinical characteristics, size and location of osteoma, method of surgery and treatment outcomes. RESULTS: The average age of patients was 41.8 years with the male predominance of 6:2. All of the lesions in the osteoma were unilateral and solitary (average size 5.0 mm). All of the eight cases were pedunculated: in four cases, the stalks of the osteoma were found on the tympanomastoid suture line and in three cases, it was found on the tympanosquamous suture line. Four patients were asymptomatic, where the lesions were found incidentally during unrelated evaluations. No patients were found with conductive hearing loss in the pure tone audiometry. Transcanal and endaural approach were used in five and three cases, respectively. Most of the cases were removed by curettage only, except for the two who needed additional drilling. The average surgery time was 15.6 minutes. There was no postoperative complication or recurrence. CONCLUSION: The external auditory canal osteoma was mostly unilateral and solitary. The removal of osteoma in the early stage was relatively easy with no recurrence or complication.

Congenital Cholesteatoma: Analysis of Risk Factors for the Postoperative Recurrence / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The incidence of recurrence after surgery of congenital cholesteatoma is increasing due to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. There is no general consensus on the risk factors affecting recurrence. In this study, analyzing clinical characteristics of recurred cases from a tertiary hospital, we investigated risk factors for the recurrence of congenital cholesteatoma after surgery. SUBJECTS AND METHOD: From 1999 to 2016, data were collected from retrospective chart reviews of patients who have undergone surgeries for congenital cholesteatoma at Hospital. We analyzed data about clinical characteristics and recurrence according to the age at diagnosis, location, stage and type of disease, pneumatization of mastoid, ossicular erosion, and surgical techniques. RESULTS: Sixty-eight patients underwent surgery for congenital cholesteatoma. The average age at operation was 4.8 years. Recurrence was detected in 7 cases of the 68 patients, with the recurrence rate of 10.3%. Sex, age, cholesteatoma type, location, stage, mastoid pneumatization, and operation method did not show significant differences between the recurred group and the non-recurred group in the univariated analysis. CONCLUSION: The recurrence rate of congenital cholesteatoma after primary operation was 10.3%. In this study, there was no statistically significant risk factor for postoperative recurrence of congenital cholesteatoma.

Clinical Characteristics of Bilateral Chronic Otitis Media / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine the prevalence of bilateral chronic otitis media (BCOM) and the ratio of unilateral or bilateral cholesteatoma in BCOM. Pre- and post-operative hearing were analyzed to see if bilateral balanced hearing were achieved. SUBJECTS AND METHOD: A retrospective review was done with a computerized otologic database to identify all patients who underwent surgical treatments for COM between 1998 and 2011, and has a follow up duration for at least 6 months. Comparative analysis between pre- and post-operation hearing was measured by pure tone audiometry and achievement of bilateral balanced hearing was analyzed with 'The Belfast rule of thumb'. RESULTS: Two hundred and eighty-one (14.5%) of 1938 patients suffered from BCOM, and of these, 73 (25.9%) of the patients with BCOM had cholesteatomas in one (12.4%) or both ears (13.5%). When a patient with BCOM is found with cholesteatoma in one ear, the odds of there being cholesteatoma in the other ear was 52.1%. According to 'The Belfast rule of thumb', it is considered difficult to achieve successful bilateral hearing gains sufficient for the patients to perceive subjective hearing improvements in BCOM. CONCLUSION: Approximately 15% of the COM patients were found with the disease in both ears, and the odds of a patient with BCOM having cholesteatoma in one ear also having cholesteatoma in the other ear was 53.4%. It was difficult to achieve subjective, successful and balanced bilateral hearing gain with three-dimensional hearing improvements.

Clinical Characteristics of Labyrinthine Concussion

BACKGROUND AND OBJECTIVES: Inner ear symptoms like hearing loss, dizziness or tinnitus are often developed after head trauma, even in cases without inner ear destruction. This is also known as labyrinthine concussion. The purpose of this study is to determine the clinical manifestations, characteristics of audiometry and prognostic factors of these patients. MATERIALS AND METHODS: We reviewed the medical records of the 40 patients that had been diagnosed as labyrinthine concussion from 1996 to 2007. We studied the hearing levels in each frequency and classified them according to type and degree of hearing loss. Rates of hearing improvement were evaluated according to age, sex, hearing loss type, degree and presence of dizziness or tinnitus. To find out any correlation between hearing improvement and these factors, we used chi2 test or Fisher's exact test. RESULTS: Bilateral hearing loss was observed in 22 patients, and unilateral hearing loss in 18 patients. There were 4 (6.5%) ascending, 34 (54.8%) descending, 24 (38.7%) flat type hearing loss, which indicated hearing loss was greater in high frequencies than low frequencies. Among 62 affected ears, 20 (32.3%) gained improvement, and it was achieved mainly in low frequencies. There were only 2 ears with dizziness in 20 improved ears and among 20 dizziness accompanied ears, also only 2 ears were improved. CONCLUSIONS: High frequencies are more vulnerable to trauma than low frequencies. The hearing gain is obtained mainly in low frequencies, and association with dizziness serves poor prognosis.

Endoscopic Endonasal Reduction of Medial Blow Out Fracture Using Nasopore Forte(R) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Before the introduction of transnasal endoscopic sinus surgery, transorbital approach with an external incision used to be one of the representative reconstructive surgical repairing method of blow out fracture. The important advantages of transnasal endoscopic technique are magnified direct visualization and easy accessibility to the medial orbital wall. Nasopore Forte(R) is a slowly absorbable material and provides excellent durability. The purpose of this study is to evaluate outcomes of endoscopic endonasal reduction (EER) of medial blow out fracture using Nasopore Forte(R). SUBJECTS AND METHOD: A retrospective study was performed on 26 patients with medial blowout fracture who had undergone EER using Nasopore Forte(R) from January to December of 2010 at our clinic. A review of medical records included demographic data, preoperative ocular symptoms and signs, and surgical outcomes including postoperative symptom improvement and complications. RESULTS: Of 26 patients, 5 had persistent diplopia, 5 enophthalmos, and 3 both diplopia and enophthalmos preoperatively. Seventeen patients were asymptomatic, but had large defects with the mean defect size of 2.4 cm2. Postoperative computed tomography scan showed excellent (22) to good (4) reduction. Preoperative symptoms were resolved in all of 13 symptomatic patients and there was no enophthalmos during the follow-up period. No significant complications including sinusitis or synechia were found. CONCLUSION: EER is a highly effective and safe procedure for the reduction of medial blow out fracture. Nasopore Forte(R) is easy to handle and can be tailored to individual defects, and is useful for securing the reduction and preventing adhesion after EER.

The Chromosomal Aberrations in the Head and Neck Squamous Cell Carcinoma Cell Lines:PCI-1, PCI-13 and PCI-50 / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The knowledge about chromosomal aberrations manifestated in cancer has been spotlighted recently. The genetic analyses based on the knowledge about chromosomal aberrations are important for the development of diagnotic methods and evaluation of prognostic factors in cancers. Comparative genomic hybridization (CGH) is a powerful tool for evaluating chromosomal aberrations and array CGH significantly enhances these diagnostic effectiveness. The incidence of head and neck squamous cell carcinoma (HNSCC) has been increasing worldwide but the treatment outcomes still have been limited. The aim of this study is to evaluate the location of chromosomal aberrations in HNSCC cell lines with the combination of CGH and array CGH. Materials and MethodZZThe locations of chromosomal aberrations were evaluated in 3 HNSCC cell lines (PCI-1, PCI-13, PCI-50) using the combination of CGH and array CGH. RESULTS: The sites of chromosomal gain shown by CGH in all 3 cell lines were 8q22-qter, 9q32- qter, 10q22, 10q26-qter, 16q12.1-qter, 17p10-p13, 17q21-qter, 19p13.2-pter and 20q. The chromsomal loss found in 2 cell lines were 3p, 4q21-qter, and 18q21-qter. In array-CGH, gained loci were AHRR, MYT1 and PTGIS, etc. Loci of genetic losses were ELAVL4 and GRM7. CONCLUSION: In this study, we identified various genetic gains and losses using CGH and high resolution array-CGH. These data about the patterns of chromosomal aberrations in HNSCC cell lines would be a basic step for understanding more detailed genetic events in the carcinogenesis. CGH combined with array CGH can be a powerful option for transitional oncologic research.

Cytologic Features of Epithelial-Myoepithelial Carcinoma Occurring in External Auditory Canal: A Case Report / 대한세포병리학회지

Epithelial-myoepithelial carcinoma (EMC) is a low grade malignant neoplasm that commonly occurs in the parotid gland. Recently, we investigated a case of EMC that occurred in the external auditory canal (EAC) in a 35-year-old male, and this tumor was initially diagnosed as pleomorphic adenoma. The difficulty associated with diagnosing EMC by aspiration cytology arises from both the rare incidence of this tumor and the overlapping spectrum of cytological features found in various salivary gland tumors, such as pleomorphic adenoma, basal cell adenoma and adenoid cystic carcinoma.

Delayed Reduction of Pure Medial Blowout Fracture of the Orbital Wall / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The timing of surgery is an important consideration point in the management of blowout fracture (BOF) of the orbit. This study aimed to compare the surgical outcome of early and delayed reduction and to suggest the best timing of surgery in the pure medial BOF of the orbit. SUBJECTS AND METHOD: Fifty-two patients who had endoscopic endonasal reduction of medial BOF were studied retrospectively. Patients were divided into an early group (N=42) who had surgery within one month after the trauma and a delayed group (N=10) who had surgery after one month from the trauma. Surgical indications, results of the surgery, and complications were compared between the two groups. RESULTS: The surgical indications in the early group were persistent diplopia, large defect expecting later enophthalmos and limitation of EOM, whereas the delayed group complained mainly of enophthalmos and diplopia. There were no significant differences in surgical outcomes and the rate of complications between the two groups. CONCLUSION: When patients with pure medial BOF have large defects without any persistent diplopia and limitation of EOM, surgery would be safely deferred until significant enophthalmos occurs.

Congenital hernia of the lung through the azygoesophageal recess / 소아과

A lung hernia, defined as the protrusion of pulmonary tissue and pleural membranes through a defect in the thoracic wall, is a rare event. It can be congenital or acquired, and cervical, thoracic, or diaphragmatic in location. We report the rare occurrence of a congenital atraumatic lung herniation through the azygoesophageal recess. An 8 -month-old male infant, who was born at 3 5 weeks gestation, had a chronic cough. Chest radiography showed haziness at the right lower lobe of the lung (RLL). Chest computed tomography (CT) revealed herniation of the RLL through the azygoesophageal recess. If persistent unilateral haziness is observed on chest radiography, the possibility of lung herniation should be considered.

A case of mixed connective tissue disease presenting initially with Raynaud's phenomenon / 소아과

Mixed connective tissue disease (MCTD) is characterized by diverse symptoms including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and dermatomyositis, associated with high titers of antibodies to extractable nuclear antigen (ENA), especially anti-ribonucleoprotein (anti-RNP) antibody. Since the first report of 25 cases with MCTD in adults, there have been only a few cases of MCTD reported in children. Here, we report a rare childhood case of MCTD in a 7-year-old girl presenting initially with Raynaud's phenomenon, swollen hands, and ulceration of the right index finger tip followed by alopecia and arthritis during follow-up.

Effect of Chloral Hydrate Used for Pediatric Sedation

PURPOSE: Sedation is often needed to perform an imaging study or procedure on a child. Although chloral hydrate is the most commonly used drug for pediatric sedation, little data are available for its efficacy or adverse effects. This study was undertaken to evaluate the efficacy of chloral hydrate for sedation and define any problems for using this agent in children. METHODS: The medical records of 324 infants and children, who were admitted at Chonnam National University Hospital from January 2005 to December 2005 were retrospectively reviewed. Age, sex, body weight, underlying diagnosis, performed procedure, dose of chloral hydrate, initial response, delayed response and other additional agents for sedation were reviewed. If the desired level(3 on the Skeie scale) was not reached within 30 min after the administration of drugs, sedation was considered as potentially failed. RESULTS: The average age of the study group was 27 months. Among 324 patients, 107 (33.0%) failed for chloral hydrate sedation. 77(47.8%) of the neurologically impaired 161 patients and 30(18.4%) of the unimpaired 163 patients failed on sedation with chloral hydrate. Among neurologically impaired cases, who had either developmental delay or seizures or both of them, 56.8%(25/44), 50.0%(58/116) and 64.7%(22/34) in each category respectively failed on sedation with chloral hydrate. CONCLUSION: In neurologically impaired patients, sedation by chloral hydrate was so difficult and prone to have adverse effects that it is recommended to supplement another drug than to administer the same drug again. However, further studies on effective methods of sedation are needed.

A case of pulmonary thromboembolism in a healthy infant / 소아과

A pulmonary thromboembolism (PTE), which is a sudden blockage in a pulmonary artery, usually due to a blood clot, is rare in children. The clinical presentation is often subtle or masked by the underlying clinical condition and the condition must be suspected during clinical testing. Although the choice of treatment depends on the clinical presentation, anticoagulation is the mainstay of therapy for children with PTE. We report the case of a healthy 1-month-old boy who presented with hemoptysis without hemodynamic instability. He was diagnosed based on chest computed tomography with angiography and 99mTc macroaggregated albumin lung perfusion scintigraphy and treated with low-molecular-weight heparin.

Primary Facial Skin Cancer: Clinical Characteristics and Surgical Outcome in Chungbuk Province, Korea

Clinical features of facial skin cancer in Asian population including Korean are not readily available. In the present study, we analyzed the clinical characteristics and the surgical results of primary facial skin cancer in Chungbuk Province, Korea. Eighty-six cases of primary facial skin cancer collected during a 10-yr period (1994-2003) were retrospectively reviewed about the clinical characteristics including age, sex, annual diagnostic rate, types of tumor, specific sites of occurrence, and the surgical results. The average age at the diagnosis was 67 and male to female ratio was 1 to 1.05. The average annual diagnostic rate was 0.73% and the rate surged during the period 2001-2003 compared with the period 1994 to 2000. Basal cell carcinoma was the most common tumor and the nose was the most frequent site. Traditional surgical excision with immediate reconstruction was performed in 81 cases. During the 23 months of average follow-up, three patients had recurrences (3.7%) and three patients had secondary skin cancers. Facial skin cancer is increasing in the province and basal cell carcinoma is most frequent. Traditional surgical excision and immediate reconstruction with local flap are a good therapeutic modality with an acceptable recurrence rate.

5 Cases of Major Complications after Rhinologic Surgery: Avoidable and Unavoidable Cases

Otolaryngologists are sometimes confronted with various complications. They may be minor or sometimes they can be major, and rarely fatal. Some complications can be prevented, but some are unavoidable. Five cases of major complications, which occurred during or after routine rhinologic surgery, are presented. Two patients died of toxic shock syndrome: one patient after endoscopic sinus surgery (ESS) and the other patient after closed nasal bone reduction. One patient died of acute myocardial infarction during the recovery of anesthesia after uneventful ESS. One patient had a lidocaine shock, which required treatment in the intensive care unit. One patient had a transient unilateral blindness after intranasal steroid injection. Though the 3rd and 4th cases of complications were unavoidable, the others could have been prevented if precautions had taken place. The presumed pathophysiology, possible prevention measures, and their implications in routine otolaryngologic surgery are discussed.

The Effect of Ketamine Added to a Ropivacaine Supuraclavicular Brachial Plexus Blockade / 대한마취과학회지

BACKGROUND: In addition to its general anesthetic effect, ketamine has a local anesthetic-like action by a peripheral mechanism. We evaluated the effects of injecting ketamine 45 mg in a supraclavicular brachial plexus blockade (SBPB) with 0.5% ropivacaine 150 mg. In addition, we evaluated the incidence of side effects. METHODS: Thirty four adult patients scheduled for upper extremity surgery were randomly allocated to one of three groups; group 1 (placebo group, n = 10) received 0.5% ropivacaine 30 ml for SBPB and intravenous saline 0.9 ml, group 2 (ketamine group, n = 13) received 0.5% ropivacaine 30 ml with ketamine 0.9 ml (45 mg) for SBPB, and group 3 (control group, n = 8) received 0.5% ropivacaine 30 ml for SBPB and intravenous ketamine 0.9 ml (45 mg). At 1-minute intervals after SBPB, patients were assessed for loss of shoulder abduction, elbow flexion, and wrist flexion, and for loss of pinprick sensation in the deltoid, radial, median, and ulnar dermatomes. Side effects and sedation scores were recorded at 5-minute intervals after SBPB. Before discharge, patients were asked when full sensation or motor function recovered. RESULTS: The speeds of onset for both the motor and sensory blocks were similar in all three groups. The duration of postoperative analgesia and paralysis were similar in the three groups. Side effects were experienced by 62% of patients in group 2 and by 100% of patients in group 3. CONCLUSIONS: We found that the addition of ketamine (45 mg) to brachial plexus blockade does not offer either a quicker onset or a longer duration of anesthesia when using 0.5% ropivacaine SBPB, and it caused a relatively high incidence of side effects.

The Optimal Administration of Epidural Droperidol to Reduce the Side Effects of Epidural Opioid / 대한마취과학회지

BACKGROUND: Epidural opioids are used for the treatment of postoperative pain, but the incidence of side effects like nausea, vomiting, and pruritus is high. The aim of this study was to determine the optimal method for administering epidural droperidol to reduce the side effects of epidural opioids. METHODS: A randomly sampled group of 145 patients that had undergone abdominal or lower leg surgery under general anesthesia were divided into the four groups. All patients received morphine 4 mg, fentanyl 500microgram and 0.2% ropivacaine 100 ml using a 2-day epidural infusion pump, and morphine 1 mg, fentanyl 50 mg and 0.2% ropivacaine 10 ml by epidural bolus. Group 1 patients (control group, n = 40) did not receive epidural droperidol. Group 2 patients (n = 35) received 2.5 mg of droperidol as an epidural bolus. Group 3 patients (n = 35) received 2.5 mg of droperidol as a continuous infusion. Group 4 patients (n = 35) received 1.25 mg of droperidol as an epidural bolus and 1.25 mg of droperidol as a continuous infusion simultaneously. Nausea, vomiting, and pruritus were assessed and recorded by a blind observer 1, 6, 24, and 48 hours after the bolus epidural administration of droperidol. RESULTS: There was no significant difference between the four groups in terms of the intensity of sedation, nausea, vomiting, and pruritus. The incidence of nausea and vomiting in groups 2, 3, and 4 at 1 hour, in groups 2 and 4 at 6 hours, and in groups 3 at 48 hours was significantly lower than in control group. The incidences of pruritus in groups 2, 3, and 4 at 6 hours, and in groups 3 and 4 at 24 and 48 hours were significantly less than that of the control group. CONCLUSIONS: Epidural bolus droperidol is effective at reducing nausea, and vomiting during the early postoperative stage. Continuous epidural droperidol is also effective at reducing the pruritus during the late postoperative stage.