Masui. The Japanese journal of anesthesiology
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Here we report a case of severe septic shock immediately following cesarean section. A pregnant woman with dichorionic diamniotic twins was diagnosed with preterm rupture of membranes (PROM). Ritodrine hydrochloride and betamethasone did not sufficiently relieve abdominal extension; emergency cesarean section was scheduled 4 days later, at 31 week 5 day gestation. ⋯ Catecholamine and antibiotics relieved her symptoms. Retrograde infection of Escherichia coli was attributed to fetal distress and septic shock. Early phase septic shock should be considered in pregnant women with PROM.
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The aim of this meta-analysis is to evaluate the efficacy of the Pentax-AWS for tracheal intubation during chest compression, compared with that of the Macintosh laryngoscope. ⋯ Compared to the Macintosh laryngoscopy, Pentax-AWS offers advantages for novice laryngoscopists during chest compression, while these benefits are not seen with experts' hands.
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Epidural anesthesia is a useful tool for postoperative pain control. However, inappropriate fixing of the catheter not only hinders the analgesic effect, but could lead to serious accidents as a result of the untoward removal of the epidural catheter. ⋯ The group using the Steri-Strip, was able to significantly reduce the untoward removal (P = 0.002).
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At our hospital, intending to obtaining an approval from the Joint Commission International (JCI), we conducted a workshop on sedation for all staff physicians. ⋯ The sedation lecture in the hospital was effective.
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Case Reports
[Anesthetic Management of Three Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy].
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronically progressing or relapsing disease caused by immune-mediated peripheral neuropathy. We report the anesthetic management of three CIDP patients who underwent elective orthopedic surgeries. Owing to the risk of neuraxial anesthetics triggering demyelination, general anesthesia was selected to avoid epidural or spinal anesthesia or other neuraxial blockade. ⋯ For tracheal intubation, under careful monitoring with peripheral nerve stimulators, minimal doses of rocuronium (0.6-0.7 mg x kg(-1)) were administered. When sugammadex was administered to reverse the effect of rocuronium, all patients rapidly regained muscular strength. Postoperative courses were satisfactory without sequelae.