A Comparison of Personality Characteristics in Trigeminal Neuralgia and Atypical Facial Pain Using Minnesota Multiphasic Personality Inventory (MMPI) / 대한마취과학회지

BACKGROUND: Trigeminal neuralgia and atypical facial pain are representative disease entities of chronic facial pain. Most patients of these disaeses could be accompanied with psychological, emotional problems as their pain become chronic. The purpose of this study is to investigate whether different types of chronic facial pain lead to alteration in personality disorder or they are associated with particular characteristics of personality disorders using Minnesota multiphasic personality inventory (MMPI). METHODS: 40 patients of trigeminal neuralgia and 21 patients of atypical facial pain who had responded MMPI were enrolled in this study. Two groups were compared for age, sex, pain intensity (Visual analogue scale, VAS), duration of pain, MMPI scores and psychological impression from MMPI results. RESULTS: Pain intensity and chronicity were more severe and longer in trigeminal neuralgia group than atypical facial pain. However, some MMPI profiles such as hypochondriasis and hysteria were significantly elevated in atypical facial pain. Pain intensity and duration did not correlate with MMPI profiles in each group. Meaningful psychological impression from MMPI results which were interpreted by one psychologist were shown in 13 patients of trigeminal neuralgia (32.5%) and 14 patients of atypical facial pain (66.7%). Especially, psychosomatic disorder was most frequently found in atypical facial pain patients (47.6%). CONCLUSIONS: Atypical facial pain have more psychologic and emotional problems than trigeminal neuralgia, regardless of pain intensity and chronicity. Therefore, psychologic evaluation and treatment should be considered in atypical facial pain.

Pulmonary Embolism Detected in the Postanesthesia Care Unit Following Operation of Long Bone Fracture: A Case Report / 대한구급학회지

Clinical manifestations of pulmonary embolism are nonspecific during anesthesia. A 44 years old female received elective operation for right tibio-fibular fracture under spinal anesthesia. During operation, the patient received oxygen supply 5 L/min via mask with oxygen. On arrival of postanesthetic care unit, oxygen saturation of pulse oxymeter (SpO2) was 89% and with the 100% oxygen 10 L/min by mask, SpO2 went up rapidly to 100%. When the patient breathed under room air, SpO2 suddenly decreased to 80%. Chest x-ray at that time was non-contributory. Under the suspicion of pulmonary embolism, the patient was transferred to intensive care unit (ICU), and low molecular weight heparin (LMWH) treatment was started. LMWH was changed to regular heparin on the second day of ICU admission after conclusive diagnosis with spiral computed tomography and lung perfusion scan. The patient's oxygenation progressively improved and on the 10th day of ICU, the patient was transferred to general ward and she was discharged without any sequelae on the 23th day postoperatively.

The Effect of Pretreatment with Lidocaine for the Withdrawal Movement Associated with the Injection of Rocuronium in Children / 대한마취과학회지

BACKGROUND: The purpose of this study was two fold; first, to determine the incidence and type of withdrawal movement associated with IV injection of rocuronium in pediatric patients; and second, to determine whether pretreatment with IV lidocaine affects the incidence of movement associated with rocuronium administration in pediatric patients. METHODS: Forty-two pediatric patients were randomly assigned to two groups. After general anesthesia was induced with thiopental sodium 5 mg/kg and manual occlusion of venous inflow was performed, one group of patients received 0.1 ml/kg 1% lidocaine IV. A second group received 0.1 ml/kg of normal saline as a placebo control. Venous inflow occlusion was held for 5 seconds, and immediately followed by the injection of rocuronium 0.6 mg/kg IV. The patient's response to rocuronium injection was graded using a 5-point scale. RESULTS: We observed that the incidence of movement was 100% in the placebo group and was significantly decreased to 28.8% in the group pretreated with lidocaine (P<0.001). CONCLUSIONS: Withdrawal movement on injection of rocuronium in pediatric patients can be decreased or prevented by pretreatment with IV lidocaine.