Masui. The Japanese journal of anesthesiology
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A 54-year-old man (height 155 cm, weight 49 kg) was scheduled for retroperitoneoscopic nephrectomy. He had a history of schizophrenia that had been controlled with propericiazine 10 mg and bromperidol 3 mg daily for 34 years. After induction of anesthesia, 1% mepivacaine 5 ml was administered via an epidural catheter. ⋯ Surgery was cancelled and he was extubated 45 minutes later without any complications. These findings suggest that caution must be exercised when combining general and epidural anesthesia for patients on long-term major tranquilizers. In the event of refractory hypotension, the use of direct-acting vasoconstrictors such as noradrenaline or vasopressin should be considered.
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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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The risk of accidental removal of a central venous catheter is a major concern in anesthesia and intensive care. We hypothesized that the force required to remove a fixed catheter depends on the size of the catheter (diameter) or use of a dry or wet catheter. ⋯ The force required for the accidental removal of dry catheters was greater than that required for the accidental removal of wet catheters, regardless of catheter diameter. Therefore, it is essential to use dry catheters and fixtures to prevent accidental removal of central venous catheters.
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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.