Masui. The Japanese journal of anesthesiology
-
A 40-year-old man was scheduled for video assisted thoracoscopic surgery due to pneumothorax. He had been diagnosed with inclusion body myositis and received nocturnal non-invasive positive pressure ventilation. Anesthesia was induced with propofol, remifentanil, and rocuronium, and maintained with propofol, remifentanil and fentanyl. ⋯ Rocuronium 10 mg was administered in this case and we thought it could be antagonized by neostigmine, but extubation on the day of operation was impossible. We think this is not because of the residual effect of muscle relaxant, but because of decreases in pulmonary function. In this case, we expected long-term mechanical ventilation might be necessary, but he showed a good postoperative course owing to minimally invasive surgery, NPPV, and suctioning of sputum via Minitrach.
-
[Effect of interscalene block on perioperative pain during arthroscopic rotator cuff repair (ARCR)].
There are some reports stating that interscalene block is effective in relieving perioperative pain during arthroscopic rotator cuff repair (ARCR), and we used this procedure for ARCR in our department since May 2011. ⋯ Single-shot interscalene block before ARCR reduced both blood pressure variability and the dose of fentanyl given during operation.
-
Case Reports
[Refractory headache after epidural catheter placement in a girl in whom epidural blood patches were ineffective].
A 12-year-old girl who had received epidural catheter placement for an orthopedic surgery developed postural headache on postoperative day (POD) 1 which resolved in 24 hours. She was discharged on POD 6 but readmitted on POD 16 for headache accompanied by nausea and photophobia. On POD 17 and 35 she received epidural blood patches (EBPs) with 15 ml and 20 ml of autologous blood, respectively and her headache disappeared shortly after the second EBP. ⋯ Headache gradually and completely disappeared on the POD 200. It took more than 100 days for her to regain her usual life. In conclusion, in adolescents whose symptoms and atypical, psychosomatic disorder should be taken into consideration as a differential diagnosis and a referral to a specialist is important.
-
Case Reports
[Acoustic respiratory rate monitoring in a patient with a tracheostomy: a case report].
Acoustic respiratory rate (RRa) monitoring has been validated for patients after general anesthesia and has been shown to be a useful technique. However, its feasibility in patients with a tracheostomy has not been assessed yet. Successful monitoring of RRa in a patient with a tracheostomy is described in this case report. ⋯ Statistical analysis was made for comparison of respiratory rate determined by RRa monitoring with respiratory rate visually counted by intensive care nurses. There was no statistically significant difference between the two respiratory rates (P = 0.82). RRa monitoring is useful even in patients with a tracheostomy.