A comparison study between newly-designed pencil-point and cutting needles in spinal anesthesia.

OBJECTIVES: The goal of this single blinded randomized study was to compare the use of routine cutting-tip spinal needle and newly-designed pencil-point Pajunk(AE) in terms of success rate, complications and satisfactions in priests undergoing spinal anesthesia for orthopedic, general and urological surgery at Priest Hospital, Thailand. MATERIAL AND METHOD: After Institutional Review Board approval and patients' signed consent, from August 2006 to October 2007, 91 priests were randomly assigned to have 27-gauge Quincke (control group, C) or 25-gauge Pajunk(AE) (study group, S) spinal needles used in their spinal anesthesia. The number of attempts to successful cerebrospinal fluid return and the success rate of the spinal blockade were documented. Postoperatively, an investigator blinded to the study interviewed patients daily. RESULTS: The first-time needling success rate for Quincke was 79% but for Pajunk(AE) only 46%, lower than reported. The incidence of minor complications was small, even there were 2 postoperative dead cases not related to anesthesia. Over 80% of both groups still preferred the same technique and surgeon satisfaction was good to excellent. CONCLUSIONS: The newly-designed, pencil-point spinal needle was another example on the development of more refined towards quality anesthesia. To be cost-effective, it should be selected for patients at risk of CSF leakage-related complications.

Management of endobronchial cancer using bronchoscopic electrocautery.

From December 2004 until November 2005, 15 cases of endobronchial cancer presenting with 22 episodes of mechanical obstruction of the airway, difficulty in breathing, hemoptysis, severe coughing, obstructive pneumonia and identified recurrent atelectasis of the lungs. The cancer was removed rapidly, effectively and without complication by a technique of fiberoptic bronchoscopic electrocautery.