Masui. The Japanese journal of anesthesiology
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A case of accidental total spinal anesthesia was presented. A 47-year-old woman was scheduled for a total abdominal hysterectomy. ⋯ Therefore propofol was administered again until the recovery of sufficient spontaneous breathing confirmed approximately 3 hours following administration of ropivacaine, and patient was extubated. No neurologic deficits could be detected.
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TruViewEVO2 videolaryngoscope (Truphatek, Israel) is a modified version of the Truphatek 1. We used this device in four patients with difficult airways. A 77-year-old obese woman, scheduled for nasal surgery, had short neck and small jaw. ⋯ A full view of the glottis was obtained when the TruView was used, and the trachea was easily intubated. In another two patients, in whom laryngoscopy with a Macintosh blade had failed, and in one patient with limited mouth opening, the TruView allowed us to see the glottis and to intubate the trachea without difficulty. Therefore, we believe that the TrueViewEVO2 videolaryngoscope is useful in patients with difficult airways.
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The objective of this study was to investigate the effects of posture after spinal anesthesia with 2% lidocaine and 0.5% isobaric bupivacaine in parturients undergoing caesarean section and to demonstrate our modified combined spinal epidural (CSE) method. ⋯ Our modified CSE method can provide beneficial effects on full term pregnant women by preventing hypotension due to spinal anesthesia.
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Coronary artery bypass graft surgery in patients with immune thrombocytopenic purpura (ITP) refractory to preoperative medical therapy accompanies an increased risk of bleeding perioperatively. In the ITP patient without responding to intravenous immunoglobulin and corticosteroids, we performed combined off-pump coronary artery bypass grafting with splenectomy to minimize the risk of intraoperative bleeding and cardiac ischemia. Using platelets infusion, we successfully managed the patient without major bleeding and ischemic events.
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We experienced a case of epidural hematoma caused by coagulopathy 3 days after surgery. A 72-year-old man, who had undergone a total gastrectomy, suffered from nausea and vomiting by ileus. He underwent repair of ileus under general anesthesia with thoracic epidural anesthesia. ⋯ After a discussion with orthopedic consultants, we selected a conservative therapy rather than surgical removal of the hematoma. Thoracic epidural hematoma disappeared two months after surgery, but motor paralysis requiring rehabilitation remained. In conclusion, when patients have not eaten anything for a few days and antibiotics with an NMTT sidechain has been administered, care must be taken to prevent vitamin K deficiency and coagulopathy.