Type II postobstructive pulmonary edema during adenotonsillectomy in a child: A case report

Type II postobstructive pulmonary edema developes after the relief of chronic airway obstruction. We describe one case of type II postobstructive pulmonary edema during adenotonsillectomy. Awareness of this rare complication is crucial for the anesthesiologist to make early diagnosis and treatment.

The Inhibitory Effect of Propofol on Splenocytes Proliferations to Lipopolysaccharide in BALB/c Mice: Based on the Measurement of BrdU Incorporation in vitro / 대한마취과학회지

BACKGROUND: Anesthetics have been suspected of impairing various aspects of the immune function either directly by affecting the function of immunocompetent cells or indirectly by modulating the stress response. Splenocytes play important roles in the cellular host defense against infection. In order to assess the immune modulatory effects of propofol, this study examined the cytotoxic and proliferative effects of propofol on splenocytes. METHODS: Splenocytes, as responders, were isolated from BALB/c mice (n = 10). The cells were pretreated with different propofol concentrations (0micrometer, 30micrometer, 100micrometer, 300micrometer) for 24 hours. The cytotoxic effect was assayed by the NADH dehydrogenase activity and the proliferation was evaluated by the level of 5-bromo-2'-deoxyunridine (BrdU) incorporation during DNA synthesis in the presence or absence of propofol, in addition to lipopolysaccharide (LPS, 1 microgram/ml) for mitogenic stimulation. A cell proliferation enzyme-linked immuno-sorbent assay (ELISA) system was used, and the stimulation index was calculated in the presence or absence of propofol. RESULTS: The percentage of the NADH dehydrogenase activity was changed by the propofol pretreatment (P < 0.001). LPS stimulation significantly decreased the NADH dehydrogenase activity at 100micrometer and 300micrometer compared with the propofol-added or pretreated cells (P < 0.05). The stimulation index to LPS was lower at concentrations of 100micrometer and 300micrometer than at 30micrometer, and proliferative response of splenocytes were completely abrogated by adding toxic concentrations (100micrometer) of propofol (P < 0.05). CONCLUSIONS: Neither cytotoxicity, as defined by the NADH dehydrogenase activity, nor a proliferative effect, as measured by the level of (BrdU) incorporation in the splenocytes, were affected by the clinical concentration of propofol.

Management of Pulmonary Thromboembolism with Inferior Vena Cava Filter: A Case Report / 대한구급학회지

We managed a case in which an inferior vena cava filter was inserted for a pulmonary thromboembolism that occurred during general anesthesia. A 71-year-old woman was prepped for reduction of a distal femur fracture and arthroplastic surgery. Her initial vital signs were stable, but the end-tidal CO2 and SaO2 were decreased gradually after application of the tourniquet for surgery. Because of impaired ventricular wall motion and a dilated inferior vena cava on echocardiogram, we suspected a pulmonary thromboembolism. Thus, we inserted an inferior vena cava filter percutaneously under propofol sedation in the Radiology Department. In addition to ventilatory support and hemodynamic management, heparin was administered as anticoagulant therapy postoperatively in the intensive care unit. Multiple thrombi in the pulmonary artery were confirmed on chest CT. On the 4th postoperative day, she was transferred to the general ward without any complications.