A case of cardiac arrest following bupivacaine injection for shoulder arthroscopy : A case report

Intra-articular administration of local anesthetics such as bupivacaine can produce short-term postoperative analgesia in patients who are undergoing shoulder arthroscopy. Yet bupivacaine can result in cardiovascular toxicity that can lead to cardiac arrest. We experienced a case of 63-year-old male patient with severe cardiac toxicity that led to ventricular fibrillation 15 minutes after injecting 0.5% bupivacaine into the patient's shoulder joint for shoulder arthroscopy.

The Preventive Effects of Dexamethasone and Ondansetron for Postoperative Nausea and Vomiting after Tympanomastoidectomy / 대한마취과학회지

BACKGROUND: Postoperative nausea and vomiting (PONV) is the major cause of patient's discomfort after surgery. Dexamethasone and ondansetron have been known to have some preventive effects on PONV. The purpose of this study was to compare the effects combination therapy of these drugs in the prevention of PONV after tympanomastoidectomy which has been known to be a high risk factor of PONV. METHODS: Ninty patients scheduled tympanomastoidectomy under general anesthesia were included. Patients were randomly divided into three groups and received dexamethasone 5 mg (group D), ondansetron 4 mg (group O), or dexamethasone 5 mg plus ondansetron 4 mg (group DO) at 30 min before the end of operation. The degree of PONV was assessed at 6 h, 12 h, 24 h, and 48 h after operation. RESULTS: The degrees of nausea in group DO during 0-6 h and 6-12 h were lesser than those of other groups. The overall incidences of nausea were 73% (group D), 62% (group O), and 23% (group DO, P < 0.05). The degrees of vomiting in group O and DO during 0-6 h were lesser than those of group D. The overall incidences of vomiting were 37% (group D), 17% (group O), and 7% (group DO, P < 0.05). CONCLUSIONS: The combination of dexamethasone and ondansetron is more effective than single use of each drug for the prevention on PONV after tympanomastoidectomy.

Multiple Metastatic Brain Tumor: Complicated with Post-dural Puncture Headache : A case report

Epidural blood patch is an effective management for treatment of severe post-dural puncture headache. Here we describe a case of a patient with hip fracture, who was complained regarded as having suspicious post-dural puncture headache after epidural anesthesia, but it failed to be treated with 4 times of epidural blood patch, and later was diagnosed with multiple metastatic brain tumor.