Masui. The Japanese journal of anesthesiology
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Comparative Study Clinical Trial
[Postoperative sore throat and intracuff pressure: comparison among endotracheal intubation, laryngeal mask airway and cuffed oropharyngeal airway].
We studied which device is most useful to reduce postoperative sore-throat. We investigated the relationship between intracuff pressure and postoperative sore-throat in using endotracheal intubation (ET), the laryngeal mask airway (LMA) and the cuffed oropharyngeal airway (COPA) in adult patients. We classified sore-throat into categories; pain at rest, hoarseness and dysphasia. ⋯ Hoarseness was complained by 15 patients in ET group, 2 in LMA group and 4 in COPA group, showing significantly lower incidence of hoarseness in LMA and COPA groups than in ET group. Dysphasia was complained by 3 in ET group, 1 in LMA group and 2 in COPA group, showing no significant difference. These results suggest that LMA is most appropriate to reduce postoperative sore-throat.
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Randomized Controlled Trial Clinical Trial
[Pre-incisional administration of ketamine reduced the postoperative pain].
This study was designed to examine the postoperative analgesic effect of pre-/post-incisional administration of ketamine. Thirty-nine female patients scheduled for transabdominal hysterectomy were randomly allocated into 3 groups. Patients in group-K1 (n = 13) received intravenous ketamine 100 mg before surgical incision and patients in group-K2 (n = 13) received the same after laparotomy. ⋯ VAS and VRS in group-K1 were significantly lower compared with those in group-C, while there was no difference between group-K2 and C. The incidence of side effects and additional use of analgesics were similar among the three groups. In conclusion, pre-incisional administration of ketamine reduced the postoperative pain, but post-incisional ketamine was not effective.
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Case Reports
[Complications of spinal anesthesia as the initial symptom in patients with spinal tumor--a report of two cases].
This report describes the onset of symptoms of spinal cord compression by tumor after spinal anesthesia. Two patients underwent caesarean section. Postoperatively, they complained of backache and heaviness in the legs. ⋯ In another case, operation was not performed, but the patient recovered gradually. Onset of symptoms of spinal cord compression by tumor after lumbar puncture can be attributed to displacement of the mass or to vascular engorgement. If after the lumbar puncture, a patient complains numbness, loss of strength, and paresthesias in the legs, we should suspect the presence of the spinal tumor.
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Duchenne's muscular dystrophy is a genetic disorder whose features include abnormal responses to muscular relaxants and possible respiratory dysfunction after general anesthesia. The purpose of this report is to describe one management strategy used successfully to anesthetize an obese man with this disorder for atypical mastectomy. ⋯ Postoperatively 0.25% bupivacaine was infused for epidural analgesia. The patient was observed in the intensive care unit until the first postoperative day and showed an uncomplicated intra- and post-operative course.
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Randomized Controlled Trial Clinical Trial
[Extent and duration of isobaric 0.5% bupivacaine spinal anesthesia by using new open-end pencil point spinal needle].
Extent and duration of isobaric 0.5% bupivacaine spinal anesthesia by using two spinal needles; a new 25 gauge open-end pencil point spinal needle (needle tip is open as a hole after pulling out the stylet, Doctor Japan Co., Japan) and a 25 gauge Quincke needle (TOP Co., Japan) were studied clinically in 24 patients for elective lower extremity surgery. Patients were randomly assigned into two groups of 12 patients each according to the spinal needle used. Lumbar puncture was performed between L3-4 with the patient in lateral decubitus position. ⋯ Two groups did not differ significantly in sensory block and also in motor block. No adverse effect was observed in both groups. These results indicate that this new open-end pencil point spinal needle is very useful for preventing adverse effects of spinal anesthesia.