Study on Sugar Consumption of Adult Workers According to Smoking Status / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the smoking status among adult workers, and current status of sugar intake. METHODS: The survey included 500 men working in Gyeonggi-do from October to November in 2016. Questionnaire items covered their age, working status, smoking status, eating habits, eating behaviors, snack consumption status, habits and behaviors related to sugar intake. All data were analyzed by SPSS program (Ver. 23) and descriptive statistics was performed; a t-test, χ² test, One-way ANOVA and Scheffe test were used for post-hoc test. RESULTS: The study results showed that eating habits and behaviors of non-smokers were better than those of smokers. The frequency of daily snack consumption was the highest in smokers compared to and non-smokers. The smokers' favorite taste after smoking was ‘Sweet’. The average score of sugar-related nutrition knowledge was higher in non-smokers compared to smokers. Non-smokers had better recognition of ‘sugar reduction’, and smokers were more likely to eat sweet foods, respectively. On the other hand, non-smokers could observe that they were trying to control themselves for health reasons. According to the results of the study, non-smokers showed better eating habits and dietary habits and consumed less sugar. Also, it was found that non-smokers tried to drink more water than beverages and refrain from eating sweets to reduce their sugar intake. Further, the most of the bread, coffee and beverages were also consumed at a lower frequency by non-smokers compared to smokers. CONCLUSIONS: This study results showed that smoking and sugar consumption were closely related. Therefore, adult workers should actively promote and learn so that they can maintain healthy and suitable dietary habits through reduction of sugar consumption.

Arytenoid dislocation after uneventful endotracheal intubation: a case report / 대한마취과학회지

Arytenoid dislocation is an unusual complication of endotracheal intubation. We reported a case of a 48-year-old female with arytenoid dislocation after uneventful endotracheal intubation, which was successfully treated with arytenoid reduction. The patient complained of persistent hoarseness until the fourth day after an uneventful gynecologic surgery under general anesthesia. On laryngoscopic examination, paralyzed left vocal cord with minimal arytenoid movement was observed. An anteromedial dislocation of the left arytenoid cartilage was suspected and surgical reduction was performed by the laryngologist. The hoarseness was immediately resolved after surgical intervention. Anesthesiologists should be careful not to cause laryngeal trauma in anesthetized patients. In addition, early diagnosis and prompt surgical reduction are essential for a better prognosis for arytenoid dislocation.

Comparison of the central venous pressure from internal jugular vein and the pressure measured from the peripherally inserted antecubital central catheter (PICCP) in liver transplantation recipients / 대한마취과학회지

BACKGROUND: Unlike its use during stable conditions, central venous pressure (CVP) monitoring from a peripherally inserted central venous catheter (PICC) has not often been used in surgeries with significant hemodynamic alterations. The aim of this study was to evaluate the feasibility of measuring PICC pressure (PICCP) as an alternative to measuring centrally inserted central catheter pressure (CICCP) in adult liver transplantation (LT) patients. METHODS: We measured PICCP and CICCP simultaneously during each main surgical period in adult LT. Statistical analysis was performed using simple linear regression analysis to observe whether changes in PICCP paralleled by simultaneous changes in CICCP. Correlation analysis and Bland-Altman analysis were used to determine the degree of agreement between the two devices. Differences were considered statistically significant when P values were less than 0.05. RESULTS: A total of 1342 data pairs were collected from 35 patients. The PICCPs and CICCPs were highly correlated overall (r = 0.970, P < 0.001) as well as at each period measured. The differences among each period were not clinically significant (0.33 mmHg for pre-anhepatic, 0.32 mmHg for anhepatic, -0.15 mmHg for reperfusion, and -0.10 mmHg for neohepatic periods). The overall mean difference was 0.14 mmHg (95% confidence interval: 0.09-0.19) and PICCP tended to give a higher reading by between 0.09 and 0.19 mmHg overall. The limit of agreement was -1.74 to 2.02 overall. CONCLUSIONS: These findings suggest that PICCP can be a reasonable alternative to CICCP in situations of dynamic systemic compliance and preload, as well as under stable hemodynamic conditions.

Unpredicted tachycardia and hypotension in a patient with medullary thyroid cancer and undiagnosed pheochromocytoma: A case report / 대한마취과학회지

A 35 year old woman with hypercalcitoninemia was scheduled for an operation to treat her medullary thyroid cancer (MTC). TIVA with propofol and remifentanil was planned, and about 3 minutes after the infusion of anesthetics, her heart rate was suddenly elevated to 180/min and the systolic blood pressure was lowered to nearly 50 mmHg. The blood pressure returned to normal after the injection of phenylephrine 100 microgram and a rapid infusion of 700 ml crystalloid solution. After the operation, bilateral pheochromocytoma and a RET proto-oncogene mutation related with multiple endocrine neoplasia 2A (MEN-2A) were found. Patients with MTC can present with peripheral vasodilation and relative hypovolemia that are related with hypercalcitoninemia. Patients with MEN-2A can be anesthetized for a MTC operation without the appropriate preparation for their pheochromocytoma. Therefore, we suggest that patients with MTC and hypercalcitoninemia should be cautiously anesthetized with TIVA. They also should be screened for pheochromocytoma and the RET proto-oncogene mutation to prevent deleterious hemodynamic events during anesthesia.

Comparison of General Anesthesia using Propofol-Remifentanil and Propofol-Nitrous Oxide / 대한마취과학회지

BACKGROUND: Remifentanil is a novel, ultra-short acting opioid. This study was performed to compare the hemodynamic responses of remifentanil and nitrous oxide under propofol-based anesthesia during the intraoperative period. METHODS: Forty patients undergoing gynecologic surgery were randomly allocated to either remifentanil (R group) or N2O group (N group). In the R group, remfentanil was continuously infused from the induction of anesthesia (0.5 microgram/kg/min) to the end of surgery (0.1-0.5 microgram/kg/min). In the N group, fentanyl (2 microgram/kg) was injected intravenously and N2O was used thereafter. In both groups, target-concentration infusion of propofol was applied. We compared mean arterial pressure (MAP) and heart rate (HR) before and after tracheal intubation and during the rest of anesthetic time between the two groups. Postoperative parameters such as nausea/vomiting, consciousness level and pain at 2 and 24 hours were also compared. RESULTS: The magnitude of MAP and HR after tracheal intubation were significantly smaller and more stable in the R group than in the N group. Hypertensive (systolic blood pressure > 140 mmHg) episodes were significantly less frequent in the R group (3.0%) than in the N group (12.4%) during the operation. R group showed less MAP (76+/-12 mmHg) and HR (61+/-10 bpm) compared with those of N group (86+/-17 mmHg, 63+/-8 bpm, P < 0.05 respectively). Other postoperative measures were comparable between the two groups. CONCLUSIONS: We conclude that the continuous infusion of remifentanil can provide more stable hemodynamic status than N2O without significant adverse effects, in propofol-based general anesthesia.

A Comparison of Epidural Morphine-Bupivacaine with Intravenous Morphine-Ketorolac in Patient-Controlled Analgesia after Gynecologic Operation / 대한마취과학회지

BACKGROUND: Postoperative pain control is provided for humanitarian reasons and to alleviate nociception-induced responses, such as endocrine metabolic responses, autonomic reflexes, which have adverse effects on organ function, and other undesirable results. Of the various methods of treatment, patient-controlled analgesia (PCA) is considered the gold standard for the of control postoperative pain. PCA can be administered via intraveous, epidural, or subcutaneous routes. Although patient-controlled epidural analgesia (PCEA) has been compared to IV-PCA, there is no optimal administrative route for the treatment of postoperative pain. This randomized study compared the effectiveness of PCEA and IV-PCA on postoperative pain and the side-effects after gynecologic surgery. METHODS: Ninety-seven patients undergoing gynecologic surgery were randomly assigned to receive either IV-PCA using a mixture of morphine and ketorolac or PCEA using 0.1% bupivacaine and morphine. Pain intensity was tested using a visual analog scale (VAS) until postoperative day 2. Nausea, vomiting, sedation, and pruritus were also measured. RESULTS: Among the 97 patients, 12 patients were excluded during study. Pain relief was better at rest and after coughing in the PCEA group during the 2 postoperative days, except at the first visit. Additional analgesics were used significantly less in the PCEA group, whilst the incidence of other complications was comparable in the IV-PCA and PCEA groups. CONCLUSIONS: After gynecologic surgery, PCEA using bupivacaine and morphine provides better pain relief than IV-PCA using morphine and ketorolac.

Noninvasive Positive Pressure Ventilation Using a Face Mask for a Child with Spinal Muscular Atrophy: A case report / 대한마취과학회지

Respiratory complications are a major cause of morbidity and mortality in pediatric neuromuscular disease. In adults with acute or chronic respiratory failure, noninvasive positive pressure ventilation (NIPPV) is superior to standard therapy in terms of preventing intubation and reducing mortality. Moreover, domiciliary ventilation with NIPPV in children can prolong life and optimize the quality of life by allowing patients to eat, speak and sleep well. But the role of NIPPV in pediatric patients with respiratory failure is not well established. We report the case of a pediatric spinal muscular atrophy patient who was managed by using NIPPV for acute hypercapnic respiratory failure at a pediatric intensive care unit and by nocturnal hypoventilation late r at home. In this case, NIPPV restored normal blood oxygenation, removed excess blood carbon dioxide, and normalized the work and pattern of breathing.