Masui. The Japanese journal of anesthesiology
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Complications related to anesthesia remain a problem. We studied the incidence of complications during anesthesia in 2758 patients who had undergone anesthesia in the University of Occupational and Environmental Health Hospital. ⋯ The incidence of complications in inhalation anesthesia was almost as same as that in inhalation anesthesia plus epidural, spinal or conduction block. More study should be necessary to prevent complications related to anesthesia.
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We report a case of anesthesia for cesarean section in a schizophrenic patient. Her psychiatric symptoms were well controlled with low doses of risperidone until 35 weeks' gestation, when she suddenly developed psychotic manifestations. Risperidone 6 mg x day(-1) and haloperidol 12 mg x day(-1) PO were given for 3 weeks before delivery. ⋯ The parturient showed good psychiatric condition during and after the surgery. The neonate did not show any symptoms which antipsychotics could have caused. Maternal and umbilical blood concentrations of risperidone and haloperidol are reported.
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Combined administration of local anesthetics and an opioid is frequently used in order to minimize the dose of each drug and to reduce adverse effects. Although fentanyl is commonly administered with local anesthetic, side effects of fentanyl increase in a dose-dependent manner. In this study, we determined the optimal dose of epidural fentanyl after gynecological surgery. ⋯ Ropivacaine alone could not provide sufficient analgesia. Although the addition of 5 microg x ml(-1) fentanyl to 0.2% ropivacaine at a rate of 5 ml x hr(-1) improved postoperative pain, side effects caused by fentanyl increased. Supplementing 2 microg x ml(-1) fentanyl provided sufficient analgesia with the least incidence of side effects.
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Case Reports
[Retrograde nasal intubation for a patient with difficult airway by using 28 Fr double lumen tube].
We experienced retrograde nasal intubation with a 28 Fr double lumen tube (DLT) in a patient with difficult airway. A 56-year-old man who had undergone an operation for carcinoma of the floor of the mouth was scheduled for right upper lobectomy with video-assisted thoracic surgery. Because of the postoperative anatomical anomaly, the usual laryngoscopy and retrograde oral intubation was not successful. ⋯ We could complete one lung ventilation. There was no trouble of inflation and deflation in anesthesia term. We conclude that 28 Fr DLT is one of the useful tools for difficult airway.