Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Comparative Study
[Comparison of the Supreme Laryngeal Mask Airway(SLMA), single use, with the reusable Proseal Laryngeal Mask Airway(PLMA) in anesthetized adult Japanese patients].
Supreme laryngeal mask airway (SLMA) is a single use, new supraglottic airway device with anatomically designed curved airway conduit. It has second channel for gastric tube insertion. We compared the performance of the SLMA with that of the Proseal LMA (PLMA), the older reusable LMA, during anaesthesia in spontaneously breathing adult patients. ⋯ Our result indicated that SLMA can be inserted faster without inserting one's finger into patient oral cavity. Leak pressure was lower but acceptable for clinical use in spontaneously breathing anesthetized adult patients.
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Randomized Controlled Trial Comparative Study
[Local instillation of 0.75% ropivacaine compared with intravenous fentanyl and flurbiprofen for postoperative analgesia following inguinal hernia repair in adults].
We compared postoperative analgesia provided by local instillation of 0.75% ropivacaine with that by intravenous fentanyl and flurbiprofen. ⋯ Local instillation of 0.75% ropivacaine is safe and effective, and provides adequate analgesia for a long period in adult patients following an inguinal hernia repair procedure.
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Most patients with arteriosclerosis obliterans (ASO) have severe complications such as coronary artery disease, congestive heart failure and chronic kidney disease. They receive long-term antithrombotic therapy which is a contraindication to neuraxial anesthesia. In this retrospective study, we reviewed nine high-risk patients with ASO (revised cardiac risk index more than three) who underwent an urgent lower limb surgery under ultrasound-guided peripheral nerve block (PNB). ⋯ In eight of the nine cases, analgesics are not required until 10 hours after the operation. No complication related to PNB occurred. Ultrasoundguided PNB for patients with ASO undergoing lower limb surgery can be a useful anesthetic technique, providing cardiovascular stability and good postoperative analgesia.
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Case Reports
[Unilateral temporary meralgia paresthetica after caesarean section: report of a case].
We report a patient who developed unilateral temporary meralgia paresthetica after caesarean section. A 28-year-old morbidly obese woman underwent caesarean section under combined spinal and epidural anesthesia. ⋯ She noted pain and hypesthesia along the anterolateral aspect of the right thigh on the second postoperative day, when postoperative continuous epidural analgesia was stopped. The pain and sensory impairment resolved 8 days after surgery without medications.
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We experienced three cases of latex anaphylaxis during cesarean section in one year. ⋯ A 25-year-old woman underwent emergency cesarean section. We noticed wheals involving her eyelids and legs after operation and administered methylprednisolone. CASE 3: A 23-year-old woman underwent elective cesarean section. Five minutes after delivery and oxytocin injection, she complained of edema of eyelids, facial erythematous edema, and dyspnea. We suspected latex anaphylaxis and stopped using latex products. Then, we treated her with antihistamines, methylprednisolone and beta-stimulators. The diagnosis of latex anaphylaxis was made by positive results of skin tests to latex and an increase in the levels of latex-specific immunoglobulin E. We conclude that cesarean section is an important risk factor for latex anaphylaxis.