Masui. The Japanese journal of anesthesiology
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Although obstetric disease is one of the major causes of disseminated intravascular coagulation (DIC), no gold standard exists. Three current criteria, the Japanese Association for Acute Medicine (JAAM) -DIC criteria, the revised Japanese Ministry of Health and Welfare (JMHW) criteria and the International Society on Thrombosis and Haemostasis (ISTH) criteria, do not clarify the usefulness in obstetric DIC. We therefore conducted a retrospective study by simulation. ⋯ The current study indicates that JAAM-DIC criteria can be useful but may overdiagnose the DIC.
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Comparative Study
[Relationship between postoperative neurological complications and regional cerebral oxygen saturation during retrograde cerebral perfusion].
Transient postoperative neurological disorders are common in patients undergoing aortic surgery with retrograde cerebral perfusion (RCP). We evaluated the relationship between transient postoperative neurological disorders and regional cerebral oxygen saturation (rSO2) during RCP. ⋯ The rSO2 monitor could detect the decrease of cerebral perfusion during RCP. The wide asymmetry of rSO2 was associated with transient neurological disorders, although the lowest rSO2 value and the rate of decline did not relate.
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Surgery during pregnancy is suspected to have various harmful influences to pregnant patients and fetuses. Although laparoscopic surgery has been recently reported to have some advantages over open surgery in this condition, it often requires general anesthesia. ⋯ General anesthesia during pregnancy is not necessarily associated with harmful influences on mother and babies compared with lumbar and epidural anesthesia if selected appropriately.
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Since no pre-medication has been widely accepted especially in spinal anesthesia, anesthesiologists should manage the control of patient's anxiety during surgery. Instead of sedatives, we have been using music-therapy during spinal anesthesia. Bispectral index monitoring (BIS) is used as one of the sedation indices in spinal anesthesia. The aim of this study was to assess the music-therapy on reducing anxiety of patients under spinal anesthesia using BIS and interview type psychology test, State Trait Anxiety Inventory (STAI). ⋯ Music-therapy reduced BIS value and was effective to reduce patient's anxiety during spinal anesthesia.
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Case Reports
[Use of the Pentax-AWS videolaryngoscope for bougie-assisted exchange of tracheal tubes].
A gum elastic bougie can be useful for tube exchange. One major problem with this technique is that it may not possible to pass a new tube over the bougie into the trachea, because the tip of the tube can collide with tissues around the glottis. We report a case in which tube exchange using the bougie was difficult, but the Pentax-AWS videolaryngoscope enabled tracheal intubation. ⋯ Although it was not possible to see the glottis with the Pentax-AWS, the tube was easily advanced over the bougie into the trachea. Operation went on uneventfully. We believe that, when it is difficult to advance a tracheal tube over a tube exchanger, the use of the Pentax-AWS may facilitate intubation.