Masui. The Japanese journal of anesthesiology
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A 74-year-old man was scheduled for coronary artery bypass graft surgery with cardiopulmonary bypass. After intravenous heparin (200 U.kg-1), the activated clotting time (ACT) increased from 124 to 436 sec. However, it decreased to 128 sec immediately after cardiopulmonary bypass. ⋯ Several recent articles have reported that heparin resistance was corrected with antithrombin III concentrates, fresh frozen plasma, or argatroban. In this case, these drugs could not be used because the mechanism of heparin resistance remains uncertain. Thus, the off-pump technique is useful for unknown heparin resistance.
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A 69-yr-old man underwent emergency laparotomy. He was in endotoxic shock. Preoperative evaluation including a full blood count, chest X-ray and ECG were normal. ⋯ He was discharged from the ICU on the 12th postoperative day. Postoperative Holter ECG and echocardiography showed no abnormalities. It is likely that stimulation of the trachea triggered vagovagal reflex and propofol prolonged AV conduction, causing the AV block.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Postoperative delirium after general anesthesia vs. spinal anesthesia in geriatric patients].
Influence of the type of anesthesia on postoperative delirium was examined in geriatric patients with femoral neck fracture. ⋯ The type of anesthesia, general or spinal, does not affect the postoperative delirium in geriatric patients with femoral neck fracture.
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Randomized Controlled Trial Clinical Trial
[Spinal anesthesia using hyperbaric bupivacaine HCl for cesarean section].
We performed this prospective study to determine the proper amount of hyperbaric bupivacaine hydrochloride as a spinal anesthetic agent for cesarean section. ⋯ 1. As a spinal anesthetic agent for cesarean section, hyperbaric bupivacaine is superior to tetracaine. 2. Hyperbaric bupivacaine 10 mg, 12.5 mg or 15 mg can be used safely and effectively as a spinal agent for cesarean section. 3. High dose bupivacaine is recommended in an urgent case, and low dose bupivacaine is recommended when maternal hypotension must be strictly avoided.
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A 73-year-old female complained of pain in the right lower-abdomen and medial aspect of the distal thigh after a gynecological operation. Computer tomography and MRI findings excluded obturator canal herniation or lumbar plexopathy. ⋯ Treatment with radio-frequency lesion of 50 degrees C for 60 seconds of the right obturator nerve relieved her pain for 9 months without muscle weakness. This case shows usefulness of radiofrequency lesion for obturator nerve pain.