Spinal anesthesia for emergency cesarean section in a preeclampsia patient diagnosed with type 1 neurofibromatosis / 대한마취과학회지

No abstract available.

Comparison of postoperative renal and hepatic function between desflurane-remifentanil and propofol-remifentanil for nephrectomy

BACKGROUND: Choice of anesthetics in patients with a history of nephrectomy is very important for anesthesiologists. It is important for the anesthesiologist to preserve the ipsilateral kidney function and minimize deleterious effects. This study was performed to compare anesthetic agents on postoperative renal and hepatic function in patients who underwent nephrectomy. METHODS: From 2008 to 2012, 116 patients who underwent nephrectomy in our hospital were evaluated through a retrospective study. Anesthesia was maintained with desflurane-remifentanil in the desflurane group (Group D), and propofol-remifentanil, using a target controlled infusion pump (Group T). In order to evaluate postoperative renal and hepatic function, blood urea nitrogen (BUN), serum creatinine (Cr), estimated glomerular filtration rate (eGFR), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was measured preoperatively, postoperative day 1, 3 and 7. RESULTS: When compared to preoperative measures, Cr and BUN levels were elevated on postoperative day 1, 3 and 7 while eGFR was decreased in both groups. There was no significant difference between the two groups. AST and ALT were also mildly elevated on postoperative day 1, 3 and 7 in both groups. There was also no significant difference between the two groups. CONCLUSIONS: Anesthesia with desflurane-remifentanil or propofol-remifentanil alter postoperative renal and hepatic function with no significant difference between groups. Both desflurane and propofol may be chosen for general anesthesia undergoing nephrectomy patients.

Comparison of postoperative renal and hepatic function between desflurane-remifentanil and propofol-remifentanil for nephrectomy

BACKGROUND: Choice of anesthetics in patients with a history of nephrectomy is very important for anesthesiologists. It is important for the anesthesiologist to preserve the ipsilateral kidney function and minimize deleterious effects. This study was performed to compare anesthetic agents on postoperative renal and hepatic function in patients who underwent nephrectomy. METHODS: From 2008 to 2012, 116 patients who underwent nephrectomy in our hospital were evaluated through a retrospective study. Anesthesia was maintained with desflurane-remifentanil in the desflurane group (Group D), and propofol-remifentanil, using a target controlled infusion pump (Group T). In order to evaluate postoperative renal and hepatic function, blood urea nitrogen (BUN), serum creatinine (Cr), estimated glomerular filtration rate (eGFR), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was measured preoperatively, postoperative day 1, 3 and 7. RESULTS: When compared to preoperative measures, Cr and BUN levels were elevated on postoperative day 1, 3 and 7 while eGFR was decreased in both groups. There was no significant difference between the two groups. AST and ALT were also mildly elevated on postoperative day 1, 3 and 7 in both groups. There was also no significant difference between the two groups. CONCLUSIONS: Anesthesia with desflurane-remifentanil or propofol-remifentanil alter postoperative renal and hepatic function with no significant difference between groups. Both desflurane and propofol may be chosen for general anesthesia undergoing nephrectomy patients.

Clinical Experiences on the Effect of Scrambler Therapy for Patients with Postherpetic Neuralgia

Postherpetic neuralgia (PHN) is a debilitating complication of herpes zoster, especially in elderly and comorbid patients. Unfortunately, the currently available treatments have shown limited efficacy and some adverse events that are poorly tolerated in elderly patients. Scrambler Therapy, proposed as an alternative treatment for chronic neuropathic pain recently, is a noninvasive approach to relieve pain by changing pain perception at the brain level. Here, we report our clinical experiences on the effect of Scrambler Therapy for three patients with PHN refractory to conventional treatment.

Effects of intraoperative low dose ketamine on remifentanil-induced hyperalgesia in gynecologic surgery with sevoflurane anesthesia / 대한마취과학회지

BACKGROUND: Remifentanil is useful during general anesthesia because of its rapid onset and short acting time. However, some studies report that due to opioid-induced hyperalgesia (OIH) and tolerance, remifentanil also increases early postoperative pain. The occurrence of OIH and opioid-induced tolerance is mainly thought to be due to central sensitization by the activation of NMDA receptors. Therefore, we investigated the effects of continuous infusion of ketamine, an NMDA receptor antagonist, on postoperative pain and the quantity of opioids used. METHODS: 40 patients scheduled to undergo laparoscopic gynecologic surgery were randomly allocated into two groups. Anesthesia was equally maintained with sevoflurane and 4 ng/ml of remifentanil in all patients. Ketamine (0.3 mg/kg) was injected and followed with a continuous dosage of 3 microl/kg/min in the ketamine group (n = 20) while the control group was injected and infused with an equal amount of normal saline. We compared postoperative VAS up to 7 hours and morphine demand through PCA. RESULTS: Postoperative VAS and morphine demand was significantly lower in the ketamine group 2 and 3 hours after surgery, respectively. CONCLUSIONS: When general anesthesia is maintained with sevoflurane and remifentanil in patients undergoing laparoscopic gynecologic surgery, continuous infusion of low dose ketamine decreased early postoperative pain and the quantity of opioids used.