Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial
[Effect of dexmedetomidine on anesthetic requirements in cardiovascular surgery].
An anesthetic-sparing effect of dexmedetomidine has been shown in several studies. We investigated the effect of dexmedetomidine on anesthetic requirements in 24 patients undergoing cardiovascular surgery. ⋯ The combined use of dexmedetomidine decreases anesthetic requirements in cardiovascular surgery.
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As laparoscopic cholecystectomy is assumed to be with less postoperative pain, it is managed only by general anesthesia during the surgery in our hospital. However, about 70 percent of cases needed the additional analgesic drugs after the operation. In addition, about 70 percent needed analgesic drugs within three hours after the operation, and it has been understood that early postoperative analgesia is insufficient. We focused on the ultrasound guided nerve block and used it to relieve postoperative pain after the laparoscopic cholecystectomy. ⋯ The use of ultrasound guided nervous block for the postoperative pain after laparoscopic cholecystectomy has been helpful, and excellent pain relief has been obtained.
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Case Reports
[Apnea and severe respiratory depression induced by dexmedetomidine after general anesthesia in intensive care unit].
Dexmedetomidine (DEX) is widely used in intensive care unit for perioperative sedation. The one advantage of DEX administration for sedation is the lack of significant respiratory depression. However, DEX shows significant interaction with anesthetics and narcotics, and we present a case in which post-anesthetic administration of DEX induced apnea and severe respiratory depression after extubation. ⋯ After 3.5 hr from the end of anesthesia, the patient's trachea was extubated under continuous infusion of DEX (0.26 microg x kg(-1) x hr(-1)). Ninety min later, she showed apnea and severe respiratory depression. The interaction of DEX and residual narcotics might have induced life-threatening respiratory complication.
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Comparative Study
[Postoperative nausea, vomiting and pain after pediatric outpatient surgery : comparison of laparoscopic and conventional inguinal hernia repair].
The number of laparoscopic surgery is increasing in pediatric surgery. There are few studies in which the pediatric outpatient postoperative course was compared between the laparoscopic and conventional open surgery. ⋯ The patients undergoing LPEC required more postoperative analgesics. The measures to lower postoperative nausea and vomiting should be adopted in these patients.
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In this article, we describe 14 case reports of using ultrasound guidance to facilitate blockade of the cervical nerve root. ⋯ We conclude that ultrasound guidance might be useful for cervical nerve root blocks by improving nerve and vascular localization, and injections under real-time fluoroscopy might make this block safer by identification of the intravascular injection.