Masui. The Japanese journal of anesthesiology
-
We report a case of successful procedural sedation using dexmedetomidine (DEX) in a 68-year-old woman undergoing left gasserian ganglion block for intractable trigeminal neuralgia. DEX was chosen to provide an effective sedation and clear communication about the injection of drugs or thermocoagulation. After 15 minutes of DEX administration at 0.8 microg x kg(-1) x hr(-1), nerve block needle insertion was bearable. ⋯ High-frequency thermocoagulation elicited tolerable radiating pain with minimum vital sign change. She was comfortable and had no communication difficulty under DEX sedation. DEX sedation for interventional pain management during procedures such as gasserian ganglion block may be useful.
-
We conducted a retrospective analysis of the intraoperative lactate level and its association with patients' outcome in adult cardiac surgery patients requiring cardiopulmonary bypass. ⋯ Increased lactate concentrations after weaning from CPB were significantly and independently associated with ICU free survival days at POD 28. This finding may be important to physicians in managing patients undergoing cardiac surgery using CPB.
-
A 77-year-old man scheduled for coronary artery bypass grafting underwent left superficial temporal artery-middle cerebral artery anastomosis (STA MCA). Before anesthesia, we planned to insert an intraaortic balloon pump as a perioperative circulatory assist. In addition, a fiberoptic catheter was inserted in the proximity of the right jugular bulb to monitor jugular venous oxygen saturation (Sjv(O2)) as an index of the balance between cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2). ⋯ Sjv(O2) is normally approximately 55-75%. If Sjv(O2) is < 50%, therapy (s) directed at increasing CBF and/or decreasing CMRO2 should be initiated. Sjv(O2) monitoring can be used to determine the minimal blood pressure that should be maintained to avoid cerebral ischemia in the case of STA-MCA.
-
Femoral nerve block and sciatic nerve block are used to provide intraoperative and postoperative analgesia for total knee arthroplasty. Sciatic nerve block is contraindicated in our hospital, because orthopedists want to assess peroneal nerve function after the surgery. We retrospectively assessed postoperative analgesic effect and complications of the continuous femoral nerve block for total knee arthroplasty. ⋯ Femoral nerve separation with 5% glucose solution using in-palne method and catheter placement with out-of-plane method could be useful for perineural catheter placement. Perineural infusion of 0.15% ropivacaine at 4 ml x hr(-1) combined with IV-PCA provided a good postoperative analgesia in patients receiving total knee arthroplasty.
-
Previous reports indicate that Prader-Willi syndrome may present various problems during anesthesia and the perioperative period. We retrospectively investigated anesthesia records of 10 patients (2 adults and 8 children) who were diagnosed to have Prader-Willi syndrome, and who had an operation under anesthesia. Three patients had small mouths, small jaws or both. ⋯ Difficult tracheal intubation occurred in one patient. No other major problems occurred. We conclude that the incidence of problems during anesthesia and postoperative period in patients with Prader-Willi syndrome would be less than previously considered.