Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Efficacy of spinal anesthesia with small-dose lidocaine in ambulatory prostate biopsy procedures for elderly patients : comparison with propofol anesthesia].
Opinions differ as to what is more appropriate anesthetic technique for elderly patients undergoing ambulatory surgery. The objective of this study is to compare the efficacy and safety of spinal anesthesia with small-dose lidocaine and those of propofol general anesthesia in elderly patients undergoing ambulatory prostate biopsy. ⋯ Spinal anesthesia with 10 mg of hyperbaric 1% lidocaine may be more preferable to propofol anesthesia in elderly patiens undergoing ambulatory prostate biopsy, with respect to safety and costs.
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A 21-year-old morbidly obese parturient with a body mass index of 45.5 kg x m(-2) underwent an emergent cesarean section for obstructed labor under combined spinal and epidural anesthesia. At age 15, she was diagnosed as borderline personality disorder. In spite of the drug therapy, her mental status was unstable. ⋯ A 3 ml bolus of 0.5% hyperbaric bupivacaine was given. The anesthetic level was T4 at the start of the operation. Throughout the surgery, sufficient analgesia was obtained and any complication such as severe hypotension or respiratory depression did not develop and her postoperative course was uneventful.
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Case Reports
[Anesthetic management of two cases with placenta percreta that caused massive hemorrhage during cesarean section].
We report the anesthetic management of two cases with placenta percreta that caused massive hemorrhage during cesarean section. These pregnant women, with a past history of cesarean section underwent elective operation after being diagnosed with total placenta previa and suspected adhesion of the placenta. ⋯ In recent years, the incidence of adhesion of the placenta has increased, but definitive, preoperative diagnosis is difficult; especially for the severe type: placenta percreta. Therefore, intensive management is necessary for the anesthesia of pregnant women with suspected adhesion of the placenta, including adequate preparation of transfused blood, since it might be difficult to save the mother's life after the onset of massive hemorrhage.
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A 74-year-old man with gastric cancer was complicated with abdominal aortic aneurysm. A two-stage operation was scheduled (repair of abdominal aortic aneurysm and subsequent gastrectomy). He also had severe chronic obstructive pulmonary disease (COPD). ⋯ In both operations, sufficient analgesia was provided with epidural anesthesia, and the surgeons rated muscle relaxation as satisfactory. No respiratory complications developed postoperatively. Maintaining spontaneous breathing during abdominal surgery using epidural anesthesia and light general anesthesia is a good option for COPD patients.
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In U.S.A., Pulse CO-Oximetry has emerged as a quick, simple, and non-invasive diagnostic modality to measure the concentration of COHb in arterial blood. To investigate its efficiency, we measured COHb levels by employing Pulse CO-Oximetry and by CO-Oximeter in arterial blood. ⋯ The correlation coefficient between the COHb level by Pulse CO-Oximetry and that in the blood sample was not so high, but Pulse CO-Oximetry has the potential of changing the way victims of CO exposure are diagnosed and treated, because of its easiness.