Masui. The Japanese journal of anesthesiology
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Comparative Study
[Intra- and postoperative heart rate changes following propofol anesthesia; a comparison with isoflurane anesthesia].
Bradycardia during propofol anesthesia is well known, but bradycardia after propofol anesthesia has not been studied well. We compared perioperative heart rates in patients who had undergone gynecological surgery under lumbar epidural anesthesia supplemented with light general anesthesia using isoflurane and nitrous oxide in oxygen (Group Iso, n = 25) with those who had received lumbar epidural anesthesia supplemented with propofol (Group Prop, n = 25). ⋯ In one of them intravenous atropine was necessary to treat bradycardia. We conclude that more attention should be paid to postoperative as well as intraoperative bradycardia in patients who receive propofol.
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We describe our experience of an accidental decrease in the air flow during air/oxygen sevoflurane anesthesia. According to the malfunction of an air compressor system, dehydration of the compressed air was inadequate, and the wet air was delivered to the anesthesia machine. The moisture was formed at a flow control valve to cause a gradual decrease in the air flow. ⋯ Although the synthetic air is always dry and clean, the former contains dust, bacteria, and moisture. There is a possibility that all of these particles cannot be excluded before use. Accordingly, we must check the air compressor system routinely when a source of the compressed air is used.
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We report a successful electrocorticography (ECoG) monitoring for a epileptic cortical focus resection in a 9-month-old girl with uncontrollable epileptic seizures. Anesthesia was induced and maintained with nitrous oxide, oxygen, and sevoflurane with vecuronium. ⋯ It was necessary to maintain adequate depth of anesthesia throughout the procedure to clarify the epileptic waves. For this purpose, sevoflurane (2.5%) with and oxygen (97.5%) under controlled-hyperventilation (PaCO2 30 mmHg), was useful for monitoring the epileptic seizure wave from cortical focuses properly.
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Fracture of the femoral neck (FNF) is a significant cause of morbidity and mortality in the elderly, and the elderly with FNF are often high-risk patients for anesthesia. We studied 15 patients above 80 years of age with severe physical status (ASA III-IV). ⋯ After the operation, morphine 2 mg was administered subcutaneously. In our experience, the majority of 15 patients cardiovascular status of remained stable, except one patient who needed ephedrine for hypotension and another patient who needed diclofenac sodium for post-operative pain relief.
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Case Reports
[An anesthetic experience of a patient with subacute myelo-optico-neuropathy for bilateral mastectomy].
A 79-year-old woman with subacute myelo-optico-neuropathy (SMON) underwent a bilateral mastectomy for breast cancer. She has been suffering from SMON for 32 years. Her preoperative neurological examination revealed cryesthesia and dyskinesia in the lower extremity, and numbness in the crues. ⋯ A combination of general anesthesia and epidural block was employed to minimize the dose of anesthetics which may affect the neuronal symptoms. Intraoperative course was uneventful and continuous epidural block was effective for postoperative pain control. There was no neurological deterioration postoperatively.