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1.
Korean Journal of Anesthesiology ; : 408-415, 2011.
Article Dans Anglais | WPRIM | ID: wpr-226278

Résumé

BACKGROUND: Ischemia reperfusion (IR) injury is a complex phenomenon that leads to organ dysfunction and causes primary liver failure following liver transplantation. We investigated whether an intravenous administration of magnesium before reperfusion can prevent or reduce IR injury. METHODS: Fifty-nine living donor liver transplant recipients were randomly assigned to an MG group (n = 31) or an NS group (n = 28). Each group was also divided in two groups based on the preoperative magnesium levels (normal: > or = 0.70 mmol/L, low: < 0.70 mmol/L). The MG groups received 25 mg/kg of MgSO4 mixed in 100 ml normal saline intravenously before reperfusion and the NS groups received an equal volume of normal saline. The levels of lactate, pH, arterial oxygen tension, and base excess were measured to assess reperfusion injury at five specific times, which were 10 min after the beginning of anhepatic phase, and 10, 30, 60 and 120 min after reperfusion. To evaluate postoperative organ function, the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin and creatinine levels were measured at preoperative day 1, postoperative day 1 and 5. RESULTS: The blood lactate levels were significantly lower at 10, 30, 60 and 120 min after reperfusion in the MG groups compared to the NS groups. In addition, significantly higher blood lactate levels were observed in the NS group with preoperative hypomagnesemia than in MG groups. CONCLUSIONS: Magnesium administration before reperfusion of liver transplantation significantly reduces blood lactate levels. These findings suggest that magnesium treatment may have protective effects on IR injury during living donor liver transplantation.


Sujets)
Humains , Administration par voie intraveineuse , Alanine transaminase , Aspartate aminotransferases , Bilirubine , Créatinine , Concentration en ions d'hydrogène , Ischémie , Acide lactique , Foie , Défaillance hépatique , Transplantation hépatique , Donneur vivant , Magnésium , Oxygène , Reperfusion , Lésion d'ischémie-reperfusion
2.
Anesthesia and Pain Medicine ; : 214-217, 2008.
Article Dans Coréen | WPRIM | ID: wpr-91249

Résumé

Takayasu arteritis is a nonspecific chronic inflammatory disease of the aorta and its major branches, which has a higher incidence during the child-bearing years. There have been several reports of Takayasu arteritis during pregnancy with Cesarean delivery under general or epidural anesthesia. However, there have been few reports of successful vaginal delivery under epidural analgesia. We report a case of successful vaginal delivery under epidural analgesia in a 31-year-old primigravida with a history of Takayasu arteritis.


Sujets)
Adulte , Humains , Grossesse , Analgésie péridurale , Anesthésie péridurale , Aorte , Incidence , Maladie de Takayashu
3.
Korean Journal of Anesthesiology ; : 363-366, 2008.
Article Dans Coréen | WPRIM | ID: wpr-58973

Résumé

Chronic treatment with renin-angiotensin system antagonists frequently causes deleterious hypotension during anesthesia. We present a case of marked intra-operative refractory hypotension in a 61-year-old male patient undergoing elective total thyroidectomy. He has been chronically treated for hypertension with angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and atenolol, which were taken until the morning of surgery. After induction of anesthesia, marked hypotension which was refractory to fluid therapy occurred and did not respond to ephedrine administration. After continuous norepinephrine infusion, blood pressure increased and remained stable during the anesthesia period. Before extubation, norepinephrine was discontinued and recovery took place without complications. We discuss the anesthetic implication of chronic renin-angiotensin system antagonists treatment and intra-operative hemodynamic instability.


Sujets)
Humains , Mâle , Adulte d'âge moyen , Anesthésie , Antagonistes des récepteurs aux angiotensines , Inhibiteurs de l'enzyme de conversion de l'angiotensine , Aténolol , Pression sanguine , Éphédrine , Traitement par apport liquidien , Hémodynamique , Hypertension artérielle , Hypogonadisme , Hypotension artérielle , Maladies mitochondriales , Norépinéphrine , Ophtalmoplégie , Système rénine-angiotensine , Thyroïdectomie
4.
Korean Journal of Anesthesiology ; : 719-723, 2007.
Article Dans Coréen | WPRIM | ID: wpr-98986

Résumé

In tracheal stenosis, airway management is most challenging for anesthesiologists. A small sized endotracheal tube, laryngeal mask airway, with high frequency jet ventilation can be used, but may result in ineffective oxygenation and ventilation. In such cases, extracorporeal life support, ECLS, can be helpful. Herein, a case of tracheal stenosis in an adult assisted with the ECLS is reported.


Sujets)
Adulte , Humains , Prise en charge des voies aériennes , Jet ventilation à haute fréquence , Masques laryngés , Oxygène , Sténose trachéale , Ventilation
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