Masui. The Japanese journal of anesthesiology
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We report a patient with subacute myelo-optico-neuropathy (SMON) in whom spinal anesthesia was employed to treat fracture of the femur neck. An 87-year-old woman was diagnosed as having SMON at the age of 45. The patient was admitted to our hospital with fracture of the femur neck. ⋯ General anesthesia has been chosen in SMON patients, because there was a report of severe pain of the lower limbs after spinal anesthesia with dibucaine. In our patient, general anesthesia was considered inappropriate due to hypoxemia. We used a mixture of bupivacaine and fentanyl for spinal anesthesia, because the neurotoxicity of bupivacaine is weaker than that of dibucaine.
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Tracheal extubation and emergence procedures induce abrupt changes in hemodynamics and humoral responses. The purpose of this study was to examine the effects of different doses of landiolol on hemodynamics during emergence from anesthesia. ⋯ Landiolol could prevent the increase in heart rate but not blood pressure during emergence from anesthesia. Effects on the changes in heart rate between 0.125 and 0.06 landiolol groups were not significantly different.
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Malignant hyperthermia (MH) is a potentially fatal complication of general anesthesia following exposure to a depolarizing muscle relaxant and/or volatile anesthetics. MH is inherited as autosomal dominant and is thought to result from disordered Ca2+ regulation by the sarcoplasmic reticulum of the skeletal muscle. ⋯ It is difficult to diagnose by usual examinations preoperatively. Therefore, early detection, prompt treatment, discontinuation of triggering agents, and sufficient administration of dantrolene are needed.
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Difficult airway management (DAM) including cannot intubate and cannot ventilate (CICV), and difficult mask ventilation is a life threatening issue during anesthesia care. Although American Society of Anesthesiologists (ASA) has presented the guideline for this purpose, it is still not available in this country. We as a specialist for airway management should be prepared this trouble any time by equipping a laryngoscope, fiberoptic bronchoscope, and novel devices such as Airway Scope and Airtraq.
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Transversus abdominis plane block (TAP block) is useful for lower abdominal operations. Recently, ultrasound guided nerve block has been performed with ultrasound scanning. ⋯ We concluded that TAP block was effective in pediatric patients receiving bone graft to the alveolar cleft.