Blood sampling for a newborn screening test is necessary for all neonates in South Korea. During the heel stick, an appropriate intervention should be implemented to reduce neonatal pain. This study was conducted to identify the effectiveness of kangaroo care (KC), skin contact with the mother, on pain relief during the neonatal heel stick. Twenty-six neonates undergoing KC and 30 control neonates at a university hospital participated in this study. Physiological responses of neonates, including heart rate, oxygen saturation, duration of crying and Premature Infant Pain Profile (PIPP) scores were measured and compared before, during and 1 min and 2 min after heel sticks. The heart rate of KC neonates was lower at both 1 and 2 min after sampling than those of the control group. Also, PIPP scores of KC neonates were significantly lower both during and after sampling. The duration of crying for KC neonates was around 10% of the duration of the control group. In conclusion, KC might be an effective intervention in a full-term nursery for neonatal pain management.
Myofascial pain syndrome is defined as the sensory, motor and autonomic symptoms caused by the myofascial trigger points. The sternocleidomastoid muscle is a complex muscle that frequently contains multiple trigger points. These trigger points cause symptoms that are easily misdiagnosed as other conditions. Earache of unexplained origin is likely to be caused by trigger points in the clavicular division of the sternocleidomastiod muscle. The authors report a case of earache caused by a trigger point in the sternocleidomastoid muscle. A 34 year-old woman had earache without any history of trauma or infection. The patient did not have any abnormal finding by otolaryngologic testing, except for an earache, which had not subsided. On physical examination, trigger points in the clavicular division of the sternocleidomastiod muscle were found, and the earache was successfully treated by trigger point injections. (Korean J Anesthesiol 2004; 46: 497∼500) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
These case reports describe the authors' experiences with ten cases in which an amored endotracheal tube (ETT) was partially inserted through a nostril into the nasopharynx to relieve the upper airway obstruction and respiratory depression during monitored anesthesia care. The amored ETT was connected to the semiclosed circuit system of an anesthesia machine equipped with an end-tidal CO2 monitor; assisted positive ventilation was applied if needed. This manuever enabled airway obstruction relief, the oxygen saturation to be increased immediately, and the respiratory pattern to be monitored continuously, but it did not interfere with the surgical procedure. Therefore, we introduce this universally available amored ETT for airway maintenance without interfering with surgical procedure such as facial chemical peeling.
Characteristically pulmonary edema is bilateral, unless there is an underlying defect or abnormality in the cardiopulmonary system. Unilateral pulmonary edema following general anesthesia is a rare complication in a healthy patient. The etiology of unilateral pulmonary edema include, the re-expansion of a collapsed lung, unilateral pulmonary veno-occulusive disease, pulmonary contusion, compression of pulmonary vasculatures, cerebral autonomic dysfunction, bronchial obstruction and severe ischemic left ventricular dysfunction. We describe a 52-yr-old patient who developed acute unilateral pulmonary edema after a total hip replacement athroplasty in the lateral decubitus position. The patient recovered following 16 hours of intensive treatment involving fluid restriction, diuretics, sedation, and continuous positive airway pressure ventilation.
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