Masui. The Japanese journal of anesthesiology
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Neuropathic pain, as a chronic intractable pain, is well known to be difficult in prevention, diagnosis and treatment. Especially, neuropathic pain from different causes has each characteristics for prevention, diagnosis and treatment. These include post-herpetic pain, persistent chronic pain following traffic accident, pain after peripheral nerve injury in venipuncture, phantom limb pain originating from dysfunction of the primary motor cortex, pain from failed back surgery syndrome, and diabetic neuropathy, and are helpful for understanding prevention, diagnosis and treatment of neuropathic pain.
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Randomized Controlled Trial
[Optimal analgesic effect of continuous supraclavicular brachial plexus block with ropivacaine after shoulder surgery].
Optimal dose of local anesthetics for supraclavicular brachial plexus block (BPB) is still unknown. We prospectively investigated the analgesic effect of ultrasound-guided continuous supraclavicular BPB with ropivacaine at different infusion rates. ⋯ Continuous supraclavicular BPB with 0.2% ropivacaine at 6 ml x hr(-1) is effective for the pain management after shoulder surgery and is not an excess dose.
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The i-gel (Intersurgical Ltd., Wokingham, Berkshire, UK) is a new single-use noninflatable supraglottic airway device. It is composed of a soft, gel-like, transparent, thermoplastic elastomer, which provides a perilaryngeal seal without cuff inflation. In this case report, we describe the airway management using i-gel in two patients scheduled for awake craniotomy. ⋯ The i-gel was reinserted before the closure of the dura without difficulties despite the fact that necks were rotated about 30 degrees rightward, and remained in place until the end of surgery. All procedures finished uneventfully and without adverse events. We conclude that i-gel is effective in asleep-awake-asleep technique because of its easiness in reinsertion under condition of rotated neck.