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Cardiac rupture is rare but potentially life-threatening complication after chest trauma. We present the case of a 57-year-old male who developed cardiac arrest because of extensive pericardial tamponade after a falling injury. We decided to perform an exploratory sternotomy in the operating room (OR). The patient was transported to the OR on extracorporeal membrane oxygenation (ECMO) support. We found a rupture of the coronary sinus after evacuation of an extensive hematoma in the pericardium and primarily repaired the injured site. After 2 days, the patient died due to refractory cardiogenic shock. To our knowledge, this is the first reported case of rupture of the coronary sinus after blunt chest trauma. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to compare the intravenous bolus effect of oxycodone and fentanyl on hemodynamic response after endotracheal intubation and postoperative pain in patients undergoing closed reduction of nasal bone fracture., Methods: In this prospective randomized double-blinded study, 64 patients undergoing closed reduction of nasal bone fracture were randomized into one of two groups: the fentanyl group (Group F) or the oxycodone group (Group O). Each drug (fentanyl 2 mcg/kg in Group F and oxycodone 0.2 mg/kg in Group O) was administered prior to the induction of general anesthesia. Hemodynamic changes after endotracheal intubation and postoperative pain were then measured in both groups., Results: There was no significant difference in the change in mean arterial pressure and heart rate between pre-induction and post-intubation in both Groups F and O (P > 0.05). Postoperative pain in Group O was milder than that in Group F (P < 0.001); however, time to awakening from the end of operation was shorter in Group F (P = 0.012)., Conclusion: In patients undergoing closed reduction of nasal bone fracture, oxycodone attenuates hemodynamic response to endotracheal intubation similar to fentanyl. However, oxycodone is more effective than fentanyl in improving postoperative pain., Trial Registration: Clinical Research Information Service (Trial registry number: KCT0001153 ) on 3 July, 2014.

Background: The purpose of this study was to evaluate the antinociceptive effect of black raspberry (Rubus occidentalis) fruit extract (ROE) in a rat model of chronic muscle pain and examine the mechanisms involved., Methods: Adult male Sprague-Dawley rats were used, and chronic muscle pain was induced by two injections of acidic saline into one gastrocnemius muscle. For the first experiment, 50 rats were randomly assigned to five groups. After the development of hyperalgesia, rats were injected intraperitoneally with 0.9 % saline or ROE (10, 30, 100, or 300 mg/kg). For the second experiment, 70 rats were randomly assigned to seven groups. Rats were injected intraperitoneally with saline, yohimbine, dexmedetomidine, prazosin, atropine, mecamylamine, or naloxone after the development of hyperalgesia. Ten minutes later, ROE (300 mg/kg) was administered intraperitoneally. For both experiments, the mechanical withdrawal threshold (MWT) was evaluated with von Frey filaments before the first acidic saline injection, 24 h after the second injection, and at 15, 30, 45, 60, 80, 100, and 120 min, 24 and 48 h after the drug administration., Results: Compared with the control group, the MWT significantly increased up to 45 min after injection of ROE 100 mg/kg and up to 60 min after injection of ROE 300 mg/kg, respectively. Injection of ROE together with yohimbine or mecamylamine significantly decreased the MWT compared with the effect of ROE alone, while ROE together with dexmedetomidine significantly increased the MWT., Conclusions: ROE showed antinociceptive activity against induced chronic muscle pain, which may be mediated by α2-adrenergic and nicotinic cholinergic receptors.

Background: The Streamlined Liner of the Pharynx Airway (SLIPA), a type of supraglottic airway, has a non-inflatable cuff that softens at body temperature to fit the laryngeal structure. We investigated whether pre-warming of SLIPA to body temperature may improve insertion parameters., Methods: Ninety adult patients were assigned equally randomized to either Group W or Group R. Anesthesia was induced using propofol, fentanyl, and rocuronium. In Group W, the SLIPA was warmed to 37 ° C before insertion, whereas in Group R, it was inserted at room temperature. The insertion time, oropharyngeal leak pressure, postoperative throat pain, blood staining, regurgitation, number of attempts at insertion, and difficulty of insertion were compared between the two groups., Results: The insertion time was shorter in Group W than in Group R (3.60 [3.15-4.06] s vs. 6.00 [4.45-7.50] s; P < 0.001). Oropharyngeal leak pressure from the time of insertion until 3 min after insertion was significantly higher in Group W than in Group R (P < 0.05). Postoperative throat pain, measured using the visual analog scale, was lower in Group W than in Group R (0.00 [0.00-2.50] vs. 2.00 [0.00-4.50]; P = 0.006). The difficulty of insertion was lower in Group W than in Group R (P < 0.004). There were no significant differences in terms of blood staining, regurgitation, and number of attempts., Conclusions: Pre-warming the SLIPA to body temperature has significant benefits compared to maintaining the device at room temperature. Specifically, insertion was easier, both insertion and fitting to the laryngeal structure could be performed more quickly, and the incidence of sore throat was reduced., Trial Registration: Clinical Research Information Identifier NCT01209000.

Background: Postoperative nausea and vomiting (PONV) is one of the most common postsurgical complications. Palonosetron, a 5-hydroxytryptamine receptor antagonist, is effective for PONV prevention. Herein, we compared palonosetron and aprepitant (a neurokinin-1 receptor antagonist) for PONV prevention in patients indicated for laparoscopic gynaecologic surgery., Methods: Ninety-three patients who were scheduled to undergo laparoscopic gynaecologic surgery under general anaesthesia were assigned to receive either a single intravenous injection of 0.075-mg palonosetron or 40-mg oral aprepitant in a double-blind randomised trial. The primary efficacy end points included complete response (visual analogue scale [VAS] nausea score <4 and no use of rescue therapy) 0-48 h after surgery. Nausea severity (0-10) and use of rescue therapy were monitored for 0-48 h. The secondary efficacy end points were the effect of aprepitant quantified using a 10-point VAS for pain, consumption of intravenous patient-controlled analgesia, and use of rescue analgesics., Results: Aprepitant was non-inferior to palonosetron in terms of complete response 0-48 hours after surgery (74% vs. 77%). At 0 and 2 h after administration, the nausea severity with 40-mg aprepitant was significantly lesser than that with 0.075-mg palonosetron (P < 0.05). At 6 and 24 h after administration, fentanyl consumption with 40-mg aprepitant was significantly lower than that with 0.075-mg palonosetron. Greater amounts of rescue analgesics were required in the aprepitant group., Conclusions: Palonosetron and aprepitant were both effective for PONV prevention in the patients indicated for laparoscopic gynaecologic surgery. The drugs can be used in combination for multimodal therapy because they bind to different receptors. More research is needed to evaluate the effects of aprepitant on pain management in humans.