Background: Sevoflurane is widely used to ambulatory pediatric anesthesia. But, sevoflurane is associated with a high incidence of emergence agitation in children. In this study, we examined the effect of single intravenous lidocaine prior to extubation on emergence agitation and cough in children undergoing adenotonsillectomy.Methods: All patients received a standardized anesthetic regimen with 2 3% sevoflurane in 50% O2/N2O after anesthetic induction with intravenous glycopyrrolate 0.004 mg/kg, thiopental 5 mg/kg and vecuronium 0.1 mg/kg. In a double-blinded trial, 120 children (3 9 years) were randomly assigned to receive normal saline 0.1 ml/kg (Group C), 1% lidocaine 1 mg/kg (Group L1) or 2% lidocaine 2 mg/kg (Group L2), at 1 min after beginning of spontaneous respiration. After extubation, the sedation score and the incidence of agitation and cough were recorded.Results: The incidence of agitation and cough in Group L1 and L2 were significantly less than Group C (P ＜ 0.05). At 5 min after arrival at postanesthetic care unit (PACU), more patients in Group L1 and L2 were in deeper sedation (the sedation score ≥ 2) than Group C. More patients in Group L1 were in deeper sedation than Group L2 and C at 10 min after arrival at PACU.Conclusions: We conclude that intravenous lidocaine prior to extubation reduces emergence agitation and cough after sevoflurane anesthesia in children undergoing adenotonsillectomy. (Korean J Anesthesiol 2007; 53: 458～62)

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Background: Radiographic modalities have been commonly used to evaluate pectus carinatum (PC), and compressive orthotic bracing is the most widely accepted treatment method. The aim of this study was to determine the efficacy of 3-dimensional (3D) body surface scanning as an alternative modality for the evaluation of PC. Methods: The medical records of 63 patients with PC who were treated with compressive orthotic bracing therapy between July 2017 and February 2019 were retrospectively analyzed. Using both 2-view chest radiography (posteroanterior and lateral view) and 3D body scanning, the height of maximal protrusion of the chest wall was measured both before and after 2 weeks of bracing therapy. The difference between the pre-and post-treatment measurements was calculated for both modalities, and these differences were compared and analyzed. Results: Based on the comparison between the pre-and post-treatment radiographs, bracing therapy produced favorable outcomes in all patients (p<0.001). The measurements obtained via 3D scanning were strongly correlated with those obtained via chest radiography (r=0.60). Conclusion: Based on the findings of this study, 3D body surface scanning appears to be an effective, radiation-free, and simple method for the post-treatment follow-up evaluation of PC, and thus can be considered an alternative to radiography.

Objectives: To date, there is no consensual definition of what constitutes a postoperative recurrence of primary spontaneous pneumothorax (PSP), despite there being many studies reporting a high incidence of recurrence. This study aims to describe the long-term recurrence rates of pneumothorax and to suggest a possible way to differentiate recurrence events based on temporal patterns. Methods: This single-center study retrospectively evaluated all postoperative recurrence of PSP from January 2007 to May 2019. Patients’ demographics, history of pneumothorax, radiologic data, surgical technique, and the time between operation and recurrence were analyzed. Univariate and multivariable analyses were conducted to find potential risk factors related to long-term recurrence. Results: Of the 77 postoperative recurrent cases of pneumothorax, 21 (27.2%) occurred within 30 days after surgery and, thus, were classified as early recurrences (ER), while the remaining cases were classified as late recurrences (LR). There was no difference in preoperative variables between the two groups. However, the rate of incidence of second recurrence (SR), which represented a long-term prognosis, was significantly higher in the LR group (28.6% vs. 4.8%, p = 0.030). On univariate and multivariable analyses, late recurrence was the only significant factor predicting later recurrence events. Conclusion: Postoperative recurrence (PoR) within 30 days had a lower SR rate. Therefore, it might not be a ‘true’ postoperative recurrence with a favorable prognosis. Further studies investigating postoperative recurrence based on temporal patterns would be warranted to improve the classification of PoR.