Masui. The Japanese journal of anesthesiology
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Generally, anesthesiologists believe that patients with Eisenmenger syndrome (ES) undergoing noncardiac surgery have significant risks of perioperative morbidity and mortality. Because of the recent strides in medical care, these patients often require anesthesia. ⋯ She had no adverse perioperative events, and was discharged the next day. Patients with ES have increased risks with general anesthesia for noncardiac surgery, but the risk of morbidity and mortality seems to be less than previously thought.
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Case Reports
[Anesthetic management of emergency cesarean section in a patient with acquired von Willebrand syndrome].
Acquired von Willebrand syndrome (AvWS) is generic name of bleeding disorders caused by acquired decrease of von Willebrand factor. A 25-year-old woman with AvWS underwent emergent cesarean section under combined spinal and epidural anesthesia. Before operation, her APTT was within normal ranges. ⋯ Epidural catheter was removed just after administration of factor VIII concentrate 3 days after operation. The perioperative course was uneventful and the patient was discharged 11 days after the operation. It is important to co-operate with other related departments in managing the perioperative coagulation status in a patient with AvWS.
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Perioperative complications are prevalent among current smokers. Smoking cessation program is covered by national insurance for patients who meet certain criteria in Japan. We established a smoking cessation program in a preoperative clinic of our anesthesia department in July 2010. ⋯ Smoking cessation program is effective when offered to patients right before surgery. Preoperative anesthesia clinic may be one of the most suitable opportunities for the program.
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Increasing number of patients are suffering from chronic kidney disease (CKD). Accordingly, the opportunity of anesthesiologists taking care of patients with CKD will be expected to increase. This issue highlights the anesthetic management of patients with CKD, so that every anesthesiologist may refresh knowledge and clinical skills to manage patients with CKD.