Masui. The Japanese journal of anesthesiology
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The present study was conducted to determine the relationship between magnesium concentration in cerebrospinal fluid (CSF) and delayed cerebral ischemia (DCI) in patients with subarachnoid hemorrhage (SAH). ⋯ The results indicate that preoperative hypomagnesemia within the CSF might play a role in the development of DCI in patients with SAH; however, further studies will be necessary to confirm this observation.
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We report a case of cranial subdural hematoma with intracranial hypotension. A 34-year-old woman had laparoscopic ovarial cysterectomy under general anesthesia combined with epidural anesthesia. Two days later, she developed a severe headache and nausea. ⋯ We thought that these were due to epidural anesthesia first, but there was no evidence of dural puncture. It was also considered that it is influenced by change in CSF pressure, and intracranial venous engorgement may be due to Trendelenburg position for several hours. Because cranial subdural hematoma is a life-threatening complication, it is necessary to reconsider application of epidural anesthesia for laparoscopic surgery with Trendelenburg position.
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Electroconvulsive therapy (ECT) is a widely acceptable therapy for psychiatric symptoms. ECT provokes abrupt hemodynamic changes, and sometimes induces serious cardiac complications. In this study, we examined the time course of changes in perfusion index (PI) and pleth variability index (PVI) during ECT using Radical-7 (Masimo Corp., USA). ⋯ This finding suggests that tissue perfusion was transiently impaired during ECT.
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Takotsubo cardiomyopathy is a cardiac syndrome characterized by transient left ventricular dysfunction. A 79-year-old woman was scheduled for posterior lumbar interbody fusion for spinal compression fracture. ⋯ Emergent transthoracic echocardiography revealed excessive contraction of the base and severe hypokinesis of the apex suggesting Takotsubo cardiomyopathy. Chronic hypovolemia and electrolyte disorder due to habitual glycerin enema were considered to be causes of this sudden cardiac collapse.
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With the spread of total intravenous anesthesia, clinical pharmacology has become more important. We report Microsoft Excel file applying three compartment model and response surface model to clinical anesthesia. ⋯ Time-dependent changes in these calculated values are shown graphically. Recent development in anesthetic drug interaction studies are remarkable, and its application to clinical anesthesia with this Excel file is simple and helpful for clinical anesthesia.