Masui. The Japanese journal of anesthesiology
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Adjuvant analgesics including antidepressant and anticonvulsant are highly useful toward intractable chronic pains, especially neuropathic pain. In recent years, selection of the first line treatment is done by balancing between efficacies of candidate drugs and their potential adverse effects. While evaluating the efficacy of a drug is easy when it is used alone; however, it may not be always so if multiple drugs are used concurrently.
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Anesthetic management of cesarean section for placenta accreta is very challenging. The aim of our retrospective study was to review past placenta accreta cases in our hospital to suggest a strategy for anesthetic management for placenta accreta. ⋯ We suggest the minimum requirements for anesthetic management in patients with placenta accreta as follows: (1) discussion with obstetricians to formulate a cesarean section plan, (2) early evaluation to formulate an anesthetic plan and to obtain informed consent, (3) two experienced anesthesiologists, (4) general anesthesia, (5) 2 large-bore intravenous lines, (6) an arterial line and (7) 10 units of both fresh frozen plasma and crossmatched packed red blood cells.