Masui. The Japanese journal of anesthesiology
-
A 58-year-old man with hypertension underwent laparoscopic distal gastrectomy under general and epidural anesthesia. Preoperative laboratory date revealed a normal platelet count and normal coagulation profile. Epidural puncture was successfully performed at the T9-10 intervertebral space on the first attempt without bleeding. ⋯ Ten minutes later, paraplegia disappeared spontaneously. It is suggested that the spinal cord of the patient was subjected to transient pressure hematoma. A decline in blood pressure may have caused the blood to spread through the epidural space, such that the neurologic symptoms disappeared.
-
The ability to assess pain intensity is essential for both clinical trials and effective cancer pain management, although cancer pain assessment is complicated by a number of other bodily and mental symptoms such as fatigue and depression, all affecting quality of life. Several pain assessment tools have been shown to be reliable and reasonably valid in assessing cancer pain. ⋯ A variety of scales use drawings of faces (from smiling to distressed) for children or patients with cognitive impairment or dementia. The healthcare providers should use tools valid for the patient's age and cognitive abilities, with additional attention to the language needs of the patient.