The Usefulness of Serum Lipid Concentration as a Predictor of Convulsion in Patients with Glufosinate Ammonium Poisoning

PURPOSE: Glufosinate ammonium (GA; phosphinothricin) can induce neurological complications such as altered mental status, amnesia, and convulsions. This study was conducted to evaluate whether blood lipid profiles can help predict convulsions in patients with GA poisoning. METHODS: This study was a retrospective review of data acquired at a tertiary academic university hospital from March 2014 to July 2016. Independent t-test, Mann-Whitney test and Analysis of covariance (ANCOVA) of demographic and laboratory findings of 50 patients with GA poisoning were performed to identify correlations of general characteristics and laboratory findings, including blood lipid profiles of GA-poisoned patients between with and without convulsions. RESULTS: Convulsion as a GA complication showed a significant association with poison volume, age, white blood cell count, and creatine phosphokinase (CK), albumin, lactate dehydrogenase (LDH), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) content in blood according to an independent t-test and Mann-Whitney test. However, ANCOVA demonstrated significant association with LDL and triglyceride. CONCLUSION: Blood lipid profiles, especially serum LDL and triglyceride, were useful in predicting convulsions in patients with GA poisoning.

Paroxysmal Supraventricular Tachycardia during Right Thoracotomy Treated with Anterior-Posterior Paddle Positioned Biphasic Cardioversion: A case report / 대한마취과학회지

A 54-year-old male patient with squamous cell carcinoma of lung was scheduled for right lower lobectomy. He had suffered from diabetes mellitus during 8 years, but his preoperative electrocardiogram was normal sinus rhythm. During right thoracotomy, 2 times of unstable paroxysmal supraventricular tachycardia (PSVT) appeared but returned to normal sinus rhythm by carotid sinus massage. But, third unstable PSVT was not controlled by adenosine and anterior-lateral paddle positioned biphasic cardioversion. We changed anterior-lateral paddle position to anterior-posterior paddle position. And PSVT terminated abruptly and changed to sinus rhythm. So we present a case of unstable PSVT during right thoracotomy and treated with anterior-posterior paddle positioned biphasic cardioversion.

The Effect of Low Dose i.v. Ketamine in Combination with Epidural Morphine on Postoperative Pain / 대한마취과학회지

BACKGROUND: The purpose of this study was to evaluate the effect of low dose i.v. ketamine in combination with epidural morphine on postoperative pain after gastrectomy. METHODS: 40 patients scheduled for elective gastrectomy were investigated in a randomized study. All patients received epidural morphine (0.05 mg/kg) and bupivacaine (0.25%) as a bolus dose of 10 ml 40 min prior to skin incision. In addition, patient- controlled epidural analgesia (PCEA) with epidural bupivacaine (0.125%) and morphine (0.1 mg/ml) (bolus dose 1 ml, continuous infusion 1 ml/h, lock out interval 15 min) was offered from the time after 10 ml bolus dose. In the ketamine group, ketamine 0.5 mg/kg was administered 10 min prior to skin incision and then maintained continuously until skin closure at a dosage of 10microgram/kg/min. In the second group anesthesia was induced with thiopental sodium 4 mg/kg, midazolam 0.5 mg/kg, vecuronium 0.1 mg/kg and maintained with 66% N2O-O2, 1-3 vol% enflurane. The intensities of spontaneous pain and of coughing associated pain were measured using a visual analogue scale. Cumulative morphine consumption was measured at 2, 6, 12, 24, 48 h after surgery. Side effects were evaluated at 48 h after surgery. RESULTS: VAS and cumulative morphine consumption at 2, 6, 12, 24, 48 h postoperatively showed no statistical differences between the two groups, and no statistical differences in side effects were observed at 48h after surgery. CONCLUSIONS: We were unable to demonstrate any additional analgesic effect of low dose i.v. ketamine in combination with epidural morphine and bupivacaine.

Respiratory Difficulty at a Postanesthesia Care Unit after Total Thyroidectomy: A case report / 대한마취과학회지

We had a case of respiratory difficulty following total thyroidectomy due to bilateral vocal cord palsy. The patient was a 49-year-old female undergoing total thyroidectomy for papillary carcinoma of the thyroid. Anesthesia was performed uneventfully. Spontaneous respiration resumed after reversal of the neuromuscular blockade. However, after arriving at the postanesthesia care unit, she developed hypertension, anxiety, tachypnea, and inspiratory stridor during deep inspiration. Because the patient maintained adequate oxygen saturation, we confirmed bilateral vocal cord palsy by fiberoptic laryngoscopy. During the operation, the surgeon experienced difficulty dissecting the bilateral recurrent laryngeal nerves from the surrounded tumor. So we consider that direct nerve injury was responsible for the bilateral vocal cord palsy. Movement of the right vocal cord recovered a week later.

Respiratory Difficulty at a Postanesthesia Care Unit after Total Thyroidectomy: A case report / 대한마취과학회지

We had a case of respiratory difficulty following total thyroidectomy due to bilateral vocal cord palsy. The patient was a 49-year-old female undergoing total thyroidectomy for papillary carcinoma of the thyroid. Anesthesia was performed uneventfully. Spontaneous respiration resumed after reversal of the neuromuscular blockade. However, after arriving at the postanesthesia care unit, she developed hypertension, anxiety, tachypnea, and inspiratory stridor during deep inspiration. Because the patient maintained adequate oxygen saturation, we confirmed bilateral vocal cord palsy by fiberoptic laryngoscopy. During the operation, the surgeon experienced difficulty dissecting the bilateral recurrent laryngeal nerves from the surrounded tumor. So we consider that direct nerve injury was responsible for the bilateral vocal cord palsy. Movement of the right vocal cord recovered a week later.