Postoperative Sore Throat with Foam Cuffed Endotracheal Tube / 대한마취과학회지

BACKGROUND: Sore throat is a common complaint after endotracheal intubation and affected by several factors. The most important causes that affect the incidence and severity of postoperative sore throat is cuff overexpansion. We evaluate the incidence and severity of postoperative sore throat when foam-filled cuff endotracheal tubes and air-filled cuff endotracheal tubes are used. METHOD: Forty patients undergoing general endotracheal anesthesia were allocated randomly to two groups to receive either foam-filled cuff tubes or air-filled cuff tubes. All patients were interviewed 24 hours postoperatively whether they had experienced a sore throat or not by individuals who did not know which tube was used. RESULTS: Incidence of sore throat was 20% in foam-filled cuff group and 50% in air-filled cuff group. In foam-filled cuff group, sore throat was less severe than air-filled cuff group. In air- filled cuff group, sore throat was more severe as intracuff pressure was increased. CONCLUSION: The incidence and severity of postoperative sore throat could be significantly reduced using the foam-filled cuff tubes.

The Neuromuscular Blocking Effect of Mivacurium in Isolated Rat Phrenic-Hemidiaphragm with Long-term Phenytoin Pretreatment / 대한마취과학회지

BACKGROUND: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of metocurine, atracurium, doxacurium, and pipecuronium. This study examine neuromuscu-lar blocking effect and recovery of mivacurium in isolated rat phrenic-hemidiaphragm with two-weeks phenytoin pretreatment. METHOD: After the administration of 14 days of phenytoin 40 mg/kg, administered intraperitoneally twice daily (n=10), ED90, antagonism of neostigmine and 4-aminopyridine on the electrically evoked twitch response and train-of-four (TOF) stimulation were compared to control groups in isolated rat phrenic-hemidiaphragm preparation. RESULTS: ED90 was significantly greater in the phenytoin group than in the control group (319 +/- 39.5 g vs. 209.5 +/- 52.2 g, respectively). After the administration of neostigmine 0.75 M, the recovery of the single twitch and TOF ratio were significantly lesser in the phenytoin group than in the control group (single twitch; 19.6 +/- 6.6% vs. 69.2 +/- 9.4%, TOF ratio; 0.258 +/- 0.149 vs. 0.543 +/- 0.1, respectively). After the administration of 4-aminopyridine 40uM, the recovery of the single twitch and TOF ratio were no significant differrence between the phenytoin group and the control group (twitch; 118.1 +/- 25.3% vs. 122.6 +/- 24.8%, TOF ratio; 0.937 +/- 0.051 vs. 0.949 +/- 0.067, respectively). CONCLUSION: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of mivacurium.

Meibomian Gland Adenocarcinoma of the Orbit

Meibomian gland adenocarcinoma is a rare neoplasm which may be overlooked until it spreads into the orbit. We have experienced a case of meibomian gland adenocarcinoma which spread into the orbit, and performed orbital exenteration. Two months later, the patient had a recurrence at the superolateral margin of the orbit that surgically excised. The radiation therapy with total dose of 5000 rads over a period of one month was performed and the tumor mass was regressed. There was no evidence of recurrence at 12 months after radiation therapy.