Masui. The Japanese journal of anesthesiology
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We conducted a retrospective study to evaluate the effectiveness of intravenous patient-controlled analgesia (IVPCA) in the early postoperative period after upper abdominal gastrointestinal surgery. We also evaluated the postoperative effects of intraoperative analgesic dosage in patients after this surgery. ⋯ The results of this study suggest that the effects of intraoperative analgesics may not be significant. Patients who had received the above mentioned anesthetic regimen intraoperatively also required full postoperative analgesia as well.
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Case Reports
[Anesthetic management of hip joint fracture surgery in an elderly patient with giant pulmonary artery aneurysm].
We report anesthetic management of an elderly patient with giant pulmonary artery aneurysm undergoing hip joint fracture surgery. Preoperative chest computed tomography showed a main pulmonary artery aneurysm with a maximal size of 55 mm. ⋯ Hypoxemia and hypothermia were avoided for the purpose of preventing an increase in pulmonary vascular resistance. Surgery was uneventful because of anesthetic management considering pulmonary hypertension.
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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.