Effectiveness of Oral Glycopyrrolate Use in Compensatory Hyperhidrosis Patients

Compensatory hyperhidrosis or reflex hyperhidrosis is the increase in sweating in the postoperative stage of thoracic sympathectomy or lumbar sympathectomy. It shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oralglycopyrrolate is one of the treatment options available. This study reviewed case notes in a series of 19 patients with compensatory hyperhidrosis. We made a comparison between the Milanez de Campos score of a pre-glycopyrrolate medication group and the Milanez de Campos score of a post-glycopyrrolate medication group. The Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the pre-medication and post-medication groups. In the post-glycopyrrolate medication group, there was decrease in the Milanez de Campos score, BAI score, and BDI score (P 0.05). Glycopyrrolate is an effective medication in the treatment of compensatory hyperhidrosis that, can alleviate anxiety and improve patients' quality of life.

Effect of YJ-7 (a calcium channel blocker) on blood pressure regulation in spontaneous hypertensive rat model

BACKGROUND: Farnesylacetone compounds that dilate blood vessels by blocking calcium channels in sargassum siliquastrum have been reported. And this study was done to demonstrate the effect of YJ-7, a synthetic material derived from these compounds, on vessel dilation and blood pressure control. METHODS: We used vasoconstricted basilar and carotid artery of rabbits. Changes in blood pressure were measured in vivo at 15, 30, 45, and 60 minutes after intravenous injection of YJ-7 3 microM, EC50 value from in vitro experiment, and nimodipine 10 microM through the tail vein of 20 rats. Spontaneous hypertensive rat (SHR) has its blood pressure higher than 190 mmHg. Measurements of blood pressure were done 6 times and the mean values were used for data analysis. RESULTS: Systolic and diastolic blood pressure before the injection of YJ-7 were 194.2 +/- 6.1 mmHg and 140.2 +/- 6.4 mmHg. Blood pressure were decreased with time, 157.2 +/- 2.6 / 120.8 +/- 4.2 mmHg at 15 minutes, 161.8 +/- 18.3 / 123.2 +/- 13.9 mmHg at 30 minutes, and 156.0 +/- 4.1 / 112.4 +/- 1.7 mmHg at 45 minutes. The blood pressure lowering effect lasted until 45 minutes. However, the blood pressure increased to 182.2 +/- 16.4 / 149.0 +/- 20.4 mmHg at 60 minutes reaching similar levels of before the injection (P < 0.05). CONCLUSIONS: We could see YJ-7 has vasorelaxation effect and would be helpful to control blood pressure with short recovery period than nimodipine.

Bilateral vocal cord palsy after removal of falx meningioma in the hyperflexion of the neck: A case report

We experienced a case of bilateral vocal cord palsy following general anesthesia for craniotomy. The patient was a 43-year-old woman undergoing tumor resection for falx meningioma on frontal lobe. She had no laryngeal symptoms prior to operation. Spontaneous ventilation resumed after reversal of neuromuscular blockade. Following extubation, she showed signs of airway obstruction and dyspnea. Reintubation was done and symptoms improved. Three days after operation, we confirmed bilateral vocal cord palsy by fiberoptic laryngoscopy. We suggested that possible causes of bilateral vocal cord paralysis were hyperflexion of neck and long operating time.

Use of premolded armored tube for a patient with tracheal stenosis: A case report

It is essential to predict possibility of difficulties beforehand in ventilating or intubating the patient for the safe airway management and anesthetic maintenance. Even if there is no internal invasion, external compression of an enlarged neck mass can cause tracheal stenosis. The patient with nontoxic goitor had symptoms of dysphagia, exertional dyspnea and wheezing. There was difficulty in endotracheal passage of small bronchoscope through the compressed portion of the trachea during preoperative bronchoscopic examination. We premolded an armored endotracheal tube to fit the patient's trachea based on chest radiography, computed tomography and brochoscopic findings. Endotracheal intubation and thyroidectomy was successful and the patient discharged without any complication. We report a new method of intubation in patient with nontoxic goiter that obstructs the trachea by compression.

Combined epidural anesthesia and ultrasound guided peripheral nerve block for wound revision in a patient with peripartum cardiomyopathy: A case report / 대한마취과학회지

Peripartum cardiomyopathy (PPCM) is a rare complication that occurs between the late stage of pregnancy and six months after delivery. PPCM presents as symptoms of left ventricular dysfunction and it can be fatal unless treated promptly. Furthermore, anesthesia and surgery in such patients is a large challenge to anesthesiologists. First and foremost, the maintenance of stable hemodynamics is a major concern. We report a case of combined lumbar epidural anesthesia and both ilioinguinal and iliohypogastric nerve block under ultrasound guided for a wound revision in a 37-year-old woman diagnosed with PPCM after an emergency cesarean section.