Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Effects of intravenous midazolam, fentanyl or ketamine on pain relief during performance of epidural anesthesia].
Performing epidural anesthesia is accompanied by pain. The aim of this study is to examine whether intravenous administration of a sedative, an opioid, or an anesthetic eliminates pain score during the epidural procedure. ⋯ The findings obtained from this study suggest that the analgesic action of the drug is not essential to the pain relief and the anxiolytic action is important for the epidural procedure.
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Case Reports
[Case of failed spinal anesthesia for cesarean section caused by spinal arachnoid cyst].
A 27-year-old pregnant woman was scheduled for cesarean section under spinal anesthesia. Although there was no trouble in three repeated spinal punctures, the anesthetic effect was insufficient. ⋯ Postoperatively, spinal arachnoid cyst was found by MRI. The cyst was thought to have caused insufficient analgesic effect of spinal anesthesia in this patient.
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Randomized Controlled Trial
[Effect of dexmedetomidine on anesthetic requirements in cardiovascular surgery].
An anesthetic-sparing effect of dexmedetomidine has been shown in several studies. We investigated the effect of dexmedetomidine on anesthetic requirements in 24 patients undergoing cardiovascular surgery. ⋯ The combined use of dexmedetomidine decreases anesthetic requirements in cardiovascular surgery.
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As laparoscopic cholecystectomy is assumed to be with less postoperative pain, it is managed only by general anesthesia during the surgery in our hospital. However, about 70 percent of cases needed the additional analgesic drugs after the operation. In addition, about 70 percent needed analgesic drugs within three hours after the operation, and it has been understood that early postoperative analgesia is insufficient. We focused on the ultrasound guided nerve block and used it to relieve postoperative pain after the laparoscopic cholecystectomy. ⋯ The use of ultrasound guided nervous block for the postoperative pain after laparoscopic cholecystectomy has been helpful, and excellent pain relief has been obtained.
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Case Reports
[Apnea and severe respiratory depression induced by dexmedetomidine after general anesthesia in intensive care unit].
Dexmedetomidine (DEX) is widely used in intensive care unit for perioperative sedation. The one advantage of DEX administration for sedation is the lack of significant respiratory depression. However, DEX shows significant interaction with anesthetics and narcotics, and we present a case in which post-anesthetic administration of DEX induced apnea and severe respiratory depression after extubation. ⋯ After 3.5 hr from the end of anesthesia, the patient's trachea was extubated under continuous infusion of DEX (0.26 microg x kg(-1) x hr(-1)). Ninety min later, she showed apnea and severe respiratory depression. The interaction of DEX and residual narcotics might have induced life-threatening respiratory complication.