Postoperative cognitive dysfunction (POCD) is a serious and frequent complication after surgery, especially in elderly patients. Ketamine an N-methyl D-aspartic acid receptor antagonist with demonstrated neuroprotective effects. An intravenous bolus of sub-anesthetic dose (0.5 mg/kg) ketamine can reduce postoperative delirium (POD) POCD cardiac surgery. But, the influence on early non-cardiac surgery unclear.The current study aimed to evaluate function orthopedic patients.Fifty six patients...

A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated terazosin, losartan, atenolol levetiracetam for 2 weeks. Dexmedetomidine started in preoperative waiting area, a combination dexmedetomidine remifentanil continuously infused most anesthetic time. To control blood pressure, bolus injection low-dose infusion sodium nitroprusside, nicardipine, esmolol were...

Sphincter of Oddi dysfunction (SOD) is a syndrome chronic biliary pain or recurrent pancreatitis due to the functional obstruction pancreaticobiliary flow. We report case spinal cord stimulation (SCS) for abdominal SOD. The patient had history cholecystectomy and suffered from right upper quadrant pain. been diagnosed as having was treated with opioid analgesics nerve blocks, including splanchnic block. However, two years later, became intractable. implanted percutaneous SCS at T5-7 level...

After total knee arthroplasty (TKA), patients suffer pain; therefore, many analgesic techniques have been invented. Epidural analgesia is widely used and can be delivered by continuous epidural infusion (CEI), patient controlled (PCEA), or intermittent bolus (IEB). However, CEI associated with greater incidence of motor block higher concentrations anesthetics, inadequate sometimes observed diluted solutions [1]. One study suggested that uniform diffusion anesthetics in space better obtained...

The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped diagnose syndrome. High dose radiotherapy could induce acute delayed muscle damage. We had experienced with fatty atrophy after for recurrent cervical cancer.

Atrial septal defect (ASD) is second common congenital heart disease that often leads to adult period. Intracardiac or transesophageal echocardiography (TEE) essential for percutaneous closure of ASD using Amplatzer occluder. Dexmedetomidine (DEX), which a highly selective α2-agonist, has sedative and analgesic properties without respiratory depression in the clinical dose range. We report with TEE under DEX sedation.

A rare case of carpal tunnel syndrome caused by a thrombosed persistent median artery is presented here. The diagnosis was delayed due to the overlapping cervical radiculopathy. Acute severe pain and nocturnal paresthesia were chief complaints. Ultrasonography, magnetic resonance imaging, computed tomography angiography revealed that nerve compressed occluded artery. Instead surgery, conservative therapy tried. It worked well for six months. importance using modalities decision making...

Dexmedetomidine, a selective alpha-2 agonist, has sedative, analgesic, and anxiolytic effects without respiratory depression. Dexmedetomidine can cause biphasic cardiovascular response, induce transient hypertension. Hypotension is common complication of spinal anesthesia. Decreasing anxiety patients before procedure important for high quality procedure. This study aimed to compare the incidence hypotension patients' comfort levels when dexmedetomidine was intravenously administered after...

Sir, Severe kyphoscoliosis can occasionally lead to torsion of the central airways and increased airway resistance.[1] Bronchial catastrophic respiratory complications general anaesthesia with endotracheal intubation be dangerous in these patients. Parathyroidectomy is usually performed under anaesthesia, a choice surgeon as well patient. If preoperative localisation intraoperative parathyroid hormone assay possible, minimally invasive parathyroidectomy (MIP) sometimes deep/superficial...

Spinal cord stimulation (SCS) in trials involving external are easily conducted under local anesthesia. However, implantation of a permanent SCS system is painful, and can be intolerable some patients. Epidural anesthesia used to perform the without discomfort if patient localize area paresthesia. little known about epidural for SCS. This paper reports 23 cases with cylindrical type lead implanted was sufficient 22 patients significant complications. The remaining experienced incomplete...

Surgical excision was performed on a 30-years old woman with painful mass her left thigh. The pathologic findings the indicated fibromatosis. After operation, she complained of allodynia and spontaneous pain at operation site ipsilateral lower leg. We treated based postoperative femoral neuropathy, but symptom aggravated. found large liposarcoma in iliopsoas muscle which compressed lumbar plexus. In conclusion, cause plexopathy related to muscle. Prompt diagnosis acute neuropathic after an...

Background: Trigger point injection [TPI] is generally considered a safe and easy procedure.Findings: We describe case of cardiac tamponade after ultrasonography [US]-guided TPI in thin patient. The symptoms progressively appeared directly the injection, patient experienced cardiogenic shock 3 h later. Cardiac was diagnosed with difficulty when US performed near site, then pericardiocentesis immediately.Conclusions: When US-guided neck chest, authors suggest that entire shaft tip needle be...

Cystic lung diseases of infants include congenital cystic adenoid malformation, pulmonary sequestration, bronchogenic cyst, and bronchial atresia. The progressions disease vary from spontaneous regression to severe respiratory difficulty [1]. Infants with can suffer variable degrees symptoms which result in recurrent infection hypoplasia [2]. Therefore, perioperative management patients be a challenge for anesthesiologists. We report our experience 2-month-old female patient multiple large...

The scarring process of bums can be accompanied by pain and/or paresthetic sensation which may persist after completion scar formation. Once the wound is healed, it possible that painful sensations as a result abnormalities in newly regenerated nerve endings or because deficient reinnervation scarred tissue, give rise to abnormal inputs. Existence glutamate receptors peripheral nerves innervating normal and inflamed skin has been well addressed. Therefore we tried ketamine postburn...