Masui. The Japanese journal of anesthesiology
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We report a case in which two fragments due to coring from the rubbercap of a 50 ml Diprivan vial were detected only immediately before infusion to a patient. The attending anesthesiologist noticed the foreign bodies by chance. ⋯ It is difficult to recognize the small fragments in Diprivan which is white unclear emulsion. Therefore, anesthesiologists should be aware of the danger of coring.
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Arthrogryposis multiplex congenita (AMC) is a syndrome with multiple persistent limb contractures, often accompanied by associated anomalies. Pediatric patients with AMC frequently require operations, necessitating general endotracheal anesthesia. ⋯ Both induction and maintenance were smooth, and no hyperthermia occurred perioperatively. Propofol can be safely used for anesthesia in AMC patients.
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Case Reports
[Usefulness of epidural infusion of ketamine for relief of localized superficial pain].
Three patients with localized superficial pain had their pain alleviated by single epidural infusion with low dose ketamine. The patients are as follows: a 62-year-old female with herpetic neuralgia on her right sixth thoracic nerve area; a 52-year-old male whose left shoulder, anterior chest and abdomen had been burned by acetylene gas; and a 49-year-old male whose bilateral hands suffering from frostbite by propane gas. ⋯ They were administered single epidural infusion of 10 mg ketamine with lidocaine or bupibacaine everyday and they continued to receive epidural block with lidocaine or bupivacaine including buprenorphine or morphine. Therefore, we suspect that single epidural infusion of ketamine, an antagonist for N-methyl-D-aspartic acid receptor, could be an effective and useful alternative treatment in patients with various refractory localized superficial pain of either acute or chronic nature.
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Lidocaine jelly or spray is usually applied to tracheal tube cuffs as lubricants, and we encountered some cuff troubles in using the spray. Damages on polyvinyl chloride (PVC) tracheal tube cuffs by applying lidocaine spray have been reported. ⋯ No tracheal tube cuffs were damaged by normal saline and lidocaine jelly, while lidocaine spray changed the shape of some tracheal tube cuffs (PVC and non-PVC). Therefore, we recommend to apply lidocaine jelly on tube cuffs rather than lidocaine spray, even on non-PVC cuffs.