Neuropsychiatric Lupus Presenting as a Thalamic Infarct in a Male Patient / 대한내과학회지

Systemic lupus erythematosus (SLE) is an autoimmune disease that can manifest systemically in many organs. It is most common in women of child-bearing age. Neuropsychiatric SLE is characterized by central nervous system (CNS) symptoms. CNS manifestations of SLE have been discovered in all parts of the brain, although thalamic infarcts associated with SLE are rare, especially in males. Here, we report a thalamic infarction in a 22-year-old male SLE patient.

Neuropsychiatric Lupus Presenting as a Thalamic Infarct in a Male Patient / 대한내과학회지

Systemic lupus erythematosus (SLE) is an autoimmune disease that can manifest systemically in many organs. It is most common in women of child-bearing age. Neuropsychiatric SLE is characterized by central nervous system (CNS) symptoms. CNS manifestations of SLE have been discovered in all parts of the brain, although thalamic infarcts associated with SLE are rare, especially in males. Here, we report a thalamic infarction in a 22-year-old male SLE patient.

Comparision of Total Intravenous Anesthesia and Sevoflurane-N2O-Alfentanil Anesthesia for Laryngeal Microscopic Surgery / 대한마취과학회지

BACKGROUND: The aim of this study was to compare the clinical properties of sevoflurane-N2O-alfentanil with propofol- remifentanil anesthesia for patients undergoing laryngeal microscopic surgery. METHODS: Sixty patients scheduled for elective ambulatory surgery received either total intravenous anesthesia (TIVA group) with remifentanil and propofol or balanced anesthesia with sevoflurane-N2O-alfentanil (sevoflurane-N2O-alfentanil group). The TIVA group patients were induced with an effective-site concentration of 4microgram/ml propofol and a bolus dose of 0.5microgram/ml remifentanil. The anesthesia was maintained with a continuous infusions with an effective-site concentration of 2-5microgram/kg propofol and 0.05-0.5microgram/kg/min remifentanil, according to the hemodynamic response. The sevoflurane-N2O-alfentanil group patients were induced with 5 mg/kg thiopental and 20microgram/kg IV alfentanil. Maintenance was obtained with 1.5-3.0 vol% sevoflurane and a bolus dose of 10microgram/kg IV alfentanil if needed. The anesthetic depth was controlled under bispectral index (BIS) monitoring: propofol and sevoflurane concentrations were adjusted to achieve target BIS values, and were between levels of 40-60 during surgery. RESULTS: Both anesthetic methods provided acceptable hemodynamic responses during surgery. The late recovery times (postanesthetic discharge scoring system), patient satisfaction and postoperative side effects were similar between patients in the two groups. Early recovery times (eye opening and the aldrete score) were shorter in the TIVA group patients, but this difference was not associated with a shorter hospital length of stay. CONCLUSIONS: Total intravenous anesthesia with remifentanil-propofol and balanced anesthesia with sevoflurane-N2O-alfentanil both provided satisfactory anesthesia for laryngeal microscopic surgeryd

Effect of Midazolam upon the Prevention of Nausea and Vomiting after Middle Ear Surgery / 대한마취과학회지

BACKGROUND: Midazolam has been reported to decrease postoperative nausea and vomiting (PONV). We studied the antiemetic effect of midazolam after middle ear surgery. METHODS: In this prospective, randomized, double-blind, placebo-controlled study, 90 healthy patients were scheduled for middle ear surgery (tympanomastoidectomy and tympanoplasty). Patients were randomly divided into two groups; Midazolam 0.075 mg/kg (n = 45) or normal saline (n = 45) was administered after induction of anesthesia. The incidence of PONV, metoclopramide and ketorolac usage, pain, sedation, and other side effects were assessed at 6, 24 h after the operation. RESULTS: The incidences of PONV were 15 (33%) in midazolam group and 27 (60%) in placebo group during 24 h postoperatively. The incidence of PONV in midazolam group was significantly lower than that in placebo group (P < 0.05). There were no significant differences between groups in adverse events. CONCLUSIONS: Midazolam 0.075 mg/kg was effective for preventing PONV after middle ear surgery without significant adverse effects.