Biomedical subjects

Jie Ae Kim

Publications and source records attributed to Jie Ae Kim.

5 recordsLinked to original sources

PubMed2006

Preoperative predictors of difficult intubation in patients with obstructive sleep apnea syndrome.

PURPOSE: It has been speculated that the severity of obstructive sleep apnea syndrome (OSAS) is related to difficult intubation. However, this has not been confirmed in OSAS patients. Thus, we undertook a retrospective study to assess this relationship in patients who had undergone uvulopalatopharyngoplasty (UPPP) surgery for OSAS. METHODS: A retrospective case-control study was undertaken following approval from the Institutional Review Board on human studies. The data from 90 patients with a polysomnograph-confirmed diagnosis of OSAS, who had undergone UPPP surgery under general anesthesia, were used to evaluate the apnea-hypopnea index (AHI), the preoperative lowest arterial saturation, the occurrence of difficult intubation as assessed by the operator intubation difficulty scale score, extubation time, lowest arterial saturation in postanesthesia care unit, and length of stay in postanesthesia care unit. We compared OSAS patients with 90 age and sex-matched control patients with respect to the prevalence of difficult intubation. RESULTS: The prevalence of difficult intubation was higher in the OSAS group than in the control group (16.7% vs 3.3%, P = 0.003). When evaluating the OSAS group according to the occurrence of difficult intubation, AHI was significantly higher in the difficult intubation subgroup (67.4 +/- 22.5 vs 49.9 +/- 28.0, P = 0.026), and patients with an AHI >or= 40 showed a significantly higher prevalence of difficult intubation. CONCLUSION: This study shows that the occurrence of difficult intubation can be predicted using AHI in patients who undergo UPPP surgery for OSAS.

Adult↗

PubMed2005

Thoracic epidural anesthesia does not improve the incidence of arrhythmias after transthoracic esophagectomy.

OBJECTIVE: The incidence of arrhythmias related to an esophagectomy is high, and its clinical significance has been well accepted. Thoracic epidural anesthesia (TEA) can modulate the sympathetic tone and neuroendocrine responses associated with major operation. This study was aimed to evaluate the effects of TEA on the incidence of arrhythmias in transthoracic esophagectomy patients. METHODS: The records of 185 patients who underwent the Ivor-Lewis operation between 2001 and 2004 by the same operator were reviewed. The patients were divided into three groups. Group 1 (n = 58) received post-operative intravenous patient-controlled analgesia without TEA. Group 2 (n = 55) received postoperative epidural patient-controlled analgesia using local anesthetics. The patients of group 3 (n = 72) were anesthetized intra-operatively by the combination technique of thoracic epidural bupivacaine and inhalation agents, and post-operative pain control was done in the same way with group 2. RESULTS: Arrhythmias occurred 29.3, 50 and 29.2% in groups 1, 2 and 3, respectively. There were no statistical differences in the incidences of arrhythmias among the three groups. CONCLUSIONS: This result shows that TEA was not beneficial to reduce the incidence of arrhythmias in the transthoracic esophagectomy patients.

Aged↗

PubMed2005

Hypobaric spinal anesthesia with 0.2% tetracaine for total joint hip arthroplasy.

PURPOSE: Hypobaric local anesthetics for total hip replacement (THR) have potential advantages related to body position and differential block. However, the dose requirements of hypobaric local anesthetics for THR have not been clearly established. Therefore, we undertook a dose-response study of hypobaric tetracaine for THR. METHODS: In a randomized, controlled, and double-blinded manner, three groups of 20 patients each undergoing THR received spinal anesthesia using either 10, 12, or 14 mg of 0.2% hypobaric tetracaine in a lateral decubitus position, with the operated side up. Adequate anesthesia was defined as: 1) upper sensory block between T10 and T4; 2) motor block of modified Bromage scale 2 or 3; and 3) time to sensory remission to the L2 level of more than three hours. RESULTS: The number of patients who achieved adequate sensory and motor block levels was similar amongst the three groups. However, all patients who received 14 mg had a sensory remission time to L2 of more than three hours while only 30% of the patients in the 12 mg group and no patient in the 10 mg group had the same remission time. A significant differential block was observed between the non-dependent and the dependent sides, but the degree of differential block was not different between the groups. CONCLUSION: 10 to 14 mg of 0.2% hypobaric tetracaine achieved similar and adequate block levels, but different regression times. To ensure complete sensory block duration for THR, we recommend using 14 mg of 0.2% hypobaric tetracaine.

Adult↗

PubMed2005

Predictive factors of immediate postoperative complications after uvulopalatopharyngoplasty.

OBJECTIVES/HYPOTHESIS: This study was performed to assess the relationships between polysomnographic data, including the level of obstruction inducing apnea, and immediate postoperative complications or oxygen saturation in patients who had undergone uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea syndrome (OSAS). STUDY DESIGN: Retrospective study. METHODS: Using the data of 90 patients with a polysomnography-confirmed diagnosis of OSAS who had undergone UPPP surgery with/without tonsillectomy under general anesthesia, we determined apnea-hypopnea indices (AHI), preoperative lowest arterial saturation (LSAT-PREOP) levels, percentages of obstruction at the upper level of the uvula during apnea (AL-U), need for an airway in the postanesthesia care unit (PACU) or during the first postoperative night in a ward (POPN1), LSAT- PACU, LSAT-POPN1, and the incidence of postoperative bleeding or other complications. RESULTS: Postoperative complications developed in 19 (21.1%) of the 90 patients, airway-related complications in 5 (5.6%), oxygen desaturation in 8 (8.9%), excessive or recurrent bleeding in 7 (7.8%), and a postoperative electrocardiogram change in 1(1.1%). Patients with postoperative complications had higher AHI (68.1 vs. 49.3, P = .008), lower LSAT-PREOP (71.1 vs. 77.8, P = .012), and lower AL-U (24.2 vs. 57.4, P = .005) than those without. After UPPP surgery, LSAT-POPN1 improved more than LSAT-PREOP (94.4 vs. 76.2%, P = .03), and LSAT-POPN1 correlated with LSAT-PREOP (r = 0.274, P = .014) and AL-U (r = 0.286, P = .046). CONCLUSIONS: This study shows that immediate postoperative complications and oxygen saturation are associated with OSAS severity and the level of obstruction, inducing apnea in those who have undergone UPPP for OSAS.

Adult↗

PubMed2005

A korean predictive model for postoperative nausea and vomiting.

Postoperative nausea and vomiting (PONV) is one of the most common and distressing complications after surgery. An identification of risk factors associated with PONV would make it easier to select specific patients for effective antiemetic therapy. We designed a case-controlled study to identify the risk factors for PONV in 5,272 surgical patients. At postoperative 2 and 24 hr, patients were visited and interviewed on the presence and severity of PONV. Thirty nine percent of patients experienced one or more episodes of nausea or vomiting. Five risk factors were highly predictive of PONV: 1) female, 2) history of previous PONV or motion sickness, 3) duration of anesthesia more than 1 hour, 4) non-smoking status, and 5) use of opioid in the form of patient controlled analgesia (PCA), in the order of relevance. The formula to calculate the probability of PONV using the multiple regression analysis was as follows: P (probability of PONV)=1/1+e(-Z), Z=-1.885+0.894 (gender)+0.661 (history)+0.584 (duration of anesthesia)+0.196 (smoking status)+0.186 (use of PCA-based opioid) where gender: female=1, male=0; history of previous PONV or motion sickness: yes=1, no=0; duration of anesthesia:more than 1 hr=1, less than or 1 hr=0; smoking status: no=1, yes=0; use of PCA-based opioid: yes=1, no=0.

Anesthesia↗