A comparison of parecoxib and thoracic epidural analgesia for postoperative analgesia following Nuss procedure.

Background: The purpose of this study was to compare the results of thoracic epidural analgesia (TEA) and parecoxib in controlling postoperative pain after the Nuss procedure.

Methods: Between August 2005 and July 2014, 120 adolescents and adults underwent Nuss procedures and received either TEA or parecoxib for postoperative pain control. Demographic data, preoperative preparation times, visual analog scale (VAS) pain scores from postoperative day 1 to day 5, medical costs of pain control, days to Foley catheter removal, days to being able to sit up, days to being able to walk, days of hospital stay, nausea/vomiting scores, and complications related to pain control were compared.

Efficacy of intramuscular nalbuphine versus diphenhydramine for the prevention of epidural morphine-induced pruritus after cesarean delivery.

Background: Pruritus is the most common side effect of epidural morphine analgesia. Diphenhydramine is a widely used agent for the treatment of urticarial pruritus. Nalbuphine is a mixed opioid agonist-antagonist and has been reported to be effective in treating opioid-induced pruritus.

Effects of postoperative analgesia on postpartum urinary retention in women undergoing cesarean delivery.

Aim: Various analgesics and administration methods are used to provide women undergoing cesarean delivery pain relief after surgery. We compared three methods of postoperative analgesia regarding the incidence of postpartum urinary retention (PUR) in primiparous women undergoing elective cesarean delivery.

Methods: We estimated post-void residual bladder volume after the first postpartum micturition among 150 parturient women.

Accuracy of a new body length-based formula for predicting tracheal tube size in Chinese children.

Background: Variations in body weight and length (height) in children in the same age group have increased. Traditional age-based formulas often fail to predict the correct endotracheal tube (ETT) size. In our previous study, we devised a new length-based formula as follows: ETT internal diameter (ID) (mm) = 2 + (body length in cm/30).

Does intrapartum epidural analgesia affect nulliparous labor and postpartum urinary incontinence?

Background: The effect of epidural analgesia on nulliparous labor and delivery remains controversial. In addition, pregnancy and delivery have long been considered risk factors in the genesis of stress urinary incontinence (SUI). We sought to determine the effect of epidural analgesia and timing of administration on labor course and postpartum SUI.

Extensive sensory block caused by accidental subdural catheterization during epidural labor analgesia.

A 32-year-old parturient requested epidural analgesia for labor. A lumbar epidural block was performed at the L1-2 interspace. Thirty minutes after the loading dose of the local anesthetic mixture, she suffered numbness in both arms and high sensory block up to the C6 dermatome without significant motor blockade.

Comparison of patient-controlled epidural analgesia and continuous epidural infusion for labor analgesia.

Background: In recent years, patient-controlled epidural analgesia (PCEA) has been developed as an attractive alternative to continuous epidural infusion (CEI) for labor pain control. PCEA is still not popular for labor pain control in Taiwan and disparities may exist between different ethnic and cultural groups toward the attitude of labor pain control. The aim of this study was to investigate whether there were any differences between PCEA and CEI in the maintenance of epidural analgesia for Taiwanese parturients undergoing spontaneous delivery.

A randomized blinded study of the incidence of postoperative nausea and vomiting in women after major gynecologic laparoscopic surgery.

Study Objective: To estimate the incidence of postoperative nausea and vomiting (PONV) in women undergoing major gynecologic laparoscopic surgery with an expected surgical duration exceeding 1 hour and anticipated overnight hospitalization.

Design: Randomized, double-blind, placebo-controlled study.

Setting: This study was set at a university hospital.

Profound hypoxemia during major abdominal surgery in a small infant with tetralogy of Fallot.

We report a protracted hypoxic event during Soave's endorectal pull-through for Hirschsprung's disease in a 2-month-old male infant with tetralogy of Fallot. After the bowel loops were delivered out of the abdominal cavity, profound hypoxemia occurred which persisted for about 120 min. The hypoxemia was completely resolved after the intestine was reduced back into the peritoneal cavity.

Postpartum unilateral Horner's syndrome following lumbar epidural anesthesia after a Cesarean delivery.

We report on a case demonstrating unilateral Horner's syndrome (HS) after lumbar epidural obstetric anesthesia. A healthy, 32-year-old woman with a breech presentation was scheduled for an elective Cesarean section. The patient had normal vital signs throughout the surgical procedure.

Factors influencing time of intubation with a lightwand device in patients without known airway abnormality.

Study Objective: To evaluate the correlation between accepted screening tests for difficult tracheal intubation and ease of intubation with a lightwand blind technique.

Design: Prospective study.

Setting: Anesthetic rooms of a university hospital.

Caudal epidural block for minor gynecologic procedures in outpatient surgery.

Background: Caudal epidural block (CEB) has become increasingly important for pediatric analgesia in recent years. However, data regarding CEB in adult ambulatory surgery are scarce. The aim of this study was to verify whether CEB could be applied as a simple, safe and economic method of anesthesia for adult patients undergoing minor gynecologic procedures (MGP).

Aspiration of a dislodged endotracheal tube: a rare cause of acute total airway obstruction.

We report an unusual cause of acute total airway obstruction after aspiration of a dislodged tube that was separated from its metallic connector. A 5-year-old boy had an emergence agitation and bucking to the endotracheal tube with a vigorous bite before extubation of the trachea. The whole uncuffed endotracheal tube was aspirated deep into the lower trachea causing laryngotracheal obstruction.

Anesthesia for pediatric patients with Prader-Willi syndrome: report of two cases.

Prader-Willi syndrome (PWS) is a sporadic disorder of chromosome abnormalities with an estimated prevalence of 1 in 15,000. It mainly affects the central nervous system, and often involves the hypothalamus. Both general and regional anesthesia for these patients is difficult mainly due to morbid obesity.

Airway management in a patient with a cleft palate after pharyngoplasty: a case report.

Purpose: To describe a practical method of aiding nasotracheal intubation in a cleft palate patient with previous pharyngoplasty using a suction catheter under tactile guidance. Problems of airway management in these patients are also discussed.

Clinical Features: A 26-yr-old woman presented for elective Le Fort maxillary osteotomy.

Awake fiberoptic intubation for cesarean section in a parturient with odontoid fracture and atlantoaxial subluxation.

We report on the anesthetic experience of a 38-week pregnant patient in labor with an upper cervical spinal cord injury after an unusual trauma. She was transferred from a district hospital to our medical center with acute quadriplegia and sensory loss. Plain cervical spine x-ray and computed tomographic scan showed a C2 odontoid (dens of axis) process type II fracture and atlantoaxial (C1-C2) subluxation.

Epidural anesthesia does not increase the incidences of urinary retention and hesitancy in micturition after ambulatory hemorrhoidectomy.

Background: This randomized, prospective study was designed to evaluate the role of various anesthesias in postoperative urinary retention and hesitancy in micturition in patients receiving hemorrhoidectomy on ambulatory basis.

Methods: In a randomized order, 128 ambulatory patients, ASA physical status I or II, were divided into two groups to receive hemorrhoidectomy under epidural or local anesthesia. In all patients, the intraoperative intravenous fluid given was limited to 200 ml +/- 2 ml/kg/h of Ringer's lactate solution.

Use of intravenous anesthesia for tension-free vaginal tape therapy in elderly women with genuine stress incontinence.

Objectives: To study the efficacy of the tension-free vaginal tape (TVT) procedure for elderly patients.

Methods: Forty-five women, 65 years old or older (mean 69.1; range 65 to 85), were treated for genuine stress incontinence with the tension-free vaginal tape procedure under intravenous anesthesia with heavy sedation.