Masui. The Japanese journal of anesthesiology
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Case Reports
[Unintentional total spinal anesthesia during cervical epidural block with ropivacaine].
We present a case of unintentional total spinal anesthesia, which occurred during cervical epidural block. A 34-year-old man with complex regional pain syndrome of the right upper arm was treated with epidural block at C7-T1 interspace. Immediately after test-dose injection of ropivacaine 1.5 ml, he complained of paresthesia of his upper extremities. ⋯ Neurological dysfunction was not seen thereafter. Although test-dose injection is recommended especially in high-risk patients and case of difficulty of epidural space identification, it does not fully prevent complications. For cervical epidural block, local anesthetics should either be given at small doses or not be given as long as a possibility of spinal injection is remaining.
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Randomized Controlled Trial Multicenter Study Comparative Study
[Neuromuscular blocking effects of Org 9426 (rocuronium bromide); a comparative study with vecuronium bromide in Japanese patients].
Efficacy and safety of Org 9426 were compared with those of vecuronium bromide in Japanese patients. ⋯ Org 9426 showed more rapid onset time than that of vecuronium and similar clinical duration and recovery times to those of vecuronium in Japanese patients.
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Pain is a private internal event, the degree of which can not be evaluated directly by others. The measurement of the nociceptive pain threshold may apply to the evaluation of the degree of the pain. The instruments using mechanical and electrical stimulation are available for the clinical application. ⋯ The method seems to be well suited for the evaluation of pain in musculoskeletal disorders. The electrical stimulation test provides a quantitative measure of pain tolerance to a transcutaneous stimulation, neuroselective for large and small myelinated and unmyelinated nerve fibers. There are characteristics including advantages and faults in each method, and the method of measurement corresponding to the purpose and application is important.
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Spinal cord stimulation has gained widespread popularity for the treatment of pain. This literature discribed our equipments, methods, patient selection, and operative procedures for spinal cord stimulation.
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When the applied cricoid pressure is too strong, or the place or direction of the pressure application is not appropriate, glottal closure may occur, but its details are unclear. ⋯ The right-to-left distance of the rima glottides was significantly reduced by backward pressure or BURP on the thyroid cartilage, and was also markedly reduced by cricoid pressure in 1 of the 12 patients.