Masui. The Japanese journal of anesthesiology
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This report shows a rare case of muscle rigidity by remifentanil just before the end of surgery. A 71-year-old man was scheduled for microvascular decompression to cure trigeminal neuralgia. ⋯ After giving muscle relaxants, the patient was uneventful. We should pay attention to muscle rigidity even using low doses of remifentanil.
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A 47-year-old woman with postdural puncture headache suffered from transient paralysis and paresthesia immediately after the epidural blood patch. After one and a half hour, these symptoms disappeared spontaneously. ⋯ With passing of time, the viscous blood spread through the epidural space, and neurological symptoms improved. Although the risks of epidural blood patch are relatively low, we should closely pay attention to unexpected side effects.
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Case Reports
[Anesthetic management of caesarean section following the Fontan procedure by using TaskForce Monitor].
The Fontan procedure is performed for patients with a corrected transposition of great arteries, and pregnancies following this surgery are likely to increase in number. We present a parturient with the Fontan physiology. In this case, we used thoracic bio-impedance cardiac output monitoring system "TaskForce Monitor". It was shown that the cardiovascular management by using TaskForce Monitor was useful because of the non-invasive beat-to-beat cardiac output monitoring.
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A 26-year-old man was scheduled for surgical extraction of a large epiglottic cyst. Mask ventilation was possible under propofol anesthesia without muscle relaxant. It was difficult to see the glottis using either a Macintosh laryngoscope or by fiberoptic bronchoscopy. ⋯ A reinforced tube was inserted nasally, and a fiberoptic bronchoscope was passed through the tube into the trachea. The tube was then passed over the fiberscope into the trachea. We believe that the Pentax AWS laryngoscope may lift the epiglottis and its cyst atraumatically, and may facilitate nasal fiberoptic intubation in a patient with a large epiglottic cyst.
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Case Reports
[Spinal anesthesia for a inguinal hernia repair in a small child with laryngeal stenosis].
We experienced spinal anesthesia for inguinal hernia repair in combination with general anesthesia in a 4-year-old child with functional laryngeal stenosis and tendency of laryngeal edema. His airway was managed without endotracheal tube or laryngeal mask airway because these devices could worsen the upper airway stenosis. Spinal anesthesia offered reliable and potent analgesia leading to safe anesthetic management under spontaneous breathing. Although spinal anesthesia in combination with general anesthesia is not common in pediatric patients, it is effective and safe to apply for a case requiring more reliable and potent analgesia with understanding anatomical and physiological characteristics in children.