Masui. The Japanese journal of anesthesiology
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We experienced anesthetic management of two cases of amyotrophic lateral sclerosis (ALS). Case 1. A 46-year-old woman underwent emergency operation for ileus. ⋯ During and after the operation, she was in good general condition and had no pain. For the patients with ALS, prolongation of muscle relaxation and residual neuromuscular block effect may cause difficult tracheal extubation and postoperative respiratory complications. We observed carefully the condition of the patients with ALS, and were able to choose the minimum invasive anesthetic methods for each case.
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In cases of hydrops foetalis, respiratory management is frequently required after delivery. We experienced 7 anesthetic managements for cesarean section in patients with hydrops foetalis. ⋯ Before surgery, we discussed perioperative and anesthetic management among pediatricians, pediatric surgeons, and obstetricians in a conference. Since the anesthetic drugs used for the cesarean section have great influences on the fetus, the choice of anesthesia should be performed based on fetal conditions.
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Randomized Controlled Trial Clinical Trial
[Ilioinguinal/iliohypogastric nerve block for pediatric inguinal herniorrhaphy; evaluation of the dose of ropivacaine].
The aim of this study was to investigate the appropriate dose of ropivacaine in efficacy and safety when administered for ilioinguinal/iliohypogastric nerve block in children undergoing inguinal herniorrhaphy. ⋯ These results suggest that more than 0.9375 mg x kg(-1) of ropivacaine might be recommended to obtain sufficient postoperative analgesia for the ilioinguinal/iliohypogastric nerve block in children undergoing inguinal herniorrhaphy.
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We experienced an anesthetic management for a patient of myotonic dystrophy with pheochromocytoma. Much attention is required to manage myotonic dystrophy on surgical manipulation. This disease interacts with anesthetic drugs. ⋯ Though, this patient was not fully awake from anesthesia and could not take enough breaths on his own. We extended the period of spontaneous breathing with careful check whether the patient has resumed spontaneous breathing. It took us fourteen days till extubation.
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Case Reports
[Anesthetic management for cesarean section in a patient with corrected transposition of great arteries].
A 20-year-old woman with corrected transposition of great arteries (height 163 cm, weight 69 kg) was scheduled for elective cesarean section at 36 weeks of gestation. Since her mitral insufficiency had deteriorated during pregnancy, she developed dyspnea and lower cardiac function. We decided to perform general anesthesia for her cesarean section. ⋯ No cardiac events were observed during surgery. The postoperative course was uneventful, and the patient was discharged from the hospital on the 10th postoperative day. Swan-Ganz catheter was useful for the evaluation of cardiac function and for anesthetic management.