Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Technical advantages of ultrasound-guided obturator nerve block compared with the nerve stimulating technique].
We investigated the onset time of obturator nerve block and time required for the nerve block comparing two groups in a prospective randomized study. ⋯ Ultrasound imaging facilitated the identification of obturator nerves between adductor muscles. Ultrasound-guided obturator nerve block is a safe, quick and useful technique.
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Randomized Controlled Trial Comparative Study
[Effects of intravenous vasopressor on spread of spinal anesthesia with 0.5% hyperbaric bupivacaine for caesarean delivery].
It is known that when isobaric bupivacaine is applied for Caesarean delivery, phenylephrine is superior to ephedrine in preventing rostral spread of spinal anesthesia. In this study, we prospectively investigated whether phenylephrine can prevent rostral spread of spinal hyperbaric bupivacaine. ⋯ 1. Phenylephrine prevented rostral spread of spinal hyperbaric bupivacaine. 2. Haemodynamic changes were significantly different between the two groups. 3. Umbilical artery pH was significantly higher with phenylephrine than with ephedrine.
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A 34-year-old woman who was 25 weeks pregnant showed neurological symptoms of bitemporal hemianopsia and vision loss on the left side. MRI study revealed a pituitary tumor requiring surgical removal. We planned cesarean section after 32 weeks of pregnancy and removal of pituitary tumor after the improvement of general conditions of the paturient following cersarean section. ⋯ Therefore, we decided to perform the cesarean section at 30 weeks and 3 days of pregnancy and simultaneous surgical removal of the pituitary tumor. As soon as cesarean section was successfully performed with epidural anesthesia, the pituitary tumor was removed trans-sphenoidally under general anesthesia. Postoperative conditions of the mother and newborn were good and neurological symptoms of the mother improved markedly.
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The GlideScope video laryngoscope (Verathon Inc. Bothell, Washington, USA) is a relatively new device for tracheal intubation, which provides a excellent glottic visualization. We here report the clinical experience of the GlideScope (small) in 50 pediatric patients. ⋯ GlideScope seemed to be a novel device in pediatric patients. Further studies are required to evaluate the usefulness in neonates, small infants and children with a difficult airway.
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Case Reports
[Prolonged apnea from rocuronium in a patient with hypermagnesemia after cesarean section: a case report].
A patient developed prolonged apnea after emergency cesarean section. The patient was a 38-year-old primiparous woman with myoma uteri and her body weight was 44.8 kg. She received intravenous magnesium sulfate 1 g x hr(-1) as tocolytic agent for threatened premature delivery. ⋯ After the operation which was finished in 65 minutes, the effect of rocuronium remained for more than 100 minutes after its administration probably due to hypermagnesemia. Rocuronium shows rapid onset, and several studies indicate that it can be used for rapid sequence induction instead of suxamethonium. But rocuronium should be used carefully and its effect should be monitored in a patient with hypermagnesemia.