Masui. The Japanese journal of anesthesiology
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Relationships between common carotid arteries (CCA) and internal jugular veins (IJV) have been investigated both in adults and children. Overlapping of CCA and IJV are reported in 70 to 90% of cases; however we seldom observe overlapping cases in children. We evaluate the relationships between CCA and IJV in children. ⋯ There appears to be little danger of puncturing the CCA during internal jugular venipuncture from the viewpoint of anatomical relationships between the CCA and IJV
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Biography Historical Article
[The first labor analgesia with drug was already performed in late Meiji-Period (1868-1912): trace of opioid-scopolamine which was used in Akiko Yosano, back to its origins].
There have been some records of labor analgesia with intravenous or rectal anesthetics in early Showa-period (1926-1989). However, the author found that labor analgesia had been already attempted for some women in late Meiji-period (1868-1912). One of agents used was pantopon, a water-soluble opioid without serious respiratory depression as morphine. ⋯ They also reported that this combination also conferred excellent analgesic effects without any serious complications in the mother and fetus. This combination was originally used for general surgery with inhaled anesthesia at that period. It remains uncertain how Japanese doctors got pantopon scopolamine from Germany.
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A baby girl, 15-month-old, 75.6 cm in height, and 7.5 kg in weight, was scheduled to undergo ventricular septal defect repair. The right IJV, 3.0 mm in thickness and 7.0 mm in depth, was punctured to place a central venous catheter with a 19-mm-long 24G puncture needle. Non-pulsatile bright red blood appeared during the 15.8-mm-long needle insertion and dark red blood appeared during the 14.7-mm-long needle insertion. ⋯ The 14.7-mm-long needle inserted at a 45-degree angle reached about 10.4 mm, which is near the posterior wall of the IJV It seemed that a small artery behind the IJV was punctured mistakenly. In withdrawing blood from a cyanotic patient, it may be difficult to judge if the blood was arterial because it was non-pulsatile when it appeared. We should be careful to know the existence of small arteries behind IJVs and to confirm which vessels the returned blood comes from.
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In cesarean section, residual neuromuscular blockade is often observed at the end of the operation. Sugammadex (SGX) is a selective relaxant-binding agent which reverses the blockade at any depth in 2-3 minutes. We investigated whether SGX improves the efficient management of operating rooms. ⋯ SGX decreased the time to extubation after cesarean section under general anesthesia after surgery, and could improve the efficient management of operating rooms.
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Anesthesia is a state made by multiple pharmacological agents that affect the functions of central, peripheral and autonomic nervous systems. Antagonists are often used to reverse the effects of anesthetic agents, muscle relaxants, and so forth. Antagonists often have side effects other than their specific antagonistic effect. ⋯ These agents may antagonize the effects of non-depolarizing muscle relaxants. Flumazenil may have adverse effects in patients on chronic benzodiazepines and tricyclic or tetracyclic antidepressants. Because sugammadex has little adverse effects, it has become a popular agent to reverse muscle relaxation by rocuronium in Japan.