Résumé
Therapeutic agents such as antibiotics, hormonal drugs and retinoids are usually applied for the treatment of acne vulgaris. Adult patients with acne vulgaris may suffer from various side effects of the therapeutic agents. Stellate ganglion blocks are known to be effective for general dermatological conditions such as atopic dermatitis and acne vulgaris. We experienced that a stellate ganglion block showed significant therapeutic effects in two patients with severe acne that did not respond to other treatments including medications. A stellate ganglion block should be considered as an effective treatment method for patients with acne vulgaris, especially in cases where little improvement is seen with the use of other treatment methods.
Sujets)
Adulte , Humains , Acné juvénile , Antibactériens , Eczéma atopique , Rétinoïdes , Ganglion cervicothoraciqueRésumé
Right internal jugular vein catheterization is performed frequently as central venous catheterization by the landmark method. This procedure, however, might prove difficulty due to anatomic variations or thrombosis of internal jugular vein. We failed to catheterize right internal jugular vein by the landmark method in 70-year-old female patient. And then, we detected right internal jugular vein thrombosis by ultrasound scan. Left internal jugular vein catheterization was performed by the ultrasound guided technique. Central venous catheterization has possibility to fail despite several attempts by the landmark method. Then, ultrasound guided approach is a good choice to aid central venous catheterization when difficulties or complications have been encountered.
Sujets)
Sujet âgé , Femelle , Humains , Cathétérisme , Cathétérisme veineux central , Cathéters , Voies veineuses centrales , Veines jugulaires , ThromboseRésumé
Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Muscle relaxants are the most common cause of anaphylaxis during anesthesia. A 54-year-old woman was scheduled for thyroidectomy. She had no history of allergy and had never previously undergone general anesthesia, Lidocaine, propofol and vecuronium were injected sequentially to induce general anesthesia. Two minutes after the vecuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. The patient recovered without any significant complications after immediate proper intensive care. The operation was delayed and a skin test was performed on the 7th day after discharge. She revealed a positive skin test for vecuronium. The anesthesia was re-induced without muscle relaxant and maintained with propofol and remifentanil infusion. Surgery was completed uneventfully, and the patient recovered without any adverse reaction.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Anaphylaxie , Anesthésie , Anesthésie générale , Bronchospasme , Exanthème , Hypersensibilité , Hypotension artérielle , Soins de réanimation , Lidocaïne , Muscles , Pipéridines , Propofol , Tests cutanés , Tachycardie , Thyroïdectomie , VécuroniumRésumé
Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Muscle relaxants are the most common cause of anaphylaxis during anesthesia. A 54-year-old woman was scheduled for thyroidectomy. She had no history of allergy and had never previously undergone general anesthesia, Lidocaine, propofol and vecuronium were injected sequentially to induce general anesthesia. Two minutes after the vecuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. The patient recovered without any significant complications after immediate proper intensive care. The operation was delayed and a skin test was performed on the 7th day after discharge. She revealed a positive skin test for vecuronium. The anesthesia was re-induced without muscle relaxant and maintained with propofol and remifentanil infusion. Surgery was completed uneventfully, and the patient recovered without any adverse reaction.