Steroid Injection into the Compartment of the Brachial Plexus in a Pediatric Patient with Traumatic Brachial Plexus Injury: A case report / 대한마취과학회지

Most brachial plexus injuries are a result of high velocity, traction-type traumas. In severe cases, brachial plexus injury results in a variable functional loss of the upper extremities. Steroid has been reported to delaye degeneration and improve regeneration of the injured nerve. Here, steroid was injected into the brachial plexus compartment in a 5-year-old female with brachial plexus injury caused by a traffic accident. After the injection of steroid into the compartment of the injured brachial plexus, motor and sensory functions of the left upper extremity were much improved. Steroid injection should be considered as another option of conservative treatment in patients with brachial plexus injury before or after operation.

Allergic Reaction after the Insertion of a Latex Urethral Catheter: A case report / 대한마취과학회지

Natural rubber latex is a processed plant product that is manufactured from the rubber tree, Hevea braziliensis. Allergy to natural rubber latex, which contains a complex blend of water-soluble plant proteins, is a major source of concern in clinical practice. Latex is the inciting factor in at least 10 percent of anaphylactic reactions that have been reported during anesthesia. IgE-mediated sensitization to natural rubber latex could induce hypersensitivity reactions ranging from mild contact urticaria to potentially life-threatening anaphylaxis. Because of the ubiquitous use of latex in medical equipment and devices, anesthesiologist should give more attention and to the management of the allergic reactions to latex in high risk groups. We report upon the anesthetic management of a parturient undergoing Cesarean section, in which an allergic reaction to latex developed just after the insertion of latex urethral catheter.

Hemodynamic Stability during the Induction of Anesthesia with Propofol Plus Fentanyl, Ketamine and Fentanyl-Ketamine / 대한마취과학회지

BACKGROUND: This study was conducted to investigate hemodynamic stability during anesthesia induction and tracheal intubation, using propofol plus fentanyl, propofol plus ketamine, and propofol plus fentanyl and ketamine. METHODS: Sixty adult patients were randomly allocated to one of three groups according to the agents used for induction: propofol (2 mg/kg) plus fentanyl (2 mcg/kg) (PF), propofol (2 mg/kg) plus ketamine (0.1 mg/kg) (PK), propofol (2 mg/kg) plus fentanyl (2 mcg/kg) and ketamine (0.1 mg/kg) (PFK). Hemodynamic responses were assessed by measuring changes in mean arterial pressure (MAP), heart rate (HR), and rate-pressure product (RPP). RESULTS: MAP, HR and RPP changes during the induction of anesthesia tended to be greater in the PK group than in the PF and PFK groups. After the injection of propofol, MAP, HR, and RPP fell significantly below baseline values in the all groups, but remained relatively stable in the PK groups. After tracheal intubation, MAP, HR and RPP increased significantly compared with the pre-intubation values in the all groups, but reached a level significantly above baseline only in the PK group. CONCLUSIONS: A combination of propofol plus fentanyl and ketamine reduces fluctuations in the hemodynamic variables associated with the induction of anesthesia and tracheal intubation than combinations of propofol plus fentanyl or propofol plus ketamine.

A Case of Paroxysmal Atrial Fibrillation before Induction of General Anesthesia in an Elderly Patient

Atrial fibrillation(AF) diagnosed by fibrillatory waves of atrial activity and an irregular ventricular response on ECG is a common arrhythmia associated with increased cardiovascular morbidity and mor- tality. The incidence of AF increases markedly with advancing age and the presence of congestive heart failure. Most patients with AF can be attributed to organic heart disease such as rheumatic, atherosclerotic and hypertensive heart disease. But there is an increasing awareness of so-called lone AF which has no underlying cardiac or metabolic abnormality. We report a case of paroxysmal AF developed just before the induction of anesthesia in a 73-year-old patient who had no history of cardiovascular disease.