Masui. The Japanese journal of anesthesiology
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Comparative Study
[Relationship between postoperative neurological complications and regional cerebral oxygen saturation during retrograde cerebral perfusion].
Transient postoperative neurological disorders are common in patients undergoing aortic surgery with retrograde cerebral perfusion (RCP). We evaluated the relationship between transient postoperative neurological disorders and regional cerebral oxygen saturation (rSO2) during RCP. ⋯ The rSO2 monitor could detect the decrease of cerebral perfusion during RCP. The wide asymmetry of rSO2 was associated with transient neurological disorders, although the lowest rSO2 value and the rate of decline did not relate.
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We report general anesthesia for a patient with multiple sclerosis (MS). A 40-year-old male patient with a 13-year history of MS was scheduled for laparoscopic surgery. The symptoms of MS had been exacerbated during feverish state or under surgical stress in the previous surgeries. ⋯ Flurbiprofen axetil was used for slight postoperative fever. There was no clinical exacerbation of MS during perioperative period. In conclusion, appropriate control of surgical stress and prevention of fever are important for perioperative anesthetic management of patients suffering from MS.
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Randomized Controlled Trial
[Prospective study on anesthesia for lumbar spine surgery--the effectiveness of the perioperative epidural anesthesia with buprenorphine].
We prospectively evaluated the efficacy of perioperative epidural buprenorphine for lumbar spinal surgery under general anesthesia. Twenty-eight patients were allocated into two groups; in one group (buprenorphine group), patients underwent the surgery under general anesthesia with perioperative epidural buprenorphine 0.2 mg, in the other group (control group), patients underwent the surgery under general anesthesia only. The epidural injection was within 2 levels of the cephalad segment of the operating site. ⋯ In buprenorphine group, requirement of analgesics was less during and after surgery compared with the control group. Neurological evaluation immediately after surgery revealed no neurological side effects in both groups. We conclude that general anesthesia with perioperative epidural buprenorphine for lumbar spinal surgery is safe and useful.
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Although obstetric disease is one of the major causes of disseminated intravascular coagulation (DIC), no gold standard exists. Three current criteria, the Japanese Association for Acute Medicine (JAAM) -DIC criteria, the revised Japanese Ministry of Health and Welfare (JMHW) criteria and the International Society on Thrombosis and Haemostasis (ISTH) criteria, do not clarify the usefulness in obstetric DIC. We therefore conducted a retrospective study by simulation. ⋯ The current study indicates that JAAM-DIC criteria can be useful but may overdiagnose the DIC.
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Case Reports
[Complications of internal jugular vein cannulation under ultrasound guidance: report of three].
Internal jugular cannulation with ultrasound guidance has been advocated to decrease its complications. However, there can be serious complications by in-experienced physicians in even ultrasound-guided internal jugular vein cannulation. We report three cases of complications associated with ultrasound-guided internal jugular vein cannulation: puncture of the common carotid artery in two patients and pneumothorax in one.