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Purpose Despite the many benefits of percutaneous thoracic sympathectomy, it also has serious complications such as pneumothorax. This study was conducted in order to determine the safe percutaneous entering window and angles for the needle during T2 and T3 thoracic sympathectomy avoiding pneumothorax. Methods Transverse section of CT images that crosses at the middle of the T2 or T3 vertebral body was selected. Medial and lateral imaginary lines were drawn from the dorsoventrally midpoint on the lateral surface of the vertebral body (v) to the skin. The medial one was drawn to the skin medially as much as possible tangent to the vertebral body (vM). The lateral one was drawn to the skin tangent to parietal pleura (vL). c was defined as the point where the midsagittal line meets the skin. The distance cM and cL, the angle aM and aL made between the midsagittal line and vM or vL lines were measured. To determine the relations between patients' covariates and measured data, mixed-effect population analysis was performed for the cL, aL, and vL. Results In males, the mean values of cL were 85.3 and 79.2 mm for T2 and T3, respectively. In females, they were 71.5 and 63.7 mm for T2 and T3, respectively. Population analysis revealed that cL was best described with age, weight, gender covariates, and interindividual variability. The aL was best described with BMI and gender covariates. Conclusions The covariates' relationship and interindividual variability resulting from the mixed-effect analysis enhanced individual prediction for safe widows., Author(s): Do Won Lee[sup.1] [sup.2] , Jung Min Hong[sup.1] [sup.2] , Boo Young Hwang[sup.1] [sup.2] , Tae Kyun Kim[sup.1] [sup.2] , Eun Soo Kim[sup.1] [sup.2] Author Affiliations: (1) Department of [...]

Purpose This prospective, double-blind, placebo-controlled study was designed to determine the efficacy of nitrous oxide ([N.sub.2]O) in alleviating the pain that followed sequential injection of propofol and rocuronium. Methods A total of 205 adult patients (age, 18-68 years) received one of the following combinations: NaCl and 100% [O.sub.2] (group C); 0.5 mg/kg lidocaine and 100% [O.sub.2] (group L); NaCl and a mixture of 67% [N.sub.2]O / [O.sub.2] (group N); or 0.5 mg/kg lidocaine and a mixture of 67% [N.sub.2]O/[O.sub.2] (group LN). Vein occlusion was released after 1 min, and 5 ml propofol was injected over 10 s. Pain was evaluated on a visually enlarged, laminated, numeric rating (0-10) scale. The remainder of the induction dose of propofol (with a 3-ml bolus of normal saline and 0.6 mg/kg rocuronium) was then injected. The response to the rocuronium injection was assessed with a four-point scale (0-3). Results The incidence and severity of pain from the propofol injection in groups L, N, and LN were significantly lower than those in group C (P < 0.001). Frequency and intensity of the withdrawal response were significantly less in groups N and LN than in groups C and L (no response, P < 0.001; severe response, P < 0.001). Conclusions Pretreatment with inhaled [N.sub.2]O can reduce the pain associated with propofol and rocuronium injection. Moreover, [N.sub.2]O (with or without lidocaine) is more effective than lidocaine alone in reducing rocuronium-related withdrawal reactions associated with sequential injection of propofol and rocuronium. Keywords Nitrous oxide * Pain * Propofol * Rocuronium, Introduction Propofol is a popular anesthesia induction drug because of its quick onset of action and smooth recovery. Rocuronium is an amino-steroidal, nondepolarizing muscle relaxant with an intermediate duration of [...]