Masui. The Japanese journal of anesthesiology
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Case Reports
[Anesthetic management of a pediatric patient with Beckwith-Wiedemann syndrome accompanied by macroglossia].
We report the anesthetic management of an infant with Beckwith-Wiedemann syndrome having massive macroglossia and umbilical hernia. Umbilical hernia repair and tongue reductions were performed under general anesthesia. ⋯ After the operation, mechanical ventilation was required for three days because of airway obstruction by secretions in the mouth and her edematous tongue. She had no complications and the postoperative course was uneventful.
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Case Reports
[Successful anesthetic management of two high-risk elderly patients using propofol-remifentanil].
This report deals with anesthetic management using remifentanil in high-risk elderly patients with many complications such as arteriosclerosis and obstructive lung disease other than the disease which was the object of operation. Case 1; an 87-year-old woman with complete left bundle branch block and aortic valve stenosis was scheduled for cholecystectomy, intestinal tract incision and gallstone extraction. Case 2; a 79-year-old woman with obstructive lung disease was scheduled for sigmoidectomy and cholecystectomy. ⋯ They received epidural anesthesia 30 minutes before the remifentanil discontinuance. After remifentanil is discontinued, they had little pain. Elderly patients considered at high-risk were treated under total intravenous anesthesia with remifentanil and propofol.
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Septic shock is an adverse clinical condition resulting in multiple organ failure from global tissue hypoxia. The importance of initial treatment is widely recognized. Thus, guidelines for septic shock recommend early goal-directed therapy (EGDT) during the first six hours of treatment. ⋯ A newly developed central venous oximetry catheter (PreSep Oximetery Catheter, Edwards Lifesciences) allows continuous and easy monitoring of central venous oxygen saturation. This report shows the usefulness of this catheter in a patient who developed septic shock during an emergency operation for perforated bowel. By using EGDT perioperatively with continuous central venous oximetry, multiple organ failure might be successfully avoided.
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Comparative Study
[Effects of postoperative continuous epidural analgesia after laparoscopy-assisted colectomy].
This study was conducted to evaluate the effects of continuous epidural analgesia on the postoperative pain and the early recovery after laparoscopy-assisted colectomy (LAC). ⋯ These results show that postoperative continuous epidural analgesia is effective for postoperative pain relief in patients after laparoscopy-assisted colectomy.
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We report drug errors during anesthesia. The data were retrieved from the incident reports in a period of June 2000 to June 2003 at the Department of Anesthesiology, Fukuoka University Hospital. ⋯ Errors in dosage were five, and wrong route of administration in one. There were no serious sequelae in the 18 patients.