RESUMO
BACKGROUND: Dexmedetomidine is a useful sedative drug with various uses. We designed this study to investigate the clinical effects and complications of different loading doses, 0.5 and 1.0 µg/kg. METHODS: Forty six patients, of American Society of Anesthesiologists physical status I and II, who required elective and emergency operation under spinal anesthesia were randomly assigned to group L or group H. Group L received a loading dose of 0.5 µg/kg for 10 minutes while group H received 1.0 µg/kg. Bispectral index (BIS), systolic blood pressure, heart rate, and Ramsay score were recorded at T0 (before loading), TL (just after loading) and T10, 20, 30 (10, 20, 30 minutes after TL). Complications, drug use, lowest BIS and time to reach BIS 80 after termination of dexmedetomidine were recorded during this study. RESULTS: In group H, BIS value decreased significantly after TL compared to the baseline (T0), while in group L after T10. Between two groups, BIS values showed a significant differences only at T10, BIS of group H was lower than that of group L. Ramsay score showed no significant differences except in TL; the score of group L was significantly lower than that of group H. Other vital signs and complications showed a minimal differences between two groups. CONCLUSIONS: Higher loading dose (1.0 µg/kg) of dexmedetomidine can lead to faster sedation without any severe complications.
RESUMO
Every operation could have a fire emergency, especially in the case of a tracheostomy. When a flammable gas meets a source of heat, the danger of fire is remarkable. A tracheal tube filled with a high concentration of oxygen is also a great risk factor for fire. Intra-tracheal tube fire is a rare, yet critical emergency with catastrophic consequences. Thus, numerous precautions are taken during a tracheostomy like, use of a special tube to prevent laser damage, ballooning of the tube with normal saline instead of air, and dilution of FiO(2) with helium or nitrogen. Since the first recorded cases on tube fires, most of the fires were initiated in the balloon and the tip. In the present case report, however, we came across a fire incidence, which originated from the wire.
RESUMO
BACKGROUND: The transversus abdominis plane block is recently described peripheral block to providing analgesia to the anterior abdominal wall. The goal of this study is to evaluate the analgesic efficacy of the ultrasound-guided transversus abdominis plane block (US-TAP block) in patients undergoing gynecologic surgery via a transverse lower abdominal skin incision. METHODS: Thirty-two patients undergoing gynecologic surgery were randomized to undergo standard care such as PCA, or to receive additional US-TAP block with standard care. After general anesthesia induction, a bilateral US-TAP block was performed using 0.375% ropivacaine 20 ml on each side. Postoperative demand of rescue analgesics in PACU and ward were recorded. Each patient was assessed postoperatively by a blinded investigator in the postanesthesia care unit (PACU) and at 2, 6, 10, 24, 48 hr postoperatively to investigate pain, drowsiness, nausea and itch. RESULTS: The US-TAP block reduced pain intensity compared to standard care in the PACU (5.2 ± 3.1 vs 8.4 ± 1.3) and at 2, 24 postoperative hours (3.0 ± 2.4 vs 5.2 ± 2.4, 0.9 ± 1.5 vs 2.2 ± 1.9). Fentanyl requirements in PACU was reduced (20.3 ± 20.9 vs 62.5 ± 35.4 µg, P < 0.05). In ward, pethidine requirements was reduced (21.9 ± 28.7 vs 56.3 ± 34.8 mg, P < 0.05). CONCLUSIONS: The US-TAP block with standard care provide more effective analgesia after gynecologic surgery via a transverse lower abdominal skin incision.
RESUMO
The surfactant-mediated shape evolution of titanium dioxide anatase nanocrystals in nonaqueous media was studied. The shape evolves from bullet and diamond structures to rods and branched rods. The modulation of surface energies of the different crystallographic faces through the use of a surface selective surfactant is the key parameter for the shape control.
