Masui. The Japanese journal of anesthesiology
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Case Reports
[A case of acute pneumococcal meningitis treated with spinal drainage and vancomycin administration].
A 25-year-old woman complaining of general fatigue, headache, high fever, and nuchal rigidity, was admitted. She was diagnosed as pneumococcal meningoencephalitis after the cell culture of cerebrospinal fluid (CSF). Despite the administration of vancomycin (VCM), she fell into a coma without amelioration of the symptom. ⋯ The lumbar drainage at the L 4-5 level and the intrathecal administration of VCM were performed to improve the mal-circulation of CSF. After the procedure, the cell count of CSF showed a significant decrease and her consciousness level was recovered gradually. The patients with pneumococcal meningitis may occasionally require the lumbar drainage with the intrathecal administration of appropriate antibiotics, in case they fail to show response to the conventional therapy.
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A 62-yr-old man presented with intractable pain due to sciatic and iliac bone fractures with metastasis of carcinoma. We treated this symptom using epidural infusion of ropivacaine over 8 weeks. He developed no complications related to epidural infusion of ropivacaine. Continuous epidural infusion of ropivacaine is useful for the management of pain from invasive carcinoma.
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Acute changes in air temperature in the vicinity of the patents' forehead may impair clinical usefulness of the forehead deep-tissue thermometry. We thus investigated usefulness of monitoring the forehead deep-tissue temperature as an index of core temperature in 12 adult patients undergoing laparotomies in operating rooms with air-movement control system using vertical flow. ⋯ The forehead deep-tissue temperature has sufficient accuracy and precision for clinical use in operating rooms with air-movement control system using vertical flow. However, the core temperature appears to be slightly underestimated with the forehead deep-tissue thermometry.