Comparison of bispectral index (BIS) and entropy in patients with cerebral palsy during sevoflurane induction / 대한마취과학회지

BACKGROUND: Demand of anesthesia for patients with cerebral palsy is more increasing. But there is still lacking in clinical research regarding how BIS and entropy reflect well on sedative and hypnotic state in patients with cerebral palsy. METHODS: Fifteen patients with cerebral palsy (Group CP) and fifteen patients without cerebral palsy (Group NL) scheduled for elective orthopedic surgery were included in the study. Induction of anesthesia was done by having the patient inhale 1 vol% sevoflurane and 100% oxygen using a total fresh gas flow of 8 L/min. Simultaneously BIS, state entropy (SE), response entropy (RE), end-tidal sevoflurane concentration were recorded every 15 seconds till there was no self respiration. When end-tidal sevoflurane concentration had not risen any more for 30 seconds, we increased inhaled sevoflurane concentration in 1 vol% increments. End point of recording was when self respiration was lost or the time sevoflurane concentration reached 8 vol%. RESULTS: No significant differences in RE, SE, BIS at baseline and end point were found between the two groups. No significant difference in the time reach end point was found between the two groups. BIS, SE and RE correlated with end-tidal sevoflurane concentration in the two groups. CONCLUSIONS: The authors found no significant difference in the entropy values between patients with CP and normal patients. Also, the entropy values could be interpreted like BIS in patients with CP. And BIS showed a stronger correlation with end tidal sevoflurane concentrations than entropy.

Conservative Treatment of Thoracic Radiculopathy due to Ossification of the Yellow Ligament in a Young Patient: A case report

Ossification of the yellow ligament (OYL) is a pathologic condition that causes spinal stenosis, which is a form of ectopic ossification. OYL causes compressive myelopathy and radiculopathy. Although the pathogenesis of OYL is still unclear, diffuse mechanical stresses and degenerative changes caused by extreme ranges of motion may be related to the development of OYL in young sportsmen. Here we report an interesting case of thoracic radiculopathy due to OYL in a 35-year-old male amateur judo player who was successfully treated with continuous thoracic patient controlled epidural analgesia and epidural adhesiolysis.

One-lung ventilation in a pediatric patient using a wire-guided endobronchial blocker for video-assisted thoracoscopic surgery: A case report / 대한마취과학회지

Video-assisted thoracoscopic surgery (VATS) has advantages compared with open thoracotomy. One lung ventilation, is indispensible to VATS, commonly is accomplished with a double-lumen endotracheal tube. For infants and small children, there is no double-lumen endotracheal tube suitable, various modified techniques are used to achieve one lung ventilation. Recently introduced a small sized wire-guided endobronchial blocker gives us another choice of one lung ventilation for VATS in small children. Using a wire-guided endobronchial blocker and multiport adapter for young children under flexible bronchoscope, we provided one lung ventilation (OLV) during VATS successfully without complications.