Masui. The Japanese journal of anesthesiology
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A 38-year-old woman with placenta previa was scheduled for cesarean section. She had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L2-3 interspace for postoperative analgesia. ⋯ MRI and myelogram showed no abnormality of the spinal cord. Her neurological deficit showed slight improvement but her sensory and motor paralysis still remained. Neurotoxicity of ropivacaine may be the cause of this neurological deficit.
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Comparative Study
[Experience in postoperative sedation with dexmedetomidine for mandibular osteotomy].
Dexmedetomidine may be suitable for postoperative sedation of patients with mandibular osteotomy. ⋯ This study shows that sedation with dexmedetomidine is more suitable than that with midazolam.
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Case Reports
[Unsuccessful anesthetic management for cesarean section in a patient with primary pulmonary hypertension].
A 31-year-old woman with primary pulmonary hypertension presented for an elective cesarean section at the 34-week gestation. After monitoring pulmonary artery, systemic artery blood pressures and an electrocardiogram, continuous lumbar epidural anesthesia was performed. Uneventful delivery was followed by a sudden decrease in systemic pressure and loss of consciousness. ⋯ Nitroprusside and milrinone were infused to decrease pulmonary artery pressure and to maintain systemic arterial pressure. However, she died after 16 hours due to an impairment of right ventricular function. Although the patient with PPH had been managed successfully using continuous epidural analgesia until delivery, sudden hemodynamic alterations following delivery could not be controlled by pharmacological interventions.
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We evaluated retrograde amnesic effects of propofol at the hypnotic dose on 28 healthy medical personnel volunteers (17 men, 11 women). ⋯ These results suggest that propofol dose not induce retrograde amnesia at hypnotic dose.
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Seven patients were subjected to intraoperative wake-up tests during reconstruction surgery of the anterior crucial ligament (ACL) to measure the tension of the reconstructed ligament. ⋯ Propofol-fentanyl is better than nitrous oxide-sevoflurane-fentanyl as the method of anesthesia for wake-up tests of ACL reconstruction surgery.