Vancomycin-induced Hypersensitivity Reaction with Slow Infusion : A case report

Vancomycin is a bacteriocidal antibiotic experiencing a resurgence of utility because of increasing clinical problems with methicillinresistant staphylcoccal infections. Vancomycin can cause two types of hypersensitivity reactions, the red man syndrome and anaphylaxis. There is a consensus that slow intravenous administration of vancomycin should minimize the risk of infusion related adverse effects. We report a case of vancomycin hypersensitivity reaction with slow infusion of vancomycin.

Approximate entropy as the measurement of the electroencephalographic effect during sevoflurane induction / 대한마취과학회지

BACKGROUND: The processed electroencephalograms are useful surrogate measures of quantification of volatile anesthetics effect. We hypothesized that there is a certain relationship between the end-tidal concentration of sevoflurane and approximate entropy (ApEn). The aim of this study was to investigate the effect of sevoflurane on ApEn during induction. METHODS: Fourteen patients were enrolled. With recording of the electroencephalogram at the F3, F4, P3, and P4 montages, anesthesia was induced by increasing the vapor setting of sevoflurane by 1 vol% up to 8 vol% via a facemask. When the end-tidal concentration of sevoflurane did not show any further change, we increased vapor setting of sevoflurane by 1 vol%. When the end-tidal concentration of sevoflurane did not show any further change with 8 vol% of sevoflurane vapor setting, measurement of electroencephalogram was finished. The relation between end-tidal sevoflurane concentration and ApEn was tested by Spearman correlation. RESULTS: ApEn showed a significant correlation (R = -0.7551, P < 0.0001) with end-tidal sevoflurane concentration. The final pharmacodynamic parameters estimated by a sigmoid E(max) model were described as follows: E(0) = 0.91, E(max) = 0.28, C(e50) = 1.36 vol%, gamma = 1.27, kappa(e0) = 0.67 min(-1). CONCLUSIONS: Sevoflurane induction with gradual increase of end-tidal sevoflurane concentration increases the amount of regularity in approximate entropy.