Masui. The Japanese journal of anesthesiology
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Case Reports
[Labor management using epidural anesthesia in a gravida patient with high spinal injury].
Since autonomic hyperreflexia (AH) is a serious complication during labor in a gravida with spinal cord injury, anesthetic measures should be taken for the suppression of AH even in a sensory-loss condition. Several reports have described various methods for the suppression of AH, in which epidural anesthesia has been advocated as a useful means for the prevention or amelioration of AH. However, it is difficult to evaluate the efficacy of epidural anesthesia due to the lack of sensory and motor functions. ⋯ Tubal-ligation was also performed under epidural anesthesia after the second delivery. No major obstetric complication including AH occurred in either of delivery. The woman with high spinal injury could have two healthy children without major complications during labor by the cooperation of gynecologists and anesthesiologists.
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When the applied cricoid pressure is too strong, or the place or direction of the pressure application is not appropriate, glottal closure may occur, but its details are unclear. ⋯ The right-to-left distance of the rima glottides was significantly reduced by backward pressure or BURP on the thyroid cartilage, and was also markedly reduced by cricoid pressure in 1 of the 12 patients.
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Randomized Controlled Trial Multicenter Study Comparative Study
[Neuromuscular blocking effects of Org 9426 (rocuronium bromide); a comparative study with vecuronium bromide in Japanese patients].
Efficacy and safety of Org 9426 were compared with those of vecuronium bromide in Japanese patients. ⋯ Org 9426 showed more rapid onset time than that of vecuronium and similar clinical duration and recovery times to those of vecuronium in Japanese patients.
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Equipments for epiduroscopy consist of an epidural endoscope, video camera system, video screen, recording system and C arm X-ray system. Epidural endoscope with a diameter of 0.9 mm is inserted from the hiatus sacralis, and has been used clinically for the observation of epidural space of a lumbar vertebrae level since 1996. There are still some problems to be solved in the epiduroscope development, but its dramatic pain reduction effect has been recognized and it has been held as an attractive diagnostic tool.
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Pain is a private internal event, the degree of which can not be evaluated directly by others. The measurement of the nociceptive pain threshold may apply to the evaluation of the degree of the pain. The instruments using mechanical and electrical stimulation are available for the clinical application. ⋯ The method seems to be well suited for the evaluation of pain in musculoskeletal disorders. The electrical stimulation test provides a quantitative measure of pain tolerance to a transcutaneous stimulation, neuroselective for large and small myelinated and unmyelinated nerve fibers. There are characteristics including advantages and faults in each method, and the method of measurement corresponding to the purpose and application is important.