Masui. The Japanese journal of anesthesiology
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Case Reports
[A survival case of cardiac arrest resuscitated initially by several anesthesiologists in an airport].
We experienced a case of cardiac arrest in a man near the boarding gate area in an airport. An anesthesiologist witnessed the onset of his cardiac arrest. Three anesthesiologists undertook cardiopulmonary resuscitation until the arrival of the emergency medical service crew. ⋯ The patient regained consciousness before hospitalization. Airport employees should be trained in techniques of basic life support in order to be able to resuscitate patients who have suffered cardiac arrest in an airport. Medical emergency kits equipped in airplanes should be made available for use in cases of cardiac arrest occurring near a boarding gate in an airport.
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Respiratory disturbance occurs sometimes after anterior cervical fusion. This is often a result of upper airway obstruction due to prevertebral soft tissue swelling. ⋯ After starting to ventilate through Mini-Trach II, respiratory disturbance disappeared soon and respiration improved markedly. Mini-Trach II is an effective device to use in patients with post-operative respiratory disturbance due to prevertebral soft tissue swelling.
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We examined the effects of oxytotics administered after fetus delivery on epidural and venous pressures in 40 parturients undergoing cesarean section under spinal anesthesia. ⋯ The increase in epidural pressure within 5 minutes after fetus delivery would be caused by uterine contraction in both groups. The vasoconstrictive effect in the methylergometrine group is likely to cause the epidural pressure increase after delivery.
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Case Reports
[A case of spontaneous intracranial hypotension effectively treated with cervical epidural blood patch].
We report a case of cervical spontaneous intracranial hypotension (SIH). The patient is a 46-year-old woman with hard of hearing, dizziness and postural headache. Radionuclide cisternography (RNC) demonstrated a cerebrospinal fluid (CSF) leak at the low cervical region. ⋯ However, if the symptoms of SIH do not show a complete recovery by conservative therapies, EBP or continuous epidural infusion of saline has reportedly been used for the management of these cases. Most of the reported cases of EBP are in the thoracic and lumbar spinal regions. We have performed cervical EBP without complications, and the 6 month-follow-up MRI and RNC demonstrated that the abnormal findings had disappeared.
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Abdominal wall lift laparoscopic surgery is often used for patients during pregnancy because it is physiologically superior to CO2 pneumoperitoneum laparoscopic surgery. Operation for adnexal cysts is performed in the 1st trimester. We report seven cases of ovarian cysts during pregnancy, resected using gassless laparoscopic method with a whole abdominal wall lift under combined spinal-epidural anesthesia (CSEA). ⋯ Post-operative analgesia was established by epidural PCA, thus anti uterine contraction medicines were prophylactically administered in only one of seven cases. There was no particular trouble during the anesthesia and all the operative procedures were performed uneventfully. Based on our limited experiences, CSEA may be a safe and appropriate anesthetic technique for laparoscopic ovarian cystectomy with abdominal wall lift during pregnancy.