Masui. The Japanese journal of anesthesiology
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Electrically elicited blink reflexes were investigated in 60 patients with peripheral facial nerve palsy. The purpose of this study was to evaluate the utility of analysis of R 2 wave in blink reflex as a prognostic indicator for the patients with facial palsy. The patients treated by stellate ganglion block were classified into three groups: Group I scored more than 90 points (full score is 100 points) within 2 weeks, Group II scored more than 90 points over 2 weeks, and Group III scored less than 90 points. ⋯ In Group III, the ipsilateral R 2 wave was not observed. The results of this study indicate that measurement of the R 2 latency of blink reflex is useful in judging the severity of the peripheral facial nerve palsy. The R 2 latencies obtained by stimulation of ipsilateral and contralateral side should be used as one of the parameters for evaluation of the prognosis of patients with peripheral facial nerve palsy.
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Case Reports
[Swelling of the tongue after intraoperative monitoring by transesophageal echocardiography].
Tongue swelling after surgery is a rare but potentially lethal postoperative complication. This is a case report of a 62-yr-old patient who developed tongue swelling after intraoperative monitoring by transesophageal echocardiography. The patient underwent replacement of the descending aorta with an interposition graft under cardiopulmonary bypass. ⋯ The tongue swelling was thought to have been caused by local mechanical compression of the tongue with the TEE probe. The tongue returned to normal size the next day. Care should be taken to prevent the occurrence of this complication during and after TEE examination under general anesthesia.
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To evaluate the effect of obesity on spinal anesthesia for cesarean section, we retrospectively studied 90 parturients who had undergone cesarean section, dividing the patients into 2 groups: obesity group (body mass index > 30, n = 41); control group (body mass index < 30, n = 49). Total surgical time and anesthetic time were longer in the obesity group than in the control group. ⋯ However, there were no significant differences in time for spinal tap and the incidence of hypotension between the two groups. Spinal anesthesia for cesarean section in obese patients may be an acceptable method.
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To compare the effect of Valsalva maneuver and 10 degrees Trendelenburg position on the right internal jugular vein (RIJV), we measured RIJV cross-sectional area using ultrasound imaging during these procedures. The study group consisted of 13 normal healthy volunteers (6 males, 7 females, aged 25-47) with no history of neck surgery or right internal jugular vein (RIJV) puncture. ⋯ The cross-sectional areas of the RIJV during Valsalva maneuver and 10 degrees Trendelenburg position compared to those with supine position were 314 +/- 162%, and 192 +/- 96%, respectively. We conclude that both procedures increase cross-sectional area of IRJV significantly and in this respect Valsalva maneuver is more effective than Trendelenburg position.
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Case Reports
[Epiduroscopy in patients with chronic low back pain without remarkable findings on magnetic resonance imaging].
Two patients with chronic low back pain and sciatica failed to respond to conservative treatments. In these patients, magnetic resonance imaging (MRI) showed no remarkable findings corresponding to their symptoms. ⋯ One patient got better after two epiduroscopic procedures, and the other did not. Epiduroscopy may be an effective, minimally invasive treatment as well as examination for patients with chronic low back pain without remarkable findings on MRI.