Masui. The Japanese journal of anesthesiology
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To evaluate obstetric and anesthetic problems relating to cesarean delivery, we investigated parturients who had undergone cesarean section at the Center for Perinatal and Neonatal Medicine in Jichi Medical University Hospital. ⋯ At the center for perinatal and neonatal medicine, population risk is increasing because of increases in maternal age, obesity, placenta previa, and rates of multifetal pregnancies.
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Case Reports
[Combined spinal-epidural anesthesia for cesarean section in a parturient with myotonic dystrophy].
Myotonic dystrophy (MD) is a muscle disorder characterized by progressive muscle wasting and weakness, and is the most common form of muscular dystrophy that begins in adulthood, often after pregnancy. MD might be related to occurrence of malignant hyperthermia. Therefore, the cesarean section is often performed for the parturient with MD. ⋯ She had no adverse events and was discharged on the 8th postoperative day. Later her baby was diagnosed as congenital MD by gene analysis. Combined spinal-epidural anesthesia with the amide-typed local anesthetic agents could be useful and safe for cesarean section in the parturient with MD.
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Randomized Controlled Trial
[Internal jugular vein cannulation guided by pulsation].
We are accustomed to right internal jugular vein (IJV) cannulation guided by pulsation for 20 years or more. This study was conducted to evaluate whether this method is a safe and certain method. ⋯ Internal jugular vein cannulation by pulsation method is a safe and certain method.
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Case Reports
[Continuous intrathecal anesthesia for total hip arthroplasty in a patient with ankylosing spondylitis].
A 73-year-old man suffering from ankylosing spondylitis with limited motion of the whole spine was scheduled for right total hip arthroplasty. Ten years before, the patient had undergone left total hip arthroplasty under general anesthesia, in which epidural anesthesia impossible, intrathecal anesthesia insufficient, and tracheal intubation difficult. In the present operation, an 18 gauge epidural catheter was inserted into the epidural space at L3-4 using paramedian approach. ⋯ There was no pain at rest and on movement, and no additional analgesics and hypertensive drugs were used until 4 hours following the discontinuation of the continuous intrathecal anesthesia in the morning after the operation. No adverse events including post-dural puncture headache were observed. Continuous intrathecal anesthesia may be effective for total hip arthroplasty in patients with ankylosing spondylitis.
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We experienced anaphylactic shock after introduction of the general anesthesia twice in the same patient. After the first incidence of anaphylactic shock, we judged that the allergen was a latex. ⋯ After the first incidence, it was necessary to retrieve the antigen from all the agents used. When we encounter the anaphylactic shock, it is necessary to examine all the medicines, and should have two or more suspectible medicines in mind.