Masui. The Japanese journal of anesthesiology
-
A 77-year-old man was scheduled to undergo the resection of hepatoma. After the induction of general anesthesia, a central venous (CV) catheter was inserted from the right internal jugular vein under the echographic observation. Then, we noticed that the size of the vein was smaller than usual, which caused a little difficulty in the insertion. ⋯ Re-evaluation of preoperative CT revealed the persistent left superior vena cava (PLSVC) with absent right superior vena cava. Post-operative examination with echography of the neck showed that the left internal jugular vein was much greater than the right. When noticing a small right internal jugular vein in pre-procedure echography, existence of PLSVC should be considered, and meticulous CV catheterization is necessary for safety.
-
The effects of the addition of remifentanil or nitrous oxide (N2O) on hemodynamics and bispectral index score (BIS) during surgery were exam-ined. ⋯ The effects of remifentanil on hemodynamics and bispectral index score in patients during surgery under sevoflurane/epidural anesthesia were completely different from those of N2O.
-
Case Reports
[Anesthesia for four pediatric patients with difficult airway in whom airway scope was useful for Intubation].
In the field of pediatric anesthesia, devices to solve difficult airway are scant compare to devices for adult difficult airways. We report successful use of an Airway Scope with a pediatric blade in four children with difficult airways. ⋯ Tracheal intubation using an Airway Scope was always easy. We conclude that the Airway Scope with a pediatric blade is potentially useful in children with difficult airways.
-
The purpose of this article is to provide an overview of some of the important information related to safety and tolerability of duloxetine. Duloxetine, a potent reuptake inhibitor of serotonin and noradrenaline, is effective for the treatment of major depressive disorder, anxiety disorder, and painful diabetic neuropathy (PDN). Duloxetine is safe and well-tolerated across indications, with few reported serious side effects. ⋯ Nausea is the most common side effect, but it occurs less frequently if treatment is initiated at 30 mg . day-1 and titrated after one week to 60 mg . day-1, an efficacious dosage at which pain relief can occur within one week. Clinical trials have demonstrated the analgesic efficacy of duloxetine for PDN and fibromyalgia in addition to improvements in quality-of-life measurements. Furthermore trials for osteoarthritis, headache, and the pain associated with Parkinson disease may provide insight into alternative uses for duloxetine.
-
Comparative Study
[Effect of continuous interscalene block with ropivacaine at a low concentration on postoperative pain relief after arthroscopic rotator cuff reconstruction].
The analgesic effect of continuous interscalene block with ropivacaine at a low concentration was compared with that of single-shot interscalene block after arthroscopic rotator cuff reconstruction (ARCR). ⋯ Postoperative continuous interscalene block with 0.1% ropivacaine provided sufficient analgesia without complete motor block.