• Title/Summary/Keyword: Sedation complication

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Usefulness of Tunneled Trans-saphenous IVC Catheters for Long Term Venous Access in Pediatric Patients (소아환자에서 대복재정맥을 통한 하대정맥도관법의 유용성)

  • Kim, Seung-Hwan;Kim, Seong-Min;Oh, Jung-Tak;Han, Seok-Joo;Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.167-174
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    • 2006
  • Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

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Mortality rate undergoing anesthesia in Thoroughbred racehorses at Busan Race Park (부산경남경마공원 Thoroughbred 경주마의 마취중 치사율)

  • Yang, Jaehyuk;Park, Yong-Soo
    • Journal of Practical Agriculture & Fisheries Research
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    • v.17 no.1
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    • pp.125-132
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    • 2015
  • The report about equine anesthesias in Korea are very rare. This paper aimed at the mortality rate during anesthesia in Thoroughbred horses at Equine Hospital of Busan Race Park, KRA in South Korea from 2005 to 2010. Drugs used in anesthesia was IV injection of detomidine hydrochloride (0.01 mg/kg) or xylazine(0.5mg/kg) for sedation and premedication, Guaifenesin(50-100 mg/kg) for muscle relaxation, ketamine hydrochloride(2 mg/kg) for induction of anaesthesia and Inhalational isoflurane(1.3-1.5 %) to maintain anesthesia. Total number of anesthetic cases was 190, 150 of inhalational anesthesia and 40 of general anesthesia, repectively. The purpose of anesthesia was highest in the disorder of musculoskeletal system, followed by urogenital system and respiratory system Mortality case due to anesthesia was one during arthroscopic surgery for removal of osteochondral chip fragments. The time of anesthesia was 150 min, fatal sign was hypoxemia and the reason was improper machine operation of the anesthetist. In conclusion, the perianesthetic mortality rate during anesthesia in Thoroughbred horses at Busan Race Park was 0.52%(1 death per 190 anesthetics).