Masui. The Japanese journal of anesthesiology
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A 69-year-old woman (156 cm, 53 kg) underwent a Miles' operation, total hysterectomy, resection of vagina, and thigh flap to vulva for rectal cancer. Before general anesthesia, an epidural catheter was inserted at T11-12 interspace, and 1.5% mepivacaine 7ml was administered. Sensory block level spread from T4 to L1. ⋯ Patient-controlled intravenous analgesia (IV-PCA) with fentanyl, ketamine, and lidocaine was added to PCEA. Then excellent pain relief was obtained without any side effects such as nausea, vomiting, drowsiness, and respiratory depression. It could be useful to use IV-PCA together with PCEA when wide spread postoperative analgesia is necessary.
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Comparative Study
[Comparative study of oral tracheal tube extubation force in a baby manikin model: taping methods and tube diameters].
Adhesive tape is the standard method for securing tracheal tubes. There have been several studies about extubation forces in adult models. However, there have been few in pediatric models. Therefore, we examined the force required to extubate tracheal tube from a manikin using three methods. ⋯ To fix a tracheal tube securely, adhesive tape should be wider and the contact area between the tube and the tape should be larger. In this regard, "puttee style" fixation seems to be effective.
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Randomized Controlled Trial Comparative Study
[Postoperative analgesia of continuous intravenous fentanyl or dexmedetomidine for patients receiving anticoagulant therapy].
It is difficult to achieve good postoperative analgesia in patients who undergo abdominal aortic surgery without epidural analgesia and who have a bleeding tendency or are undergoing anticoagulation therapy. Intravenous fentanyl analgesia can be used in such patients, but it occasionally causes respiratory depression. Dexmedetomidine is used to achieve postoperative sedation and analgesia without respiratory depression. We compared the methods used to achieve postoperative analgesia after abdominal aortic surgery. ⋯ With regard to respiratory depression, intravenous dexmedetomidine analgesia is safer and more useful than intravenous fentanyl analgesia.
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Comparative Study
[Comparison of intrathecal morphine and buprenorphine for postoperative analgesia in cesarean delivery].
It has become a popular practice to add opioids to spinal solutions to enhance and prolong intraoperative and postoperative analgesia in cesarean section. Morphine is the opioid most widely used for this purpose, but there are few reports about intrathecal buprenorphine. We evaluated the postoperative analgesic effect of intrathecal buprenorphine compared with intrathecal morphine after cesarean section. ⋯ It is concluded that intrathecal buprenorphine 0.05 mg provides similar postoperative analgesic effect with intrathecal morphine 0.1 mg without any increases of side-effects in cesarean section.
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We experienced anesthetic management of a patient with Becker muscular dystrophy. He had advanced dilated cardiomyopathy and high serum CK in the preoperative examinations. Anesthesia was planned to avoid triggering malignant hyperthermia or rhabdomyolysis and hemodynamic changes. ⋯ Arterial pressure, cardiac output and stroke volume variation were monitored by Flotrac sensor. There were no adverse events observed during the anesthetic management. In conclusion, total intravenous anesthesia with the administration of rocuronium and circulatory monitoring by Flotrac sensor could be safe and efficient for anesthetic management of patients with Becker muscular dystrophy.