Masui. The Japanese journal of anesthesiology
-
Incident rates of cardiac arrest are reported as being from 0.54 to 17.5 per 10,000 (0.54-17.5/10,000) spinal anesthesia patients. In our hospital, four cases of cardiac arrest occurred in 903 spinal and combined spinal and epidural anesthesia patients over 15 months (44.3/ 10,000). ⋯ All patients recovered without any side effects. The conditions suspected of causing strong bradycardia leading to cardiac arrest are thought to be maintained parasympathetic activity, lack of blood volume before anesthesia, rapid progress of spinal blockade, decreased blood return to the heart by high spinal blockade (T4) and protective cardiac parasympathetic reflex (Bezold-Jarisch reflex).
-
We developed a simple audio recording system using a small personal computer and free audio recording software that makes voice recordings for use in emergencies, particularly for emergency caesarean sections. The system makes a continuous audio recording while the patient receives medical treatment. The recording provides an accurate record of the anesthesia used during treatment. This audio recording system is useful as an auxiliary means of record keeping during medical emergencies.
-
Cancer pain consists of continuous pain lasting almost all day and transient exacerbation of pain called breakthrough pain. Breakthrough pain is classified as somatic pain and visceral pain, neuropathic pain according to the character of pain. Although the immediate release opioid is used as the first treatment of choice to breakthrough pain, the effect is not enough when it shows the character of neuropathic pain. ⋯ It has also been reported that pregabalin used with oxycodine reveals analgesic effect with smaller dosage than pregabalin alone. We experienced a young patient with lung cancer suffering from sudden exacerbation of symptomatic sciatica, whose pain was markedly reduced within 30 minutes by taking immediate release oxycodone 5 mg and pregabalin 75 mg simultaneously. Conclusions : Pregabalin with immediate release oxycodone simultaneously may be able to improve acute exacerbation of neuropathic cancer pain rapidly.
-
Case Reports
[Left internal jugular venipuncture in real-time ultrasound-guided pediatric central venous cannulation].
The right internal jugular vein (IJV) is usually selected for pediatric central venous cannulation (CVC); however, the left is rarely selected. We investigated cases of CVC through left IJVs from Apr to Nov of 2011. ⋯ After three failed attempts through the right IJVs in three patients (3.7%), of 2 to 9 months of age out of the 82 patients, 24 G puncture needles were successfully inserted through left IJVs with the first attempt. One of the three patients, of 9 months of age with a persistent left superior vena cava, had a thinner 2.6-mm-wide right IJV and a thicker 8.3-mm-wide left IJV It was difficult but successful to insert a 0.018-inch guidewire in another patient due to a steep 90 degree angle between the left IJV and the brachiocephalic vein.
-
Goal directed therapy (GDT) is applied during the initial resuscitation of sepsis, known as early goal directed therapy (EGDT). Recent studies in major abdominal surgery suggested that anesthetic management with GDT may decrease morbidity and hospital stay. We have utilized GDT in major invasive surgery such as pancreatoduodenectomy in November 2009. ⋯ Anesthetic management with goal-directed therapy, may have contributed to shorter postoperative hospital stay.