Relationship between Lumbar Lordosis and Asymmetry of Facet Joints / 대한마취과학회지

BACKGROUND: Facet joint is an important structure not only contributing to the stability of the lumbar motion segments but also causing low back pain. Hypothetically, the more lumbar lordosis decreases, the more corresponding facet joints orient axially and asymmetrically. Furthermore, the increased incidence of common diseases possessed of low back pain and radiologic findings such as wedging of vertebral body and spondylolisthesis were reported in the patients with asymmetric orientation of the facet joints and loss of lumbar lordosis at the same time. The purpose of our study is to define the relationship of asymmetry of the facet joints and loss of lumbar lordosis. METHODS: The asymmetry and average angle of facet joints with respect to sagittal plane were measured on the magnetic resonance images. The lumbar lordosis was measured on the lateral X-ray. The relevance of lumbar lordosis and facet orientation was analyzed through linear regression. RESULTS: There were no significant relationships between lumbar lordosis and asymmetrical orientation of facet joint. CONCLUSIONS: The loss of lumbar lordosis did not suggest asymmetrical and axial orientation of facet joints. Further investigation into pathology and consideration into individual differences of range of motion, body mass index, age, sex might be needed.

Anesthetic Management of Difficult Tracheotomy with Fiberoptic Bronchoscope: A case report / 대한마취과학회지

The purpose of tracheotomy is to obtain secure airway for difficult airway management and long-term lung ventilation. Tracheotomy is an invasive procedure with the possibility of severe complications, but it is the last choice for difficult airway management. To perform tracheotomy is difficult in patients with anatomically distorted trachea, screened trachea by mass, fibrosis or adhesion and obesity. We report the experience of successful tracheotomy in the patient of severely distorted airway due to previous surgeries with the aid of the light illumination of fiberoptic bronchoscope.

Microscopic Changes of the Spinal Cord after the Intrathecal Administration of Ondansetron in the Rat / 대한마취과학회지

BACKGROUND: Serotonin type 3 receptors are abundant in the dorsal horn of the spinal cord and in the spinal tract of the trigeminal nerve in the medulla. Moreover, the intrathecal (IT) or epidural administration of ondansetron, a selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist, might prevent postoperative nausea, vomiting and intrathecal opioid-induced pruritus more effectively than the drug administered systemically. Before new drugs for spinal administration are accepted for clinical practice, experimental neurotoxicity studies must be undertaken. This study was performed in rats in order to reveal the behavioral and morphological signs of spinal cord damage after chronic IT ondansetron administration. METHODS: Rats were anesthetized using enflurane in oxygen and an 8 cm polyethylene catheter was advanced caudally through the atlanto-occipital membrane under aseptic surgical conditions. Twelve rats were randomly divided into two groups, an ondansetron (O) group (n = 6) and a normal saline (N) group (n = 6). After postoperative 7 days, we started the IT injection of ondansetron 40microgram (20microliter) or normal saline 20microliter once a day over two weeks. Potential changes of spinal cords were evaluated morphologically by light microscopy (LM) and electron microscopy (EM) in addition to behavioral changes. RESULTS: No rat in either groups showed any motor or behavioral changes during the administration of ondansetron. By LM and EM, all six rats in the O group showed massive neovascularization over the white and gray matters of spinal cords. CONCLUSIONS: The results suggest that chronic IT administration of ondansetron causes pathologic changes in the rat spinal cord.