Masui. The Japanese journal of anesthesiology
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We experienced three cases of latex anaphylaxis during cesarean section in one year. ⋯ A 25-year-old woman underwent emergency cesarean section. We noticed wheals involving her eyelids and legs after operation and administered methylprednisolone. CASE 3: A 23-year-old woman underwent elective cesarean section. Five minutes after delivery and oxytocin injection, she complained of edema of eyelids, facial erythematous edema, and dyspnea. We suspected latex anaphylaxis and stopped using latex products. Then, we treated her with antihistamines, methylprednisolone and beta-stimulators. The diagnosis of latex anaphylaxis was made by positive results of skin tests to latex and an increase in the levels of latex-specific immunoglobulin E. We conclude that cesarean section is an important risk factor for latex anaphylaxis.
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We conducted a retrospective study to evaluate the effectiveness of intravenous patient-controlled analgesia (IVPCA) in the early postoperative period after upper abdominal gastrointestinal surgery. We also evaluated the postoperative effects of intraoperative analgesic dosage in patients after this surgery. ⋯ The results of this study suggest that the effects of intraoperative analgesics may not be significant. Patients who had received the above mentioned anesthetic regimen intraoperatively also required full postoperative analgesia as well.
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Cancer pain consists of continuous pain lasting almost all day and transient exacerbation of pain called breakthrough pain. Breakthrough pain is classified as somatic pain and visceral pain, neuropathic pain according to the character of pain. Although the immediate release opioid is used as the first treatment of choice to breakthrough pain, the effect is not enough when it shows the character of neuropathic pain. ⋯ It has also been reported that pregabalin used with oxycodine reveals analgesic effect with smaller dosage than pregabalin alone. We experienced a young patient with lung cancer suffering from sudden exacerbation of symptomatic sciatica, whose pain was markedly reduced within 30 minutes by taking immediate release oxycodone 5 mg and pregabalin 75 mg simultaneously. Conclusions : Pregabalin with immediate release oxycodone simultaneously may be able to improve acute exacerbation of neuropathic cancer pain rapidly.
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Myasthenia gravis (MG) is an autoimmune disease. The MG patients undergoing extended thymectomy under general anesthesia are at risk for postoperative complications, such as respiratory insufficiency and crisis (cholinergic and myasthenic). We evaluated the preoperative predictive factors, which are important for postoperative respiratory control. ⋯ This finding suggests that Fuchu Hospital Scoring System, duration of myasthenia and preoperative anti-acetylcholine receptor antibody are valuable for MG patients undergoing extended thymectomy as preoperative predictive factors. These factors are important for postoperative respiratory control.
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A 34-year-old woman, who had had atonic bleeding six years ago, had selective cesarean section under CSEA. On the operation, atonic bleeding occurred and persisted. Though we used uterine contracting agents (oxytocin, ergometrine), the bleeding volume exceeded 2,000 ml and the examination revealed Hb 5.9 g x dl(-1), Ht 19%. ⋯ In 2010, guideline for obstetric critical hemorrhage was published. The guideline recommends the importance of observing the perioperative change of vital sign (e. g. shock index) and obstetric DIC score. In the obstetric critical hemorrhage, we should take proper and prompt actions in accordance with this guideline.