Masui. The Japanese journal of anesthesiology
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Review Case Reports
[Venous air embolism following repositioning from sitting to supine].
We have experienced a patient in whom venous air embolism reoccurred, when the patient's position was changed from sitting to supine. A 40 year old male with Arnold-Chiari malformation underwent suboccipital decompression and cervical laminectomy under the sitting position. ⋯ This case suggests that there is some remaining air in the large veins of the upper part of the body once the air embolism has occurred during sitting position and thus we need to confirm that no air is left in the large veins before repositioning. We should be cautious of reoccurrence of venous air embolism whenever patient's position is changed.
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To clarify factors that determine the distance between skin and epidural space we analyzed the relationship between distance and factors such as age, sex, height, weight and Broca index using multivariate analysis. Epidural tap was performed in 100 adult patients. Distance was estimated by subtracting the length of needle outside the body from the total length of a Touhy needle. ⋯ In this multivariate analysis the first principal component was the site, the second one was the Broca index, the third one was age and the fourth one was height. The distance tended to increase in proportion to aging in this analysis. We conclude that the skin-epidural distance is strongly influenced by the site of puncture and Broca index, but not influenced by pregnancy.
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Case Reports
[An emergency cesarean section using general anesthesia for a patient with schizophrenia].
A 27 year-old female in 39th week gestation with schizophrenia underwent an emergency Cesarean section using general anesthesia. A diagnosis of schizophrenia was made two years previously, since then oral anti-psychotic drugs such as chlorpromazine had been given to her. In June 1989 she suddenly became excited and generalized muscle rigidity was observed without any triggering episodes. ⋯ The baby's Apgar score was 9 and 1 min and 9 at 5 min after the delivery. The baby developed slight generalized tremor until next day, probably due to effect of levomepromazine given before the Cesarean section. The patient was discharged without any cardiorespiratory trouble and her baby has been doing well so far.
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Convenient and useful computer software for the anesthesiologist to draw figures for presentation, or to perform statistical analysis were presented. Each software is selected in the condition that it does not need special optional hardware, and processes the data quickly even with an old type computer, and also that even a computer beginner can easily operate it. The presented software are as follows: 1) Silhouette (drawing figures), 2) NEO (drawing figures), 3) Graph note (drawing figures), 4) Chart up science (drawing figures), 5) Z's word JG (making slide manuscripts) and 6) Biostat (doing statistical analysis).
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Comparative Study
[Evaluation of dopamine and dobutamine for use in circulatory depression associated with induced total spinal block].
We carried out total spinal block (T. S. B.) in adult mongrel dogs with 0.5 ml.kg-1 of 2% lidocaine, and compared the effects of dopamine (DOA) and dobutamine (DOB) to correct the circulatory depression produced by T. ⋯ From the results, it is concluded that DOB is more effective than DOA to correct the circulatory depression by T. S. B., and in order to correct it more than 5 mcg.kg-1.min-1 of DOA and approx. 2.5 mcg.kg-.min-1 of DOB are necessary.