Masui. The Japanese journal of anesthesiology
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Comparative Study
[Anesthetic management for cesarean section involving placenta previa].
There are few consistent anesthetic guidelines how to manage cesarean section in the presence of placenta previa. Main problem may be hemorrhage, as occasionary unexpected massive bleeding leads to life-threatening hemorrhage. ⋯ These results indicate that regional and general anesthesia did not differ in the intraoperative incidence. In all cases at least two anesthesiologists and at least two venous lines are necessary to manage cesarean section in the presence of placenta previa.
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On reversal of muscle relaxants when neostigmine-atropine mixture is used, heart rate changes occurr. We examined whether landiolol attenuate the initial increases in heart rate after intravenous injections of a neostigmine-atropine mixture. ⋯ Landiolol was useful for heart rate control after neostigmine-atropine administration during recovery from general anesthesia.
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Comparative Study
[Evaluation of a compact device for capnometry of main-stream type compared with one of side-stream type in a postoperative care unit].
Pulse oximetry is insufficient for postoperative respiratory monitoring. It is better to use capnometry for postoperative patients because it is easy to use and useful to monitor patients' breathing. However, capnometry must be improved in its wearability and detection capability. Therefore it is not used often for postoperative patients as a respiratory monitor. ⋯ We conclude that the main-stream system is a better monitor of postoperative respiratory condition.
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Case Reports
[Central venous oxygen saturation monitoring was useful in two cases of hepatectomy with massive bleeding].
To maintain adequate hepatic oxygen supply during intra-operative period is very important to prevent post-operative liver failure after hepatectomy. One of the most useful monitors is hepatic venous oxygen saturation. ⋯ Two cases of hepatectomy performed with the monitoring of continuous central venous oxygen saturation using PreSep Central Venous Oximetry Catheter (Edwards Lifesciences) suffered from massive bleeding. For the management of the circulation and organ oxygenation, the monitoring of continuous central venous oxygen saturation was very simple and useful in these cases.
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A 66-year-old man with severe chronic obstructive pulmonary disease (COPD) was scheduled for elective endovascular repair of an aortic abdominal aneurysm and femoral-femoral artery bypass. Because spirometry revealed marked reduction of percent forced expiratory volume in 1 second (%FEV1.0), postoperative respiratory failure was anticipated. Spinal anesthesia and no use of tracheal intubation were planned. ⋯ Additional analgesia was acquired with a total of 0.1 mg of fentanyl IV. The endovascular repair was completed uneventfully. In conclusion, spinal anesthesia combined with local anesthesia in the elbow is useful for management of endovascular repair of an aortic abdominal aneurysm in patients with severe COPD for whom postoperative respiratory failure is anticipated.