Masui. The Japanese journal of anesthesiology
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Case Reports
[Usefulness of intraoperative transesophageal echocardiography for pediatric patients with congenital heart disease].
This report describes usefulness of intraoperative transesophageal echocardiograpy (TEE) based on 773 cases we experienced in 7 years. We assessed residual lesions, ventricular function and preload with TEE. We found a case with stenotic lesion in her lateral tunnel which TEE revealed after Fontan procedure. ⋯ The conditions improved just after withdrawing TEE probe. Neither inadvertent tracheal extubation, nor serious complication occurred during TEE examinations. The incidence of complications during pediatric TEE is low and TEE examination is useful for pediatric patients with congenital heart disease.
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A 59-year-old man presented with severe dyspnea caused by advanced laryngeal cancer. As he had disregarded the dyspnea for a month, we did not have enough information about the extent of the tumor. The pulse oximeter showed 88% with oxygen inhalation. ⋯ On the fifth day of this treatment, after rewarming and discontinuation of thiamylal, the patient responded to command. He recovered with no neurological deficits. This case suggests that combined treatment with barbiturate, free radical scavenger, and mild hypothermia therapy is effective to minimize ischemic brain damage after cardiopulmonary resuscitation.
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A 43-year-old healthy female volunteer donor was scheduled for bone marrow harvesting. In the operating room her mouth opening was ascertained to be 5 cm. Anesthesia was induced with thiamylal 250 mg, fentanyl 0.1 mg and vecuronium 6 mg i.v. ⋯ The surgical procedure and anesthesia thereafter were uneventful. Postoperative MRI was coincident with the diagnosis of temporomandibular disorder. It was speculated that in the donor patient with preexisted type II temporomandibular disorder, muscle relaxation induced by anesthesia caused the mandibular head fall behind the articular disk and dislocated the disk forwardly ending up in closed lock of temporomandibular joint.
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Clinical Trial
[Application of a PDE III inhibitor, olprinone, for fast track pediatric cardiac surgery].
We examined the effects of olprinone (OLP), a PDE III inhibitor, on the time to extubation and on the hemodynamics in infants and children undergoing fast track cardiac surgery. ⋯ The administration of OLP enables us to perform an immediate early extubation and provides stable hemodynamics. OLP would be useful in children undergoing fast track cardiac surgery.
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Case-1: A 24-year-old woman was admitted because of pressing hydramnion. She was treated by ritodrine hydrochlorides leading to rhabdomyolysis, and she was diagnosed as myotonic dystrophy. She underwent cesarean section because of urgent premature birth. ⋯ She was anesthetized with propofol and fentanyl. Because severity of the myotonic dystrophy varies among the patients, the strategy for anesthesia should be planned on each patient. Generally speaking, regional anesthesia including spinal and epidural anesthesia is preferable.