Masui. The Japanese journal of anesthesiology
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Central venous catheterization is a procedure with a high success rate. However, life-threatening complications are occasionally caused by mechanical injury during the catheterization process. ⋯ We herein review and discuss the mechanical complications previously reported to have occurred in association with central venous catheterization. Comprehensive knowledge about various complication-inducing factors, the ability to make a quick and accurate diagnosis of such complications, and sufficient skill to prevent worsening of these complications can thus help patients from suffering lethal complications due to central venous catheterization.
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Comparative Study
[7-year survey of anesthesia for cesarean section--comparison of tetracaine and bupivacaine as intrathecal anesthetic agents].
In our institution, spinal anesthesia is the first choice for cesarean section. After the introduction of bupivacaine in 2000 in Japan, the intrathecal anesthetic agent shifted from tetracaine to bupivacaine. We analyzed the anesthesia for cesarean section in recent 7 years and compared the anesthetic quality of tetracaine with that of bupivacaine. ⋯ Comparing these two intrathecal anesthetic agents, the rate of analgesic supplementation in those anesthetized with bupivacaine was lower than in those anesthetized with tetracaine. This suggests that bupivacaine provides the more profound blockade of the visceral pain than tetracaine, and is superior as a local anesthetic.
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Randomized Controlled Trial Comparative Study
[Comparison of BIS and Ramsay score for evaluation of sedation with propofol in ICU].
BIS has not been evaluated for sedation in ICU. We examined BIS for evaluation of sedation with propofol in ICU. ⋯ The use of BIS for sedation could not improve the management of postoperative sedation in ICU.
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The Japanese Society of Anesthesiologists (JSA) survey of critical incidents in the operating room and other reports have shown that pediatric patients undergoing anesthesia are at an increased risk. Purpose was to examine the state of pediatric anesthesia in Japan. This might clarify the role of children's hospitals for pediatric anesthesia, and the relationship between critical incidents and volume of pediatric anesthetic procedures. ⋯ Almost all JSA Certified Training Hospitals conducted pediatric anesthesia, although only 15.6% of them had an annual pediatric anesthetic volume of more than 200. It was suggested that general pediatric anesthesia was conduced safely in JSA Certified Training Hospitals, even if they had a low annual pediatric anesthetic volume. The exception was newborn anesthetic procedures : the mortality was high in hospitals with an annual newborn anesthetic volume of less than 12. Analysis of critical incidents in the operating room failed to show the superiority of children's hospitals in comparison with the university hospitals and other hospitals. Collecting and analyzing data including the patients without critical incidents are required for further analysis.
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Central venous catheterization is essential for the anesthetic management of operations for congenital heart diseases. We prospectively examined the usefulness of ultrasonography in internal jugular vein catheterization in infants. ⋯ Internal jugular vein cannulation guided by ultrasonography can be performed safely and quickly in pediatric patients.