The Effect of Dexamethasone on Postoperative Pain and Nausea and Vomiting after Laparoscopic Cholecystectomy in Younger and Older Patients / 대한마취과학회지

BACKGROUND: Although postoperative pain is reduced compared with an open cholecystectomy, effective analgesic treatment after a laparoscopic cholecystectomy has remained a clinical challenge. METHODS: Of sixty patients having general anesthesia for laparoscopic cholecystectomy, thirty received intravenous dexamethasone 8 mg (Dexa group) and thirty received intravenous normal saline (Control group) before induction of anesthesia. Again, Dexa and Control group was divided the Younger group (20-50 yrs) and Older group (> or =65 yrs). Pain was assessed 1, 6, 12 and 24 hours after surgery and recorded on a visual analog scale (VAS). Experiences of Nausea and vomiting were assessed within the first postoperative 24 hours. RESULTS: In the Younger group, the VAS scores at postoperative 1 and 6 hours were significantly lower in the Dexa group than Control group. In the Older group, the VAS scores at postoperative 12 and 24 hours were significantly lower in the Dexa group than Control group. In the Dexa group, the incidence of postoperative nausea and vomiting of the Younger group was significantly lower than the Older group. CONCLUSIONS: There were differences in the analgesic effects of dexamethasone after laparoscopic cholecystectomy between the younger and older patients. Dexamathasone wasn't effective for postoperative nausea and vomiting in the older patients.

The changes of skin temperature in lower extremity during spinal anesthesia and general anesthesia

BACKGROUND: Skin temperature is well known to increase after spinal anesthesia due to sympathetic blockade and vasodilation. The purpose of this study is to find the changes of skin temperature in lower extremities during spinal and general anesthesia. METHODS: Patients were divided into three groups: SA (spinal anesthesia), GA (general anesthesia) and control (N) group. Skin temperature was recorded in the ventral aspect of mid thigh before induction and 5, 15, 30 min after induction. RESULTS: In all groups, skin temperature increased after 5, 15, 30 min significantly. And temperature gradients between before induction and after 30 minutes did not differ significantly in the three groups (P < 0.05). CONCLUSIONS: The changes of skin temperature in the lower extremities are similar with spinal anesthesia and general anesthesia.

Obstruction of the Scavenging Pathway during Surgery: A case report / 대한마취과학회지

An acute obstruction of the breathing circuit can be devastating situation. An 56-year old man who was diagnosed distal femur fracture underwent open reduction with internal fixation. During surgery, an obstruction of the breathing circuit occurred and we found the cause of obstruction was the plugging of a gas disposal tube with ice and dust accumulation. After removing the ice and dust, ventilation normalized. We report this case of an obstruction of the scavenging pathway with a review of the relevant literature.