Masui. The Japanese journal of anesthesiology
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We had a patient who had repeated inadvertent subdural catheterization. Eighty-two year old woman with post herpetic neuralgia had a continuous epidural anesthesia for the relief of pain. An epidural catheter was inserted at the Th 5-6 interspace using a paramedian approach. ⋯ The diagnosis of subdural block can be made by a subsequent injection of contrast medium, since an unusual clinical course might be seen. Subdural space has a poor blood supply, and injected medium may stay in this space for considerable period of time. Subdural catheterization in epidural anesthesia probably occurs more frequently than previously recognized.
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We reported an anesthetic experience of a 6-year-old male patient with arthrogryposis multiplex congenita who underwent tonsillectomy and adenoidectomy. The induction and maintenance of anesthesia were smoothly performed with inhalation of 1-5% sevoflurane in nitrous oxide and oxygen. ⋯ Halothane and succinylcholine chloride were not used to avoid possible hyperthermia. Anesthetic management of patients with arthrogryposis multiplex congenita was discussed citing literature references.
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[Effect of nafamostat mesilate on serum activities of pancreatic enzymes and plasma hormone levels].
To evaluate the effect of nafamostat mesilate, a potent protease inhibitor, on the pancreatic enzymes and the endocrine system in patients undergoing open-heart surgery with extracorporeal circulation, serum activities of amylase, trypsin, alpha 1-antitrypsin (alpha 1AT) and pancreatic secretory trypsin inhibitor (PSTI), and plasma levels of cortisol and catecholamines were measured. Seven patients (nafamostat group) received intravenous nafamostat mesilate 0.5 mg.kg-1.hr-1 during cardiopulmonary bypass (CPB). The remaining seven patients (non-nafamostat group) did not receive any protease inhibitor. ⋯ Nafamostat group showed lower plasma dopamine levels and higher epinephrine levels compared with non-nafamostat group. The result suggests that nafamostat mesilate administered during CPB could not influence the changes in the activities of pancreatic enzymes. Further studies are needed to clarify the effect of this protease inhibitor on the endocrine system.