Masui. The Japanese journal of anesthesiology
-
We experienced rocuronium-induced anaphylaxis in a 62-year-old man who was scheduled for laparoscopic ileocecal excision for cecal cancer under general anes- thesia. The patient did not have a preoperative history and examinations suggestive of heart disease, or pre- disposing factors for myocardial infarction. Just after induction of anesthesia, we noticed abnormally low blood pressure and ST segment elevation on his elec- trocardiogram. ⋯ The sur- gery was performed safely with this protocol. It is likely that his symptoms in the first general anesthesia were caused by Kounis syndrome. We conclude that the basophil activation test seems to be valuable in determining the causative agent of anaphylaxis, partic- ularly when a patient does not agree to undergo skin tests.
-
Fibrinogen replacement therapy con- tributes to effective hemostasis and saving blood trans- fusions in critical hemorrhage. We retrospectively studied the efficacy and indication for cryoprecipitate or fibrinogen concentrate in thoracic aortic surgery. ⋯ The fibrinogen amount of 2-3 g (per 50-70 kg in body weight) in cryoprecipitate or fibrino- gen concentrate effectively reduces postoperative bleeding and perioperative blood transfusions when a fibrinogen level is less than 100-130 mg · dl⁻¹ during cardiopulmonary bypass.
-
Historical Article
[History of Resuscitation: 1. Development of Resuscitation in the Mid-18 Century-1 : Establishment of Humane Societies and List of Literature].
In the mid-18th century, a growing number of peo- ple started to attempt resuscitation of "apparently dead" people as a result of drowning or other causes, and humane societies were established in Holland, Brit- ain, and other European countries. In this article, I describe a history of those humane societies and pro- vide an extensive list of literature related to resuscita- tion published from the mid-18th century to 1820's.
-
Historical Article
[History of Resuscitation: 2. Development of Resuscitation in the Mid-18 Century-2 : Background of Development of Resuscitation and Rescue Methods].
In the mid-18th century, a growing number of peo- ple started to attempt resuscitation of "apparently dead" people as a result of drowning or other causes. In this article, I describe the background for this movement (which was likely to be related to a fear of being buried alive and of being dissected alive). I also describe a historical development of rescue methods of drowned people.
-
With recent changes in surgical procedures and perioperative management, there has been a growing interest in peripheral nerve blocks of the trunk in patients undergoing thoracic and breast surgery. Tho- racic truncal blocks include paravertebral, pecs, intercostal, and retrolaminar blocks. Previous studies have demonstrated that paravertebral block provides similar analgesic effects and better hemodynamic stability compared with epidural analgesia. ⋯ The novel ultrasound-guided techniques for intercostal nerve blocks have also been reported. Although some case series support that these pecs and intercostal nerve blocks appear to be safe and effective, prospective randomized studies to confirm their clinical usefulness are lacking. Whether to con- duct these thoracic truncal blocks or not will become a standard clinical practice for thoracic and breast sur- gery is yet to be determined.