Masui. The Japanese journal of anesthesiology
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A 77-year-old man underwent esophagectomy for esophageal cancer. Chest radiograph just after the operation showed opacification of the right lung. Although chest radiograph still showed a marked opacification of almost whole right lung in the ICU in spite of multiple bronchoscopy examination and suctioning of pulmonary secretions, he showed no dyspnea. ⋯ Accordingly, stapled lobectomy was performed. After the second surgery, he fortunately recovered without any complications. Although lung torsion is a rare complication, not only thoracic surgeons, but also we, anesthesiologists, should be aware of this disease.
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The benefits of regional anesthesia for surgical procedures, when compared with general anesthesia and/or systemic analgesia, include improved postoperative analgesia, an associated decrease in postoperative pain medication use, decreased nausea and vomiting, and quicker recovery and discharge from the hospital. Neurologic complications associated with regional anesthesia are extremely rare. ⋯ In regional anesthesia, rare but serious complications make it necessary to always consider the risk-benefit ratio. The articles discuss these issues and give advice on its effective and safe conduct.
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More than one hundred years have passed since Bier first succeeded in spinal anesthesia. Spinal anesthesia now spreads all over the world because it has many advantages. Spinal anesthesia requires both a simple technique and a small volume of drug, produces profound analgesia, and is devoid of systemic pharmacologic side effects. ⋯ Those include cardiac arrest, meningitis, intracranial subdural hematoma, spinal epidural hematoma and cauda equina syndrome. Patients should be informed in detail of the incidence, severity, and outcome of these complications, especially when alternative analgesic methods can be chosen. The prediction, early detection and prompt start of the treatment of the complications after spinal anesthesia are important to minimize the risk of adverse outcome.