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Background: Shivering associated with spinal anesthesia is uncomfortable to the patient and may interfere the monitoring of patient. Hence, we have investigated whether intrathecal meperidine could decrease the incidence and intensity of shivering during spinal anesthesia for unilateral herniorrhaphy.Methods: Forty ASA class 1 or 2 patients undergoing unilateral herniorrhaphy were randomly allocated into two groups (group C and M). The patients of group C (n = 20) received hyperbaric bupivacaine (0.5%; 13 mg) and normal saline (0.004 ml/kg), and the patients of group M (n = 20) received hyperbaric bupivacaine (0.5%; 13 mg) and meperidine (0.2 mg/kg). After spinal block, the incidence and intensity of shivering were determined objectively by observing involuntary muscle activity. The measurement of the mean arterial pressures and heart rates of the patients, for every two minutes for ten minutes, and subsequently for every five minutes for thirty minutes were carried out. We have also checked the highest sensory block level, and other side effects.Results: There were no significant differences in age, height, weight and duration of surgery between the two groups. Also, the mean arterial pressures, heart rates, and the highest sensory block levels exhibited no differences between the two groups. But, the incidence and intensity of shivering in group M were significantly less than in group C (P ＜ 0.05).Conclusions: Intrathecal meperidine (0.2 mg/kg) was effective in reducing the incidence and intensity of shivering associated with spinal anesthesia for herniorrhaphy. (Korean J Anesthesiol 2005; 49: 484∼9)

ObjectiveInvestigation of initial 51 cases of single port access (SPA) laparoscopic surgery for large adnexal tumors and evaluation of safety and feasibility of the surgical technique.MethodsWe retrospectively reviewed the medical records of the first 51 patients who received SPA laparoscopic surgery for large adnexal tumors greater than 10 cm, from July 2010 to February 2015.ResultsSPA adnexal surgeries were successfully completed in 51 patients (100%). The mean age, body mass index of the patients were 43.1 years and 22.83 kg/m2, respectively. The median operative time, median blood loss were 73.5 (range, 20 to 185) minutes, 54 (range, 5 to 500) mL, and the median tumor diameter was 13.6 (range, 10 to 30) cm. The procedures included bilateral salpingo-oophorectomy (n=18, 36.0%), unilateral salpingo-oophorectomy (n=14, 27.45%), and paratubal cystectomy (n=1, 1.96%). There were no cases of malignancy and none were insertion of additional ports or conversion to laparotomy. The cases with intraoperative spillage were 3 (5.88%) and benign cystic tumors. No other intraoperative and postoperative complications were observed during hospital days and 6-weeks follow-up period after discharge.ConclusionOur results suggest that SPA laparoscopic surgery for large adnexal tumors may be a safe and feasible alternative to conventional laparoscopic surgery.