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ABSTRACT: Transient femoral nerve palsy (TFNP) is a complication of ilioinguinal nerve block that may result from spread of large volumes of local anesthetics at the inner surface of the different fascial planes. We report a 7-year-old healthy boy who underwent right inguinal hernia repair under general anesthesia. After induction of anesthesia, a percutaneous ilioinguinal nerve block was performed with 3 mL of 2% lidocaine in single-shot. Before wound closure, the surgeon performed a splash block onto the wound with infiltration of 1.5 mL 0.25% bupivacaine. In the recovery room, quadriceps weakness and sensory loss over the anterior thigh were noted. The patient made a complete recovery 8 hrs after surgery without any treatment. We discuss the mechanism of this complication and strategies to reduce this complication.
Acta Anaesthesiologica Taiwanica 01/2008; 45(4):237-40.
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ABSTRACT: Tramadol is a centrally acting analgesic drug used mainly in the moderate to severe pain control. In this study, the effects of this agent on ion currents of NG108-15 neuronal cells were investigated. This cell line expresses Kv3.1a mRNAs and exhibits the activity of delayed rectifier K(+) (K(DR)) channels. Tramadol suppressed the amplitude of delayed rectifier K(+) current (I(K(DR))) in a concentration-dependent manner with an IC(50) values of 25 microM. Tramadol (30 microM) also shifted the steady-state inactivation of I(K(DR)) to a more negative membrane potential by approximately -15 mV. The role of the K(DR) channel, particularly as a member of the Kv3 superfamily, is to stabilize the resting potential and to reduce the width of action potentials in the time-coding neurons. Tramadol-induced block of I(K(DR)) observed in this study could be partly responsible for its anti-depressant action.
European Journal of Pain 11/2006; 10(7):597-601. · 3.94 Impact Factor
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ABSTRACT: A 35-day-old male infant was scheduled for bilateral inguinal herniorrhaphy. No history of recent upper airway infection or other reactive respiratory disease was noted before anesthesia. Breath holding was noted immediately after laryngeal mask airway (LMA) insertion. Removal of the LMA and positive pressure ventilation via face mask did not solve the problem. On suspicion of laryngospasm, tracheal intubation facilitated by muscule relaxant was performed. However, when the patient was ventilated, high airway pressure, absence of chest wall movement and elevated end-tidal CO2 were noted. Despite visual confirmation of correct placement of tracheal tube, oxygen desaturation and bradycardia developed rapidly. After deepening the inhalational anesthesia of sevoflurane and concomitant administration of intravenous lidocaine, the patient's respiratory condition turned for the better and became compliable. Respiratory dysfunction may be caused by severe bronchospasm induced by placement of the LMA. The pathophysiology and risk factors of bronchospasm related to the LMA placement are discussed in the text.
Acta Anaesthesiologica Taiwanica 04/2006; 44(1):39-42.
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ABSTRACT: The effects of paeoniflorin, a glycoside isolated from the root of Paeonia lactiflora, on ion currents in a mouse neuroblastoma and rat glioma hybrid cell line, NG108-15 were investigated. Paeoniflorin (1-300 microM) reversibly produced an inhibition of L-type voltage-dependent Ca2+ current (I(Ca,L)) in a concentration-dependent manner. Paeoniflorin caused no change in the overall shape of the current-voltage relationship of I(Ca,L). The IC50 value of paeoniflorin-induced inhibition of I(Ca,L) was 14 microM. However, neither adenosine deaminase (1 U/ml) nor 8-cyclopentyl-1, 3-dipropylxanthine (10 microM) could reverse the inhibition by paeoniflorin of I(Ca,L). Paeoniflorin (30 microM) shifted the steady-state inactivation curve of I(Ca,L) to more negative membrane potentials by approximately -10 mV. It also prolonged the recovery of I(Ca,L). The inhibitory effect of paeoniflorin on I(Ca,L) exhibited tonic and use-dependent characteristics. Paeoniflorin could effectively suppress I(Ca,L) evoked by action potential waveforms. Paeoniflorin at a concentration of 30 microM produce a slight inhibition of voltage-dependent Na+ current and delayed rectifier K+ current. Under current-clamp configuration, unlike adenosine, this compound decreased the firing of action potentials. Taken together, this study indicates that paeoniflorin can block L-type Ca2+ channels in NG108-15 cells in a mechanism unlinked to the binding to adenosine receptors. The effects of paeoniflorin on ion currents may partly, if not entirely, contribute to the underlying mechanisms through which it affects neuronal or neuroendocrine function.
European Journal of Pharmacology 11/2005; 523(1-3):16-24. · 2.52 Impact Factor
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ABSTRACT: The severity of airway obstruction varies in infants with Pierre-Robin syndrome (PRS). Some have severe upper airway obstruction that results in respiratory failure and even death. We report a case of neonate with isolated PRS who had a severe airway obstruction and respiratory failure after birth. She had complications of bilateral pneumothorax, subcutaneous emphysema, and hypoxaemia due to difficult tracheal intubation. Respiratory failure recurred immediately after extubation; she was resuscitated by inserting a laryngeal mask airway. The laryngeal mask airway was left inserted for 6 days. It was successful in this patient and eliminated the need for invasive surgical procedures. In conclusion, the relatively long term use of a laryngeal mask airway, which has not been reported before, could be an alternative therapy for patients with PRS with airway obstruction.
Resuscitation 05/2004; 61(1):97-9. · 3.60 Impact Factor
