Search PubMed⌕ Search

Biomedical subjects

T T Wei

Publications and source records attributed to T T Wei.

At least 37 records · Page 2Linked to original sources
PubMed1992

Is routine preanesthetic hemoglobin test necessary in minor pediatric surgery?

The value of preanesthetic assessment of anemia and analysis of the hemoglobin level prior to a minor pediatric surgery has been recently questioned in some reports. This study was to retrospectively analyse 8859 pediatric patients who underwent minor surgery in the period from January 1987 to December 1990 in our hospital. They were all ASA class I-II in physical status with age ranging from one month to 19 years. Those patients with their hemoglobin values determined at other laboratories or hospitals in spite of our recognition and those suspected of having an immune or oncologic disease were excluded from this study. The mean hemoglobin value of the patients under study was 12.99 +/- 0.82 g/dl. 0.62% of the patients (55) were found to have hemoglobin values less than 10 g/dl which were similar to the results obtained by Wood et al (0.7%) in 1981 and Roy et al (0.5%) in 1990. Among the 55 anemic patients, 41 (74.5%) were at the age between 2 to 4 months (within the physiologic anemic period of infancy). Sampling of blood for routine preanesthetic hemoglobin determination which caused discomfort and pain was often rejected by pediatric patients and struggle for escape also upset the children very much. Based on the results from our analysis, we suggest that in healthy pediatric patient scheduled for minor surgery routine hemoglobin test could be excluded. Hemoglobin test is selectively performed in a patient is anemic or under suspicious circumstances. The value and shortcomings of selective hemoglobin test before surgery require further evaluation.

Adolescent↗
PubMed1992

[Intramuscular meperidine for the prevention of shivering in spinal anesthesia].

Intravenous meperidine 25mg has been employed effectively to treat shivering following regional anesthesia and general anesthesia. The study was designed to evaluate the effectiveness of intramuscular meperidine for the prevention of shivering in spinal anesthesia. The series consisted of 60 patients who were divided into 2 groups with 30 patients in each, undergoing lower abdominal or lower extremity surgery. All patients were given diazepam 0.1mg/kg i.v. for anxiolysis when they came to the operating room. In a double blind and randomized fashion, patients in the study (meperidine) group received meperidine 25mg IM (= 0.5ml). In the control group 0.9% N/S 0.5ml IM was given instead. All patients received spinal anesthesia 15 minutes later. Measurement of the levels of sensory loss to pinprick was made. The ambient temperature and the rectal temperature were continuously monitored to evaluate the effect of the change in body temperature on shivering during operation. The degree and the occurrence of shivering were carefully evaluated and recorded by a blind-trust observer. There was no significant difference in maximal analgesic level, ambient temperature and change of rectal temperature during operation between the groups. Shivering occurred in 17 patients (56.7%) in the saline group with an onset time of 7.9 +/- 2.5min following spinal anesthesia. In the meperidine group, shivering occurred only in 3 patients (10%) with an onset time of 54 +/- 29.5min after spinal anesthesia. There was a significantly lower incidence of shivering in the meperidine group than in the saline group (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1991

[Clinical assessment of laryngeal mask airway in general anesthesia with spontaneous breathing].

The laryngeal mask airway (LMA) is a new form of oropharyngeal airway that provides an alternative to endotracheal intubation and face mask anesthesia in certain cases. Once the patient is adequately anesthetised, it can be inserted blindly without recourse to laryngoscopy. The advantages over standard mask anesthesia are: better airway control, minimal leakage of anesthetic gases, and it frees the anesthetist's hands, as no mandibular support is needed. LMA does not guarantee against the risk of aspiration and it is not recommended for use in patients who may have risk of gastric regurgitation. Our preliminary study revealed that a clear and clinical satisfactory airway was obtained in 98.2% of patients. According to the intraoperative respiratory minute volume and arterial blood gases, the patency of the airway did not deteriorate during the course of the anesthesia. Blood pressure and heart rate were compared on induction in group I and II. Succinylcholine 1 mg/kg, thiopentone 4-6 mg/kg and fentanyl 2 micrograms/kg were used in group I while using the same dosage of succinylcholine and thiopentone without fentanyl for group II. We found no significant differences in vital signs between the two groups.

Anesthesia, General↗
PubMed1991

[Changes in arterial pressure and heart rate during laryngeal mask insertion in hypertensive patients: comparison with endotracheal intubation].

The pressor response associated with laryngoscopy and endotracheal intubation may be harmful to patients with ischemic heart disease, hypertension or cerebrovascular disease. The Brain laryngeal mask airway can be inserted blindly and avoid the need for laryngoscopy. Our preliminary study compared the pressor response of tracheal intubation (T group) with that of laryngeal mask insertion (L group) in 19 and 33 hypertensive patients respectively. We also divided the patients of L group into sub-groups I (n = 16) and II (n = 17). All patients in T group and sub-group I were induced with fentanyl, thiopentone and succinylcholine while in subgroup II patients were induced with the same dosage of thiopentone and succinylcholine without fentanyl. The changes of blood pressure and heart rate exhibited a similar but attenuated pattern of response with laryngeal mask insertion in comparison with tracheal intubation. We also found no significant difference in pressor response between sub-group I and sub-group II in L group. In sum, laryngeal mask insertion may therefore offer some advantages over tracheal intubation in the anesthetic management of hypertensive patients in whom less pressor response is of particular concern.

Adult↗
PubMed1991

[Surgical and anesthetic mortality in Mackay Memorial Hospital 1988-1989].

The mortality associated with 52128 anesthetics administered over two years (1988-1989) at Mackay Memorial Hospital, Taipei, was reported. The frequency of death to which anesthesia contributed was 0.4/10000 (2 cases in 52128 anesthetics). The total mortality rate from surgery within one week was 0.2% (105 cases in 52128 anesthetics). Anesthetic deaths were responsible for 1.9% of the total mortality. There were 25 cases of cardiac arrest with 18 fatal cases (7 cases were recovered after cardiopulmonary resuscitation). The causes of cardiac arrest during anesthesia included anesthetic factors (24%), surgical factors (24%) and patients' pathological factors (52%).

Anesthesia↗
PubMed1990

[Does flumazenil antagonize the anesthetic effect of ketamine, etomidate or thiopental?].

The effect of flumazenil, a benzodiazepine antagonist, was assessed in a random, double-blind clinical study in which each of the four groups of surgical outpatients comprising 20 in each was given either ketamine 100 mg (K), etomidate 20 mg (E), thiopental 300 mg (T) or flunitrazepam 4 mg (F) for induction of anesthesia. On emergence, patients in each group were randomly given 2cc of either 2 coded solutions, one of which contained 0.2 mg flumazenil and the other of which was normal saline. Following injection of coded solution, all patients were assessed at 0, 5, 15, 30, 60 and 120 min for wakefulness. All 10 patients of group F who received flumazenil were alert and able to recall at 5 min, whereas in group T this was noted from 15 to 30 min. Patients of group E and K responded alike in a manner as of those who received normal saline placebo with onset of wakefulness at 30 and 60 min respectively. These results confirm that flumazenil antagonizes flunitrazepam (within 5 min) and also indicate that the antagonizing effect occurs 30 min following injection for thiopental, suggestive of some cross-reactivity between these two drugs.

Adult↗
PubMed1990

[The effect of epidural anesthesia on tourniquet pain: a comparison of 2% lidocaine and 0.5% bupivacaine].

The incidence of tourniquet pain was evaluated in two groups of patients with 20 each undergoing orthopedic surgery of the lower extremities during epidural anesthesia using plain solution of either 2% lidocaine or 0.5% bupivacaine. The drugs were administered in a randomized fashion. Measurement of the levels of sensory loss to pinprick and incidence of tourniquet pain were made by blind-trust. The maximum analgesia level, time between 1st injection and onset of pain, time between tourniquet inflation and onset of pain were recorded similarly in both groups of patients. The incidence of tourniquet pain was significantly greater in patients given 2% lidocaine (40%) than in patients given 0.5% bupivacaine (10%). The incidence of pain was not related to the time of tourniquet inflation, because patients in the bupivacaine group had a significant longer duration of tourniquet inflation than did patients in the lidocaine group. The incidence of pain was also not related to tachyphylaxis, because 7 of 8 patients who complained tourniquet pain in lidocaine group received less than 3 injections for maintenance of analgesia when tourniquet pain started. In summary, it is apparent that tourniquet pain occurs less frequently when bupivacaine is employed for epidural anesthesia as compared to lidocaine.

Adult↗
PubMed1990

[Studies on the alkaloids of Gynura segetum (Lour.) Merr].

Six alkaloids were isolated from Gynura segetum (Lour.) Merr. Four of them were identified. Alkaloids I and II were identified as known senecionine and seneciphylline, respectively. Alkaloids III and IV were found to be new compounds named seneciphyllinine and (E)-seneciphylline respectively. Their structures were confirmed on the basis of spectral data (UV, IR, MS, 1HNMR, 13CNMR, C-H COSY).

Chemical Phenomena↗
PubMed1989

[Comparative study of the antagonizing effect to flunitrazepam between Ro 15-1788 and physostigmine].

In a double blind, randomized, placebo-controlled study, thirty patients who had received flunitrazepam during operation were divided into three groups. At the end of surgery, one group was given a placebo, one group was given Ro 15-1788 (Benzodiazepine antagonist) and a third group was given physostigmine. Each group was assessed at the end of 5 minutes, 15 minutes, 30 minutes 60 minutes and 120 minutes for alertness/sedation, recall, recognition and motor coordination. At the end of 5 and 15 minutes, the patients who had received Ro 15-1788 showed a statistically significant difference in alertness/sedation from those in the other two groups (p less than 0.01). This group also showed a statistically significant difference in motor coordination at the end of 5 minutes (p less than 0.05). There was no significant difference in recognition or recall at anytime. Physostigmine showed no significant difference change from the control group at anytime in every aspect. In conclusion, Ro 15-1788 is an effective antagonist to the alertness/sedation of flunitrazepam, but physostigmine is not.

Adult↗
PubMed1989

The optimal dose of hyperbaric tetracaine spinal anesthesia for cesarean section.

Seventy-five term parturients undergoing cesarean section were anesthetized with 9 mg, 12 mg, 15 mg and 18 mg of tetracaine in 1.5 cc of 10% using a standardized spinal anesthetic technique. The four groups were compared for their maximal spread of anesthesia, quality of analgesia, incidence of hypotension, mgs of ephedrine used to correct hypotension, and the Apgar scores of the infant. It was found that maximal segmental spread of analgesia for 9 mg. 12 mg and 15 mg groups were not different significant regardless of height or weight. But with the 18 mg-group there was significant excessive spread of analgesia. While there was no difference in maximal spread of analgesia, there was a progressive increase in good quality of analgesia with increasing dosages. There were 67%, 81%, 96%, 100% of the patients had good analgesia for their operation in the four respective group. The percentages of hypotension were significanly more in the 15 mg and 18 mg groups. However, we did not find the hypotension in the 15 mg and 18 mg group need more ephedrine to correct than the lower dosages. In addition, all babies had good Apgar scores and there was no statistical difference among the four groups.

Adult↗
PubMed1989

[Anesthetic considerations in complete obstruction of major veins of upper trunk--report of two cases].

This article presents two cases about complete obstruction of major veins of upper trunk. One was a 45 year-old woman who suffered from complete obstruction of superior vena cava due to bronchogenic carcinoma. Venous bypass grafting from left innominate vein to right atrium was performed. The other was a 41 year-old man. Both of his right and left, internal and external jugular veins were completely obstructed after radical laryngectomy and radiotherapy due to hypopharyngeal carcinoma. Venous bypass grafting from cerebral transverse sinus to right atrium was performed. In both cases, general anesthesia with neurosurgical anesthetic concepts were performed with continuous blood pressure monitoring, CVP monitoring, pulse oximetry, end-tidal CO2 monitoring, blood gas analysis, urine output and EKG monitoring. The outcome was satisfactory in both cases.

Adult↗