Masui. The Japanese journal of anesthesiology
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We report a case of intracranial subdural hematoma following spinal anesthesia in a 28-year-old woman. Subdural hematoma is a very rare, but life-threatening complication. When a patient complains of persistent post spinal headache, one should consider the possibility of subdural hematoma and carry out a careful examination, including MRI or CT scan.
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Clinical Trial Controlled Clinical Trial
[Evaluation of midazolam premedication for preoperative anxiolysis].
To evaluate the anxiolysis property of midazolam, 60 patients undergoing minor gynecological surgery were given midazolam 0 mg (n = 20), 2.5 mg (n = 20) or 4 mg (n = 20) intramuscularly as premedication 1 h before their entrance to operating theater. The degree of anxiety was evaluated objectively using the State-Trait Anxiety Inventory (STAI). ⋯ In only midazolam 4 mg group, anxiety was reduced significantly in the operating room compared to the day before operation. It is concluded that midazolam (4 mg) is suitable to reduce the preoperative anxiety in patients who are to undergo minor gynecological surgery.
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Randomized Controlled Trial Clinical Trial
[Effect of indomethacin as an adjunct to postoperative pain relief by continuous epidural infusion of bupivacaine and buprenorphine].
We examined the analgesic effects of indomethacin as an adjunct to postoperative epidural analgesia in 40 patients who underwent upper abdominal surgery. Twenty patients in control group were epidurally given 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine immediately after surgery and subsequently infused 15 micrograms buprenorphine in 1 ml of 0.25% bupivacaine at a rate of 1 ml.h-1 for 48 h. ⋯ The patients who did not need additional narcotics in the control and indomethacin groups were 45% and 80%, respectively (P < 0.05). In upper abdominal surgery, postoperative pain relief by epidural buprenorphine and bupivacaine plus rectal indomethacin was more effective than that by epidural buprenorphine and bupivacaine.
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Hare lip and cleft palate surgery team activities in Cambodia were launched in 1989 by a non-governmental Japanese organization, Operations Unies. The objectives of the project are to provide appropriate surgical treatment and safe general anesthesia for local patients and also to conduct technology transfer of general anesthesia and surgery to the local medical staffs. From June 1991 to January 1993, a surgery/anesthesia team was dispatched 4 times and a total of 130 patients received surgical treatments under general anesthesia. ⋯ The reasons why we chose intravenous agents are difficulty in obtaining inhaled agents in Cambodia and lack of scavenging system in a operating room. Although halothane anesthesia with spontaneous breathing has been recommended in developing countries, total intravenous anesthesia could be one of the applicable techniques in these countries. In Cambodia, shortage of medical doctors and the absence of anesthesiologist constitute a major barrier to technology transfer in clinical anesthesia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[A comparison between neuromuscular blocking effects of pipecuronium and vecuronium; a double blind controlled study in collaboration with 5 departments of anesthesiology].
Neuromuscular blocking effects of pipecuronium bromide 0.04 mg.kg-1 were compared those of vecuronium bromide 0.08 mg.kg-1 in a double blind study. Fifty surgical patients (ASA I or II) were allocated randomly to two groups of each 25 cases and they were anesthetized with nitrous oxide 4 l.min-1, oxygen 2 l.min-1 and isoflurane 1 MAC. Neuromuscular blockade was monitored by using mechanical twitch responses of the thumb to electrical stimulations of the ulnar nerve. ⋯ The blocks by both drugs responded to neostigmine. Cardiovascular side effects of the both agents were not found. From these results, it is concluded that pipecuronium is a useful nondepolarizing relaxant with a long duration of action and negligible side effects.