Idiopathic neuralgic amyotrophy (INA) in children is a rare peripheral neuropathy showing distinctive clinical features. An 8-year-old boy presented with left shoulder pain and weakness lasting 4 weeks. He had learned Taekwondo and swimming before the onset of pain. A fever had developed 10 weeks before onset but had completely resolved after medication. Initially, he was diagnosed with shoulder subluxation and underwent successful reduction. However, he continued to complain of persistent pain and weakness. All the studies indicated normal findings, except for the electrodiagnostic assessment, which revealed partial brachial plexopathy. A rehabilitation program was performed. It consisted of physical and occupational therapy twice a week. After 5-month rehabilitation, the patient remarkably improved in both neurologic and functional status. INA should be considered and evaluated in cases with abrupt onset of shoulder pain and weakness in children. Also, an integrated rehabilitation program during the subacute phase can be helpful to facilitate neurologic and functional recovery and reduce sequelae.
{"title":"Idiopathic Neuralgic Amyotrophy in a Child Treated with Integrated Rehabilitation Program: A Case Report","authors":"Sung Il Hwang","doi":"10.15746/sms.23.015","DOIUrl":"https://doi.org/10.15746/sms.23.015","url":null,"abstract":"Idiopathic neuralgic amyotrophy (INA) in children is a rare peripheral neuropathy showing distinctive clinical features. An 8-year-old boy presented with left shoulder pain and weakness lasting 4 weeks. He had learned Taekwondo and swimming before the onset of pain. A fever had developed 10 weeks before onset but had completely resolved after medication. Initially, he was diagnosed with shoulder subluxation and underwent successful reduction. However, he continued to complain of persistent pain and weakness. All the studies indicated normal findings, except for the electrodiagnostic assessment, which revealed partial brachial plexopathy. A rehabilitation program was performed. It consisted of physical and occupational therapy twice a week. After 5-month rehabilitation, the patient remarkably improved in both neurologic and functional status. INA should be considered and evaluated in cases with abrupt onset of shoulder pain and weakness in children. Also, an integrated rehabilitation program during the subacute phase can be helpful to facilitate neurologic and functional recovery and reduce sequelae.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amphotericin B is widely used in the treatment of neonatal invasive fungal disease. Liposomal amphotericin B (LAmB) is now preferred over conventional amphotericin B deoxycholate due to its lower kidney toxicity. However, it is essential to monitor the possible side effects of LAmB when treating extremely premature infants. Herein, we present a case of an extremely premature infant who exhibited persistent metabolic acidosis, hypoglycemia, and dyselectrolytemia after administration of LAmB for a suspected fungal infection.
两性霉素 B 广泛用于治疗新生儿侵袭性真菌病。由于脂质体两性霉素 B（LAmB）对肾脏的毒性较低，因此现在比传统的脱氧胆酸两性霉素 B 更受青睐。然而，在治疗极早产儿时，必须监测 LAmB 可能产生的副作用。在此，我们介绍了一例极早产儿病例，该患儿在服用 LAmB 治疗疑似真菌感染后出现了持续性代谢性酸中毒、低血糖和失代偿血症。
{"title":"A Case of Extremely Premature Baby with Persistent Metabolic Acidosis, Hypoglycemia and Dyselectrolytemia Induced by Liposomal Amphotericin B","authors":"Ji Won Koh","doi":"10.15746/sms.23.016","DOIUrl":"https://doi.org/10.15746/sms.23.016","url":null,"abstract":"Amphotericin B is widely used in the treatment of neonatal invasive fungal disease. Liposomal amphotericin B (LAmB) is now preferred over conventional amphotericin B deoxycholate due to its lower kidney toxicity. However, it is essential to monitor the possible side effects of LAmB when treating extremely premature infants. Herein, we present a case of an extremely premature infant who exhibited persistent metabolic acidosis, hypoglycemia, and dyselectrolytemia after administration of LAmB for a suspected fungal infection.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There have been no reported studies or case reports on the coexistence of coronavirus disease 2019 (COVID-19) in patients with dermatomyositis (DM) and its effect on swallowing. This is the first case report that addresses the impact of COVID-19 on dysphagia in a patient with DM. A 65-year-old male diagnosed with DM and undergoing steroid treatment contracted COVID-19. Subsequently, muscle power and creatine kinase levels improved, but dysphagia persisted, leading to nasogastric tube feeding. COVID-19 may hinder the recovery of dysphagia in steroid-responsive DM patients.
{"title":"The Impact of COVID-19 on Dysphagia in a Steroid-Responsive Dermatomyositis Patient: A Case Report","authors":"Hyun Jung Kim","doi":"10.15746/sms.23.017","DOIUrl":"https://doi.org/10.15746/sms.23.017","url":null,"abstract":"There have been no reported studies or case reports on the coexistence of coronavirus disease 2019 (COVID-19) in patients with dermatomyositis (DM) and its effect on swallowing. This is the first case report that addresses the impact of COVID-19 on dysphagia in a patient with DM. A 65-year-old male diagnosed with DM and undergoing steroid treatment contracted COVID-19. Subsequently, muscle power and creatine kinase levels improved, but dysphagia persisted, leading to nasogastric tube feeding. COVID-19 may hinder the recovery of dysphagia in steroid-responsive DM patients.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Woo, Woo Jong Shin, J. Shim, W. Jeon, Hyung Joon Park
Ehlers-Danlos syndrome (EDS) is a very rare genetic disorder characterized by defects in the production of connective tissue. Among them, vascular EDS is the subtype known to have the worst prognosis due to fragile blood vessels. Accordingly, we would like to report a case report of a patient with vascular EDS with a review of the literature on possible massive transfusion and anesthesiological problems. Patients with vascular EDS have very weak blood vessels and tissues that are easily broken. So there is a high possibility of unexpected massive bleeding during emergency surgery in these patients. Therefore, the anesthesiologist should be fully prepared for the possibility of massive blood loss, keeping in mind the possibility of damage to large blood vessels. The central vein must be secured using ultrasound, sufficient blood and fluids must be prepared, and equipment capable of rapid administration must be perfectly prepared before the start of operation.
{"title":"Anesthetic Management of Emergency Surgery for a Patient with Vascular Ehlers Danlos Syndrome (Type IV): A Case Report","authors":"U. Woo, Woo Jong Shin, J. Shim, W. Jeon, Hyung Joon Park","doi":"10.15746/sms.23.011","DOIUrl":"https://doi.org/10.15746/sms.23.011","url":null,"abstract":"Ehlers-Danlos syndrome (EDS) is a very rare genetic disorder characterized by defects in the production of connective tissue. Among them, vascular EDS is the subtype known to have the worst prognosis due to fragile blood vessels. Accordingly, we would like to report a case report of a patient with vascular EDS with a review of the literature on possible massive transfusion and anesthesiological problems. Patients with vascular EDS have very weak blood vessels and tissues that are easily broken. So there is a high possibility of unexpected massive bleeding during emergency surgery in these patients. Therefore, the anesthesiologist should be fully prepared for the possibility of massive blood loss, keeping in mind the possibility of damage to large blood vessels. The central vein must be secured using ultrasound, sufficient blood and fluids must be prepared, and equipment capable of rapid administration must be perfectly prepared before the start of operation.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139142182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this case was to report a case of repeated dexamethasone intravitreal implant (Ozurdex; Allergan Inc., Irvine, CA, USA) migration into the anterior chamber without any corneal complications in a patient with cystoid macular edema. A 70-year-old male patient had decreased vision due to cystoid macular edema after scleral fixation of a dislocated intraocular lens in his right eye. He had repeated intravitreal bevacizumab injection but macular edema showed little improvement. Macular edema improved after intravitreal dexamethasone implantation but he needed repeated implantation since macular edema recurred as the therapeutic effect of the implant decreased. After the third implantation, 70 days later, the implant was observed in the anterior chamber, and the intraocular pressure (IOP) measured 46 mm Hg, while the cornea remained clear. We decided to have a close follow-up with IOP control since no corneal edema was seen. The implant was completely absorbed after 40 days with clear cornea and another intravitreal dexamethasone implantation was performed owing to increasing macular edema. The implant was seen in the anterior chamber again after 78 days but no corneal edema was seen and IOP was normal. After 1 month the implant was completely absorbed and intravitreal dexamethasone implantation was repeated. Migration of dexamethasone intravitreal implant may happen in a patient with posterior capsular defect but the treatment could be maintained under close observation in absence of corneal complications.
{"title":"A Case of Repeated Intravitreal Dexamethasone Implantation for Treatment of Macular Edema after Scleral Fixation of Intraocular Lens","authors":"Hae Jung Sun","doi":"10.15746/sms.23.021","DOIUrl":"https://doi.org/10.15746/sms.23.021","url":null,"abstract":"The purpose of this case was to report a case of repeated dexamethasone intravitreal implant (Ozurdex; Allergan Inc., Irvine, CA, USA) migration into the anterior chamber without any corneal complications in a patient with cystoid macular edema. A 70-year-old male patient had decreased vision due to cystoid macular edema after scleral fixation of a dislocated intraocular lens in his right eye. He had repeated intravitreal bevacizumab injection but macular edema showed little improvement. Macular edema improved after intravitreal dexamethasone implantation but he needed repeated implantation since macular edema recurred as the therapeutic effect of the implant decreased. After the third implantation, 70 days later, the implant was observed in the anterior chamber, and the intraocular pressure (IOP) measured 46 mm Hg, while the cornea remained clear. We decided to have a close follow-up with IOP control since no corneal edema was seen. The implant was completely absorbed after 40 days with clear cornea and another intravitreal dexamethasone implantation was performed owing to increasing macular edema. The implant was seen in the anterior chamber again after 78 days but no corneal edema was seen and IOP was normal. After 1 month the implant was completely absorbed and intravitreal dexamethasone implantation was repeated. Migration of dexamethasone intravitreal implant may happen in a patient with posterior capsular defect but the treatment could be maintained under close observation in absence of corneal complications.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moon Ok Lee, Ji Hoon Lee, Chae Eun Kim, Jeong Yeon Kim
Monitored anesthesia care (MAC) has been used as a specific anesthesia service for diagnostic or therapeutic procedures performed under local anesthesia along with sedation and analgesia. Procedures such as trans arterial chemoembolization (TACE) or uterine artery embolization (UAE) performed in interventional radiology are typically accompanied by post-embolization syndrome (PES). While in TACE for hepatocellular carcinoma treatment, the severity of PES tends to be milder due to the liver’s dual blood supply, the degree is notably more severe in the case of UAE. Furthermore, the symptoms of PES after UAE procedure tend to follow a typical pattern. Most UAE patients do not develop pain until after the procedure has concluded. It is during the recovery period that patients frequently need significant doses of narcotics and analgesics to alleviate the pain. This report elucidates the application of MAC using dexmedetomidine in UAE, aimed to maintain adequate sedation during procedure and reduce severe pain after procedure.
监测麻醉护理（MAC）已被用作一种特定的麻醉服务，用于在局部麻醉以及镇静和镇痛下进行的诊断或治疗程序。介入放射学中进行的经动脉化疗栓塞术（TACE）或子宫动脉栓塞术（UAE）等手术通常会伴有栓塞后综合征（PES）。在治疗肝细胞癌的 TACE 中，由于肝脏具有双重血液供应，PES 的严重程度往往较轻，但在 UAE 中，PES 的程度明显更严重。此外，UAE 手术后的 PES 症状往往遵循一种典型的模式。大多数 UAE 患者直到手术结束后才会出现疼痛。在恢复期间，患者经常需要使用大剂量的麻醉剂和镇痛剂来缓解疼痛。本报告阐明了使用右美托咪定的 MAC 在 UAE 中的应用，目的是在手术过程中保持足够的镇静，并减轻术后的剧烈疼痛。
{"title":"Monitored Anesthesia Care Primarily Using Dexmedetomidine Provides Safe Sedation and Analgesic Effect in Uterine Artery Embolization: A Case Report","authors":"Moon Ok Lee, Ji Hoon Lee, Chae Eun Kim, Jeong Yeon Kim","doi":"10.15746/sms.23.014","DOIUrl":"https://doi.org/10.15746/sms.23.014","url":null,"abstract":"Monitored anesthesia care (MAC) has been used as a specific anesthesia service for diagnostic or therapeutic procedures performed under local anesthesia along with sedation and analgesia. Procedures such as trans arterial chemoembolization (TACE) or uterine artery embolization (UAE) performed in interventional radiology are typically accompanied by post-embolization syndrome (PES). While in TACE for hepatocellular carcinoma treatment, the severity of PES tends to be milder due to the liver’s dual blood supply, the degree is notably more severe in the case of UAE. Furthermore, the symptoms of PES after UAE procedure tend to follow a typical pattern. Most UAE patients do not develop pain until after the procedure has concluded. It is during the recovery period that patients frequently need significant doses of narcotics and analgesics to alleviate the pain. This report elucidates the application of MAC using dexmedetomidine in UAE, aimed to maintain adequate sedation during procedure and reduce severe pain after procedure.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare angiopathy inherited in an autosomal dominant manner. Because it manifests as nonspecific symptoms such as migraine with aura, ischemic stroke and transient ischemic attack, cognitive impairment, and dementia, the diagnosis may begin with a physician’s suspicion. Here, we describe a 69-year-old female patient with severe headaches and uncontrolled blood pressure at our emergency department and been diagnosed with CADASIL.
{"title":"A Patient with Severe Headache and Uncontrolled Blood Pressure in the Emergency Department: A Case Report","authors":"Hyun Noh","doi":"10.15746/sms.23.019","DOIUrl":"https://doi.org/10.15746/sms.23.019","url":null,"abstract":"Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare angiopathy inherited in an autosomal dominant manner. Because it manifests as nonspecific symptoms such as migraine with aura, ischemic stroke and transient ischemic attack, cognitive impairment, and dementia, the diagnosis may begin with a physician’s suspicion. Here, we describe a 69-year-old female patient with severe headaches and uncontrolled blood pressure at our emergency department and been diagnosed with CADASIL.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial dysalbuminemic hyperthyroxinemia (FDH) is the most common inherited cause of high serum total thyroxine (T4) levels in clinically euthyroid individuals. Mutant albumin coding gene (ALB) interferes free T4 assays and leads to discordant thyroid function tests. We describe a 19-year-old male harboring a heterozygous c.725G > A (p.Arg242His) variant using Sanger sequencing for his ALB, which is the second FDH case reported in South Korea. Appropriate genetic testing for subjects suspicious of FDH would prevent unnecessary repeat tests, although the prevalence of FDH is very low in the Asian population.
{"title":"Familial Dysalbuminemic Hyperthyroxinemia by Albumin Gene Variant (R242H) in a 19-Year-Old Male: A Case Report","authors":"Yoon Young Cho","doi":"10.15746/sms.23.018","DOIUrl":"https://doi.org/10.15746/sms.23.018","url":null,"abstract":"Familial dysalbuminemic hyperthyroxinemia (FDH) is the most common inherited cause of high serum total thyroxine (T4) levels in clinically euthyroid individuals. Mutant albumin coding gene (ALB) interferes free T4 assays and leads to discordant thyroid function tests. We describe a 19-year-old male harboring a heterozygous c.725G > A (p.Arg242His) variant using Sanger sequencing for his ALB, which is the second FDH case reported in South Korea. Appropriate genetic testing for subjects suspicious of FDH would prevent unnecessary repeat tests, although the prevalence of FDH is very low in the Asian population.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several cases of cardiac arrhythmia after coronavirus disease 2019 (COVID-19) vaccination have been reported in adults. However, the Centers for Disease Control and Prevention do not list cardiac arrhythmias as a possible side effect of the COVID-19 vaccines. A previously healthy 18-year-old man presented at the Soonchunhyang University Bucheon Hospital with complaints of palpitations, acute chest tightness, and dyspnea. Two days before presentation, he had received the COVID-19 vaccine, BNT162b2 (Comirnaty, Pfizer-BioNTech; Pfizer, New York, NY, USA). His vital signs were stable; however, physical examination revealed irregular heartbeats without a cardiac murmur. A 12-lead electrocardiography showed atrial fibrillation. The patient received several medications for 6 months, without improvement. Eventually normal sinus rhythm was restored with cardioversion. The patient has remained asymptomatic for 1 year. We report the case of an adolescent with atrial fibrillation after receiving a messenger RNA COVID-19 vaccine. Atrial fibrillation should be considered a cardiovascular side effect of the COVID-19 vaccine in adolescents.
{"title":"Atrial Fibrillation after COVID-19 Vaccination in an Adolescent: A Case Report","authors":"Min Kyu Seo, Sun Hyang Lee","doi":"10.15746/sms.23.012","DOIUrl":"https://doi.org/10.15746/sms.23.012","url":null,"abstract":"Several cases of cardiac arrhythmia after coronavirus disease 2019 (COVID-19) vaccination have been reported in adults. However, the Centers for Disease Control and Prevention do not list cardiac arrhythmias as a possible side effect of the COVID-19 vaccines. A previously healthy 18-year-old man presented at the Soonchunhyang University Bucheon Hospital with complaints of palpitations, acute chest tightness, and dyspnea. Two days before presentation, he had received the COVID-19 vaccine, BNT162b2 (Comirnaty, Pfizer-BioNTech; Pfizer, New York, NY, USA). His vital signs were stable; however, physical examination revealed irregular heartbeats without a cardiac murmur. A 12-lead electrocardiography showed atrial fibrillation. The patient received several medications for 6 months, without improvement. Eventually normal sinus rhythm was restored with cardioversion. The patient has remained asymptomatic for 1 year. We report the case of an adolescent with atrial fibrillation after receiving a messenger RNA COVID-19 vaccine. Atrial fibrillation should be considered a cardiovascular side effect of the COVID-19 vaccine in adolescents.","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Ji, Kyu Sik Kang, Y. Seo, H. Jung, H. Chun, Jeong Soo Choi
Objective: Agitation is a common symptom in children undergoing surgery, especially when surgeries are performed under sevoflurane and when patients undergo strabismus surgery. Because agitation can increase the risk of falls and lacerations on surgical sites and can delay discharge from the recovery room, adopting measures to reduce the incidence of agitation is essential. This study aimed to compare the agitation-reducing effects of lidocaine and esmolol administered individually or as a combination.Methods: We included 80 patients scheduled to undergo strabismus surgery. Thiopental and sevoflurane were administered to induce general anesthesia. Group EL received lidocaine (2 mg/kg) right after the end of surgery and esmolol (0.5 mg/kg) immediately after recovery from anesthesia after turning the anesthetic gas off; group L received lidocaine at 2 mg/kg right after the end of surgery and did not receive esmolol, group E did not receive lidocaine at the end of the surgery but received esmolol at 0.5 mg/kg right after recovery from anesthesia, and group C received neither esmolol nor lidocaine. Agitation severity was assessed using the objective pain score, Pediatric Anesthesia Emergence Delirium Scale immediately after recovery from anesthesia and until discharge from the recovery room.Results: Groups L and EL showed significantly lower agitation than groups E and C right after recovery from anesthesia, right after arrival to the recovery room, and 10 minutes after arrival to the recovery room (P < 0.05). Groups L and EL showed no differences in the reduction of the severity of agitation (P > 0.05).Conclusion: Compared to the groups without lidocaine administration, groups L and EL, which received 2 mg/kg lidocaine, showed a higher level of reduction in agitation immediately after recovery from anesthesia and right after arrival to the recovery room (P < 0.05).
目的：躁动是儿童接受手术时的常见症状，尤其是在七氟醚下进行手术和接受斜视手术时。由于躁动会增加跌倒和手术部位撕裂的风险，并会延迟从恢复室出院的时间，因此采取措施降低躁动发生率至关重要。本研究旨在比较利多卡因和艾司洛尔单独或联合用药对减少躁动的作用：我们纳入了 80 名计划接受斜视手术的患者。采用硫喷妥类和七氟醚诱导全身麻醉。EL组在手术结束后立即服用利多卡因（2 毫克/千克），并在麻醉气体关闭后立即服用艾司洛尔（0.5 毫克/千克）；L组在手术结束后立即服用利多卡因（2 毫克/千克），但未服用艾司洛尔；E组在手术结束后未服用利多卡因，但在麻醉恢复后立即服用艾司洛尔（0.5 毫克/千克）；C组既未服用艾司洛尔，也未服用利多卡因。在麻醉恢复后立即使用客观疼痛评分和小儿麻醉后谵妄量表评估躁动的严重程度，直至从恢复室出院：结果：L组和EL组在麻醉恢复后、到达恢复室后以及到达恢复室10分钟后的躁动程度明显低于E组和C组（P < 0.05）。L 组和 EL 组在减轻躁动严重程度方面没有差异（P > 0.05）：结论：与未服用利多卡因的组别相比，服用 2 毫克/千克利多卡因的 L 组和 EL 组在麻醉恢复后立即和刚到达恢复室后躁动程度的减轻程度更高（P < 0.05）。
{"title":"Comparison of the Agitation-Reducing Effects of Esmolol and Lidocaine in Pediatric Strabismus Surgery: A Double-Blind, Randomized Clinical Study","authors":"J. Ji, Kyu Sik Kang, Y. Seo, H. Jung, H. Chun, Jeong Soo Choi","doi":"10.15746/sms.23.010","DOIUrl":"https://doi.org/10.15746/sms.23.010","url":null,"abstract":"Objective: Agitation is a common symptom in children undergoing surgery, especially when surgeries are performed under sevoflurane and when patients undergo strabismus surgery. Because agitation can increase the risk of falls and lacerations on surgical sites and can delay discharge from the recovery room, adopting measures to reduce the incidence of agitation is essential. This study aimed to compare the agitation-reducing effects of lidocaine and esmolol administered individually or as a combination.Methods: We included 80 patients scheduled to undergo strabismus surgery. Thiopental and sevoflurane were administered to induce general anesthesia. Group EL received lidocaine (2 mg/kg) right after the end of surgery and esmolol (0.5 mg/kg) immediately after recovery from anesthesia after turning the anesthetic gas off; group L received lidocaine at 2 mg/kg right after the end of surgery and did not receive esmolol, group E did not receive lidocaine at the end of the surgery but received esmolol at 0.5 mg/kg right after recovery from anesthesia, and group C received neither esmolol nor lidocaine. Agitation severity was assessed using the objective pain score, Pediatric Anesthesia Emergence Delirium Scale immediately after recovery from anesthesia and until discharge from the recovery room.Results: Groups L and EL showed significantly lower agitation than groups E and C right after recovery from anesthesia, right after arrival to the recovery room, and 10 minutes after arrival to the recovery room (P < 0.05). Groups L and EL showed no differences in the reduction of the severity of agitation (P > 0.05).Conclusion: Compared to the groups without lidocaine administration, groups L and EL, which received 2 mg/kg lidocaine, showed a higher level of reduction in agitation immediately after recovery from anesthesia and right after arrival to the recovery room (P < 0.05).","PeriodicalId":22016,"journal":{"name":"Soonchunhyang Medical Science","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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