Masui. The Japanese journal of anesthesiology
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We report a case of acute subdural hematoma which occurred following cerebrospinal fluid (CSF) drainage during thoracic endovascular aortic repair (TEVAR) surgery. A 63-year-old woman was scheduled to receive TEVAR for thoracic-abdominal aneurysm extending from the descending aorta (T10) to 15 mm above the celiac trunk. Before the TEVAR operation, a lumbar cerebrospinal drain was inserted at L4-5. ⋯ The benefits of CSF drainage for spinal cord protection is well established, and ischemia of Adamkiewicz artery is prevented by careful control of CSF pressure. However, the use of CSF drainage has been associated with the risk of acute subdural hematoma. Careful observation for amount of CSF drainage is necessary during thoracoabdominal aortic aneurysm repair.
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A 32-year-old pregnant woman diagnosed with aplastic anemia was admitted for emergent caesarean delivery of 26th week of the gestation due to PIH (pregnancy-induced hypertension) and NRFS (non-reassuring fetal status). After compensating platelets counts to 5.3x10(4) microl-1, general anesthesia was induced with propofol and rocuronium. Anesthesia was maintained with O2 and sevoflurane until delivery and with modified-NLA after delivery. ⋯ She survived perioperative period and was to be treated for aplastic anemia. Her baby was discharged neurologically free. We should be ready to respond to anesthetic requirement for urgent cases of aplastic anemia.
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Enhanced recovery after surgery (ERAS) protocols aim to improve patient care, reducing complication rates, and shortening hospital stay following colorectal surgery in Europe. In cooperation of colorectal surgeons and anesthesiologists, ERAS protocols were initially introduced in our hospital to the patients who underwent open colorectal resection in July 2010. ⋯ Introduction of ERAS as collaboration of surgeons and anesthesiologists resulted in facilitating communication of surgeons and anesthesiologists.
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A 64-year-old man was diagnosed to have a tracheal tumor 2 cm proximal to the carina. He was scheduled for tracheal resection and reconstruction with omentopexy. An epidual tube was placed at the level of T5-6. ⋯ After the operation, he was extubated under anesthesia without coughing. No pain was complained during postoperative course. Epidural anesthesia combined with TAPB provided sufficient postoperative analgesia, especially in tracheal resection and reconstruction with omentopexy.
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We report the results of reviews by pharmacists of clerical errors in drugs used in the operating room by anesthesiologists from August 2005 to March 2007 at Fukuoka University Hospital. During the period, 9907 surgical patients were managed by anesthesiologists. ⋯ One medication error was detected by the review. The review of used drugs in the operating room by pharmacists can prevent financial loss and improve patients' safety.