Masui. The Japanese journal of anesthesiology
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Spinal cord stimulation has gained widespread popularity for the treatment of pain. This literature discribed our equipments, methods, patient selection, and operative procedures for spinal cord stimulation.
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A five-year-old boy with recurring tonsillitis and sleep apnea was admitted for tonsillectomy and tympanic membrane tubing. He presented with a history of bronchial asthma and hereditary spherocytosis without obvious cardiac failure symptoms. Anesthetic agents for induction included nitrous oxide, oxygen, and sevoflurane. ⋯ The patient was discharged when his general condition improved. He showed elevated levels of viral antibodies, suggesting myocarditis. Later he was treated for dilating cardiomyopathy before undergoing a heart transplant.
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Case Reports
[Labor management using epidural anesthesia in a gravida patient with high spinal injury].
Since autonomic hyperreflexia (AH) is a serious complication during labor in a gravida with spinal cord injury, anesthetic measures should be taken for the suppression of AH even in a sensory-loss condition. Several reports have described various methods for the suppression of AH, in which epidural anesthesia has been advocated as a useful means for the prevention or amelioration of AH. However, it is difficult to evaluate the efficacy of epidural anesthesia due to the lack of sensory and motor functions. ⋯ Tubal-ligation was also performed under epidural anesthesia after the second delivery. No major obstetric complication including AH occurred in either of delivery. The woman with high spinal injury could have two healthy children without major complications during labor by the cooperation of gynecologists and anesthesiologists.
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When the applied cricoid pressure is too strong, or the place or direction of the pressure application is not appropriate, glottal closure may occur, but its details are unclear. ⋯ The right-to-left distance of the rima glottides was significantly reduced by backward pressure or BURP on the thyroid cartilage, and was also markedly reduced by cricoid pressure in 1 of the 12 patients.
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Case Reports
[Unintentional total spinal anesthesia during cervical epidural block with ropivacaine].
We present a case of unintentional total spinal anesthesia, which occurred during cervical epidural block. A 34-year-old man with complex regional pain syndrome of the right upper arm was treated with epidural block at C7-T1 interspace. Immediately after test-dose injection of ropivacaine 1.5 ml, he complained of paresthesia of his upper extremities. ⋯ Neurological dysfunction was not seen thereafter. Although test-dose injection is recommended especially in high-risk patients and case of difficulty of epidural space identification, it does not fully prevent complications. For cervical epidural block, local anesthetics should either be given at small doses or not be given as long as a possibility of spinal injection is remaining.