Objective: We aimed to compare the success of non-normalized acceleromyographic neuromuscular monitoring and recovery profiles based on the depth of anesthesia at the time of sugammadex administration.
Methods: Patients undergoing general anesthesia were prospectively and randomly allocated to two groups. In the BIS60 group, sugammadex was administered when there was a bispectral index (BIS) <60 and anesthesia was maintained until a train-of-four ratio ≥1.
Objective: This study aimed to evaluate the effectiveness and safety of everolimus in treating seizures associated with focal cortical dysplasia type 2 (FCD 2).
Methods: A prospective, crossover, placebo-controlled clinical trial (ClinicalTrials.gov: NCT03198949) enrolled patients aged 4-40 years with pathologically confirmed FCD 2 and a history of ≥3 seizures per month for two out of the 3 months prior to screening.
Background: Remimazolam is an ultrashort-acting benzodiazepine that is increasingly used for its efficacy in anesthesia induction and maintenance. However, limited research has explored its impact on intraoperative hypothermia compared to that of traditional inhalation anesthetics. This study aimed to compare the incidence of hypothermia during endoscopic nasal surgery when using remimazolam for maintenance anesthesia versus using inhalation anesthetics.
View Article and Find Full Text PDFTumor necrosis factor receptor-associated periodic syndrome (TRAPS, OMIM: #142680) is a rare autoinflammatory disease (AID) with recurrent febrile episodes. To our knowledge, we report herein the first case of a patient with TRAPS in South Korea whose symptoms included fever, arthralgia, abdominal pain, rash, myalgia, cough, and lymphadenopathy. A pathogenic de novo mutation, c.
View Article and Find Full Text PDFMeasuring patients' core body temperature during surgery is essential and commonly performed with an esophageal temperature probe. The probe must be placed in the lower third of the esophagus for accurate measurement. In this case report, we describe our experience of discovering an inadvertently malpositioned esophageal temperature probe in the right inferior lobar bronchus, which led to ventilation-related problems in a patient undergoing prostate surgery.
View Article and Find Full Text PDFHypothermia is common in patients undergoing urological surgery; however, no single preventative modality is completely effective. This study evaluated the effects of combining prewarming with intraoperative phenylephrine infusion for the prevention of hypothermia in patients undergoing urological surgery. This prospective study enrolled 58 patients scheduled for urological surgery under general anesthesia.
View Article and Find Full Text PDFBackground: Remifentanil and sufentanil are potent short-acting synthetic opioid analgesics. The administration of remifentanil has been associated with the incidence of opioid-induced hyperalgesia. Opioid-induced hyperalgesia may be alleviated when opioids, such as morphine, are switched to sufentanil.
View Article and Find Full Text PDFA woman in her early 70s presented with a right fifth rib fracture along with left scapular body and glenoid fractures resulting from a traffic accident. She had no history of lung disease. The patient underwent multi-incisional video-guided arthroscopic fracture reduction and screw fixation in the right lateral decubitus position under general anesthesia, and surgery was followed by chest tube insertion.
View Article and Find Full Text PDFShort-term prewarming effectively reduces intraoperative hypothermia in adult patients. However, few data exist regarding its efficacy in elderly patients. Elderly people have a reduced ability to regulate their body temperature, which affects the efficacy of prewarming.
View Article and Find Full Text PDFSince postoperative hypothermia increases the morbidity and mortality rates of surgery, identifying its risk factors is an important part of perioperative management. Considering the increasing demand for robot-assisted surgery and other characteristics of conventional laparoscopic surgery, identifying the risk factors for hypothermia in robot-assisted surgery is necessary. However, this has not yet been clearly established.
View Article and Find Full Text PDFBackground: Older patients are more vulnerable to inadvertent perioperative hypothermia. Prewarming contributes to the prevention of inadvertent perioperative hypothermia in patients under general or neuraxial anesthesia. However, the effects of brachial plexus block (BPB) on thermoregulation and the efficacy of prewarming in the prevention of hypothermia in older patients undergoing surgery with BPB remain unclear.
View Article and Find Full Text PDFRedistribution hypothermia caused by vasodilation during anesthesia is the primary cause of perioperative hypothermia. Propofol exerts a dose-dependent vasodilatory effect, whereas dexmedetomidine induces peripheral vasoconstriction at high plasma concentrations. This study compared the effects of dexmedetomidine and propofol on core temperature in patients undergoing surgery under spinal anesthesia.
View Article and Find Full Text PDFUV-irradiation induces the secretion of double-stranded RNA (dsRNA) derived from damaged noncoding RNAs in keratinocytes, which enhance the expression of matrix metalloproteinases (MMP) in non-irradiated dermal fibroblasts, leading to dysregulation of extracellular matrix homeostasis. However, the signaling pathway responsible for dsRNA-induced MMP expression has not been fully understood. Transglutaminase 2 (TG2) is an enzyme that modifies substrate proteins by incorporating polyamine or crosslinking of proteins, thereby regulating their functions.
View Article and Find Full Text PDFMatrix metalloproteinases (MMPs) play a key role in tissue remodelling by cleaving extracellular matrix (ECM) components. In the skin, UV irradiation increases expression of MMPs that causes dysregulation of ECM homeostasis in dermis, leading to acceleration of skin aging. However, the mediator(s) that links UV irradiation to the upregulation of MMPs have not been fully defined.
View Article and Find Full Text PDFBackground: The presence of a urinary catheter, postoperative pain, and postoperative nausea and vomiting are risk factors for emergence agitation (EA). Antimuscarinic agents are primary agents used in the prevention and treatment of urinary catheter-related bladder discomfort. Chlorpheniramine has antimuscarinic, antinociceptive, and antiemetic effects.
View Article and Find Full Text PDFBackground: Catheter-related bladder discomfort (CRBD) is common in patients with a urinary catheter and is a risk factor for emergence agitation (EA). The mainstay of CRBD management is anticholinergics. Dexamethasone inhibits acetylcholine release.
View Article and Find Full Text PDFThe effects of neuromuscular blocking agents on the clinical performance of supraglottic airway devices and surgical condition in elderly patients undergoing hand surgery have not been established. We evaluated the effects of rocuronium on the clinical performance of an i-gel supraglottic device and surgical condition in elderly patients undergoing orthopedic hand surgery. Patients aged 65-85 years were randomized to receive either rocuronium (rocuronium group) or saline (control group).
View Article and Find Full Text PDFCatheter-related bladder discomfort (CRBD) associated with intraoperative urinary catheterization is a distressing symptom during recovery from anesthesia. Anticholinergics have been used to manage CRBD. Chlorpheniramine maleate (CPM) is a first-generation antihistamine, which also has anticholinergic effects.
View Article and Find Full Text PDFBackground: Although the average age of patients undergoing surgical procedures or anesthesia is increasing, differences in anesthesia-related injuries among different age groups have been not reported. This study compared older and younger patients on the basis of disputes regarding anesthesia-related injuries referred to the Korean Society of Anesthesiologists (KSA).
Methods: We retrospectively analyzed disputes regarding anesthesia-related injuries referred to the KSA between 2009 and 2018.
Keratinocyte-derived cytokines and chemokines amplify psoriatic inflammation by recruiting IL-17-producing CCR6 γδT-cells and neutrophils. The expression of these cytokines and chemokines mainly depends on NF-κB activity; however, the pathway that activates NF-κB in response to triggering factors is poorly defined. Here, we show that transglutaminase 2 (TG2), previously reported to elicit a T17 response by increasing IL-6 expression in a mouse model of lung fibrosis, mediates the upregulation of cytokines and chemokines by activating NF-κB in imiquimod (IMQ)-treated keratinocytes.
View Article and Find Full Text PDFEmergence agitation (EA), also referred to as emergence delirium, can have clinically significant consequences. The mechanism of EA remains unclear. The proposed risk factors of EA include age, male sex, type of surgery, emergency operation, use of inhalational anesthetics with low blood-gas partition coefficients, long duration of surgery, anticholinergics, premedication with benzodiazepines, voiding urgency, postoperative pain, and the presence of invasive devices.
View Article and Find Full Text PDFBackground: Sugammadex allows rapid recovery from rocuronium-induced neuromuscular blockade. Succinylcholine is often used for brief surgeries but is associated with myalgia, headache, histamine release, and increased lactate levels. Thus, we hypothesized that succinylcholine may affect emergence agitation (EA) and compared the effects of succinylcholine and rocuronium-sugammadex on EA in patients undergoing closed reduction of a nasal bone fracture under general anesthesia.
View Article and Find Full Text PDFEmergence agitation (EA) is common after nasal surgery. Strong opioids and N-methyl-D-aspartate (NMDA) receptor antagonists prevent EA. Tramadol also acts as an opioid receptor agonist and an NMDA receptor antagonist, but few studies have evaluated the effects of tramadol on EA.
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