Masui. The Japanese journal of anesthesiology
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There are only a few reports on cesarean section in a patient with cervical fracture without spinal cord injury (SCI). Such patients have high risks for deterioration of SCI following general or regional anesthesia. Here, we present a patient with a fracture of C2 vertebra who underwent cesarean section safely under combined spinal and epidural anesthesia(CSEA). ⋯ Pre-viability amniorrhexis was seen at 37 weeks' gestation, and an emergency cesarean section was scheduled under combined epidural and spinal anesthesia (CSEA). Her neck and head were carefully fixed before, during and after surgery in order to prevent subsequent SCI. As a result, cesarean section under CSEA was successfully performed in the patient without any deterioration of the spine and/or SCI.
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A 93-year-old woman with a vulvar cancer was scheduled for resection of the tumor and sentinel lymph node biopsy under general anesthesia. At the beginning of the operation, a total of 20 ml of 2.5% patent blue was injected into the tumor and the surroundings to identify sentinel lymph node. After the injection, arterial oxygen saturation measured by pulse oximetry gradually dropped to 80%. ⋯ Her perioperative course was uneventful. In case of desaturation after dye injection, it is important to rule out true hypoxemia immediately by performing arterial blood gas analysis. Conversely, CO-oximetry is not necessarily useful for accurate diagnosis.