Masui. The Japanese journal of anesthesiology
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A 63-year-man with lung cancer underwent right upper lobectomy under general anesthesia combined with thoracic epidural anesthesia. The surgical course was uneventfully completed. On the second postoperative day, he developed complete paralysis below T4 level 1 hour after removal of the epidural catheter. ⋯ Surgical removal of hematoma was scheduled. However, his neurological condition improved rapidly within a couple of hours, and the surgery was not carried out. The time course of recovery from complete paralysis suggests that extradural hematoma diffused into the extradural space, resulting in a decrease in the epidural pressure.
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In an animal model, neonatal exposure to sevoflurane induces neuroapoptosis, leading to memory deficits in adulthood. A recent study showed that resveratrol (20 mg x kg(-1)) prevent alcohol-induced cognitive deficits and neural apotosis in rat pups postnatally exposed to ethanol. We investigated if resveratorol prevent sevoflurane induced neuroapotosis. ⋯ Resveratrol did not prevent sevoflurane-induced neuroapoptosis in the neonatal mice brain.
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In cases of facial burns caused by molten asphalt, examination for possible airway burns and early removal of the asphalt should be carried out to prevent chemical-induced tissue damage and infection. However, asphalt that has adhered to tissues is difficult to remove. A 35-year-old male with burns caused by molten asphalt was scheduled for emergency debridement. ⋯ His respiratory condition was stable and a perioperative fiberoptic view revealed no airway burns. After awake intubation, orange peel oil was used to remove the asphalt from his face and eyes. Since orange peel oil does not contain any harmful substances, it is effective for removing asphalt without causing tissue damage.
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Adrenaline is the key treatment for acute anaphylaxis; however, it is difficult to use it appropriately in terms of dosage and timing. If used incorrectly, adrenaline can cause cardiac infarction, stroke, recurrence and other problems. ⋯ Adrenaline was administered appropriately in terms of dosage, but timing should have been earlies in 3 of 6 cases.
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Case Reports
[A case of rocuronium-induced anaphylactic shock successfully treated with sugammadex].
We report a case of a 19-year-old male with rocuronium-induced anaphylactic shock. He was scheduled for endoscopic sinus surgery for chronic sinusitis under general anesthesia. Induction of anesthesia was done with fentanyl, propofol and sevoflurane. ⋯ The plasma beta-tryptase increased to 46 microg x l(-1) during the shock state and returned to 14.1 microg x l(-1) 8 hrs after the event. The blood hemoglobin level also increased to 21.3 g x dl(-1) during the shock state and returned to 17.2 g x dl(-1) during the recovery phase. The laboratory data showed a marked increase in vascular permeability caused by rocuronium-induced anaphylactic shock.