Yu-Chi Tsung - Academia.edu (original) (raw)

Papers by Yu-Chi Tsung

Acta Anaesthesiologica Taiwanica, Mar 1, 2016

PubMed, Mar 1, 2006

We report a case of prominent postoperative macroglossia after posterior fossa surgery in the pro... more We report a case of prominent postoperative macroglossia after posterior fossa surgery in the prone position. The potential risk factors predisposing to its generation, prophylactic measures to avoid it and treatments for its alleviation are reviewed and discussed.

Anesthesia & Analgesia, Jun 1, 2008

BACKGROUND: Pruritus is the most common side effect of intrathecal morphine. Gabapentin is an ant... more BACKGROUND: Pruritus is the most common side effect of intrathecal morphine. Gabapentin is an anticonvulsant and had been reported to be effective in some chronic pruritus conditions. Its effect in intrathecal morphine-induced pruritus has not yet undergone an evaluation. METHODS: We randomly allocated 86 patients scheduled for lower limb surgery under spinal anesthesia into two equal groups that received either gabapentin 1200 mg or placebo 2 h before operation in a prospective, double-blind manner. All patients received an intrathecal injection of 15 mg of 0.5% isobaric bupivacaine and 0.2 mg preservative-free morphine. Pruritus was evaluated at 3, 6, 9, 12, and 24 h after intrathecal morphine administration. RESULTS: The incidence of pruritus was significantly more frequent in the placebo group compared with the gabapentin group (77.5% vs 47.5%; P ϭ 0.01). The onset time of pruritus in the gabapentin group (6.2 Ϯ 1.8 h) was significantly delayed compared with that in the placebo group (3.1 Ϯ 0.8 h) (P Ͻ 0.0001). The severity of pruritus was significantly more in the placebo group compared with the gabapentin group at 3 and 6 h after intrathecal morphine injection. CONCLUSION: Preoperative gabapentin prevents pruritus induced by intrathecal morphine in patients undergoing lower limb surgery with spinal anesthesia.

BJA: British Journal of Anaesthesia, Nov 1, 2008

Background. Activation of the serotonergic system is an important factor in the pathogenesis of i... more Background. Activation of the serotonergic system is an important factor in the pathogenesis of intrathecal morphine-induced pruritus. Mirtazapine is a new antidepressant that selectively blocks 5-HT 2 and 5-HT 3 receptors. We therefore tested the hypothesis that preoperative mirtazapine would reduce the incidence of intrathecal morphine-induced pruritus. Methods. One hundred and ten ASA I patients undergoing lower limb surgery under spinal anaesthesia were randomly allocated into two equal groups and received either mirtazapine 30 mg or an orally disintegrating placebo tablet 1 h before operation in a prospective, doubleblinded trial. All patients received an intrathecal injection of 15 mg of 0.5% isobaric bupivacaine and 0.2 mg preservative-free morphine. The occurrence and the severity of pruritus were assessed at 3, 6, 9, 12, and 24 h after intrathecal morphine. Results. Pruritus was significantly more frequent in the placebo group compared with the mirtazapine group (75% vs 52%, respectively; P¼0.0245). The time to onset of pruritus in the two groups was also significantly different. The patients who experienced pruritus in the placebo group had a faster onset time than that in the mirtazapine group [mean (SD): 3.2 (0.8) vs 7.2 (4.1) h, P,0.0001]. Conclusions. Mirtazapine premedication prevents pruritus induced by intrathecal morphine in patients undergoing lower limb surgery with spinal anaesthesia.

Inflammation, Jan 28, 2016

Inflammation following hemorrhagic shock/resuscitation (HS/RES) induces acute lung injury (ALI). ... more Inflammation following hemorrhagic shock/resuscitation (HS/RES) induces acute lung injury (ALI). Dimethyl sulfoxide (DMSO) possesses anti-inflammatory and antioxidative capacities. We sought to clarify whether DMSO could attenuate ALI induced by HS/RES. Male Sprague-Dawley rats were allocated to receive either a sham operation, sham plus DMSO, HS/RES, or HS/RES plus DMSO, and these were denoted as the Sham, Sham + DMSO, HS/RES, or HS/RES + DMSO group, respectively (n = 12 in each group). HS/RES was achieved by drawing blood to lower mean arterial pressure (40-45 mmHg for 60 min) followed by reinfusion with shed blood/saline mixtures. All rats received an intravenous injection of normal saline or DMSO immediately before resuscitation or at matching points relative to the sham groups. Arterial blood gas and histological assays (including histopathology, neutrophil infiltration, and lung water content) confirmed that HS/RES induced ALI. Significant increases in pulmonary expression of ...

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists, 2016

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists, 2007

Traumatic intubation, reintubation, intubation with endotracheal tube of inappropriate size, and ... more Traumatic intubation, reintubation, intubation with endotracheal tube of inappropriate size, and failure to firmly secure the tube may contribute to the development of subglottic stenosis. Systemic factors such as sepsis, hypotension, autoimmune and granulomatous disorders have all been implicated as contributing causes. In addition, a risky circumstance that might be considered important in the development of airway damage is the occurrence of gastreoesophageal reflux (GER), particularly in thoracotomy operations, where the patients are placed in the lateral position. The purpose of this report is to describe a patient who developed subglottic stenosis following a thoracotomy. The possible causes are macrotrauma due to multiple intubations and microtrauma due to inappropriate tube size in the course of anesthesia. Furthermore, GER may worsen mucosal injuries, which may be precipitated by the lateral position.

Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists, 2006

Anesthesia & Analgesia, 2008