Masui. The Japanese journal of anesthesiology
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A 74 year-old woman with a 6-month history of RSD following herpes zoster on her right arm was treated with stellate ganglion blocks (SGB), continuous epidural block (CEB) and continuous intravenous infusion of ketamine known as one of the NMDA receptor blockers. Of the symptoms of RSD, burning pain and hyperperspiration but allodynia disappeared after the treatment with SGB 8 times and CEB for 4 days. Allodynia disappeared completely after ketamine treatment, where ketamine was infused once using a subanesthetic dose for 2 hours. It is considered that ketamine is one of the useful drugs for the treatment of neuropathic pain with allodynia.
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We used a laryngeal mask for Nd-YAG laser operations of airway stenosis due to tracheal granulation, broncheal granulation and subglottic tumor. Anesthesia was induced with inhalation of N2O-O2-sevoflurane in two cases and intravenous thiopental in one case. The laryngeal mask was inserted with intravenous injection of vecuronium. ⋯ Laryngeal mask airway was stable with respect to circulation and respiration during Nd-YAG laser irradiation. Ignition of a laryngeal mask caused by Nd-YAG laser is much less common compared to that of a tracheal tube with cuff. Therefore, we recommend to use laryngeal mask airway for Nd-YAG laser operation of airway stenosis because of much less danger of ignition and because it keeps good cardiovascular and respiratory conditions.
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Review Case Reports
[Bronchospasm during anesthesia in a patient with Prader-Willi syndrome].
A patient with Prader-Willi syndrome developed bronchospasm during anesthesia. The patient was a 9-year-old boy and was scheduled for orchiopexy. His psychomotor development was delayed, and at 12 months of age he was diagnosed as Prader-Willi syndrome by chromosomal examination. ⋯ The bronchospasm was improved gradually and surgery was finished. Prader-Willi syndrome is an uncommon disease first reported by Prader in 1956 and characterized by hypotonia, hypomentia, hypogonadism and obesity. In the perioperative management for a patient with Prader-Willi syndrome, special attention must be paid to the abnormalities in the upper and lower respiratory systems.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Premedication in children: a comparison of oral midazolam and rectal bromazepam].
Seventy-seven children for minor surgery of less than 90 minutes in duration were divided into two groups; one group received midazolam syrup and the other received bromazepam suppository. The sedative effect before or after the induction of the anesthetic, the effect on the circulatory system, and the prolongation of the sedative effect after surgery were studied. ⋯ In children under 4 years of age, the sedative effect during the induction was obtained by administering midazolam syrup before the surgery. It is indicated that midazolam syrup is superior to the bromazepam suppository in children under 4 years of age.
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Comparative Study Clinical Trial
[Incidence of nausea and vomiting after cholecystectomy performed via laparotomy or laparoscopy].
Postoperative nausea and vomiting (PONV) are commonly observed adverse effects of general anesthesia. In a retrospective study of laparoscopy group (101 patient) and laparotomy group (101 patient), we evaluated the incidence of PONV after laparoscopic cholecystectomy. ⋯ The risk of PONV was greater in laparoscopy group in female patients (23.4% versus 9.3% in laparotomy group, P < 0.05) and in obese patients (25.0% versus 0% in laparotomy group, P < 0.01) during the first postoperative hour. We conclude that laparoscopic cholecystectomy increases the incidence of PONV in early postoperative period probably by the effect of residual stretching and irritation of the peritoneum, and the risk is increased in female and obese patients.