Anesthetic considerations in a child with Sotos syndrome: A case report

Sotos syndrome is a rare sporadic genetic disorder characterized by pathognomonic facial features, motor developmental delay induced by hypotonia, learning difficulties, and cardiac and renal anomalies. This report describes the case of a 4-year-old child with Sotos syndrome who underwent a right hydrocelectomy under general anesthesia. We report our experience with airway management, choice of anesthetic drugs, and other anesthetic implications in Sotos syndrome.

Two Cases of General Anesthesia for Laparoscopic Ovarian Cystectomy during Early Pregnancy / 대한마취과학회지

Operative laparoscopy has begun to replace laparotomy for women with various pelvic diseases. The advantages of laparoscopy include less pain, reduced postoperative complications, small scars, shorter hospital stay, reduced recovery time and low cost. However, the study about operative laparoscopy during pregnancy are still rare in Korea. We experienced two cases of laparoscopy during early pregnancy. Two pregnant women with an adnexal mass underwent laparoscopic operations under general anesthesia. One patient underwent laparoscopic salpingo-oophorectomy due to ovarian cyst at 14weeks of gestation, and the other patient did laparoscopic cystectomy at 12weeks of gestation. There was no specific anesthetic problem during operation, patients had uneventful pregnancy.

The Effects of Magnesium on Pipecuronium-induced Neuromuscular Blockade and its Reversal in the Isolated Rat Phrenic Nerve-Hemidiaphragm / 대한마취과학회지

BACKGROUND: Magnesium sulfate (MgSO4) is widely utilized in the treatment of preeclamptic hyperreflexia. It is well known that magnesium enhances nondepolarizing neuromuscular blockade. Eclamptic convulsions are almost always prevented by magnesium in plasma concentrations of 4 to 7 mEq/L. METHODS: The effects of various concentration of magnesium on the potency and reversibility of pipecuronium were investigated in vitro rat phrenic nerve-hemidiaphragm. The phrenic nerve-hemidiaphragm was dissected and suspended in organ bath containing modified Krebs' solution. Forty samples were divided into 4 groups (n=10 in each group). Group I was studied at the physiologic magnesium concentration(2.4 mEq/L, control group). Group II, III, IV were studied at the concentration of 4, 5.5, and 7 mEq/L, respectively. In each group, we added pipecuronium until twitch height decreased more than 90% of initial level. To compare the recovery, we added neostigmine and calcium, and then, measured TOF ratio. RESULTS: The amounts of added pipecuronium were 73.8+/-15.2 microgram (mean+/-S.D.) in Group I, 38.1+/-5.0 microgram in Group II, 33.0+/-4.1 microgram in Group III and 16.1+/-1.7 microgram in Group IV. The amounts of pipecuronium in Group II, III, IV were significantly less than Group I. After the addition of neostigmine, the values of TOF ratio were under 0.6 in all groups. But after the addition of calcium, all groups were recovered with TOF ratio over 0.85 except Group I. CONCLUSIONS: This study indicated that the increased magnesium concentration potentiated pipecuronium-induced neuromuscular blockade and at higher level, it was more apparent. Neostigmine was not significantly effective to reverse the pipecuronium-induced neuromuscular blockade potentiated with magnesium. But calcium was significantly effective.

Clinical Results on Intraocular Lens Implantation

A clinical study of the refractive and visual results with 104 consecutive implantations of the intraocular lens was performed between July 1984 and April 1986. Postoperative refraction of myopia was observed in 56.7% of patients, and emmetropia in 21.1%, hyperopia in 22.2%. Visual acuity of 0.5 or better at 2 month after operation was revealed in 88.9% of cases studied; 90.3% in 62 cases of posterior chamber lens implantations and 85.7% in 28 cases of anterior chamber lens implantations. There was no statistically significant difference between visual results after anterior chamber lerts and posterior chamber lens implantation.