Masui. The Japanese journal of anesthesiology
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Evidence to support the use of pregabalin in combination with opioid analgesics for the treatment of cancer-related neuropathic pain is limited. ⋯ In this retrospective investigation, we conclude that the younger cancer patients may need lager doses of pregabalin to relieve cancer-related neuropathic pain. In addition, the mild and moderate somnolence occurs frequently when pregabalin is administered with opioid analgesics for the treatment of cancer-related neuropathic pain.
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Case Reports
[Sudden increases and decreases in bispectral index values more than 30 within 1 minute during general anesthesia].
We described, in a 40-year-old man, sudden and unexpected increases in bispectral index values during the general anesthesia with total intravenous anesthesia using propofol in a dental surgery. The patient was administered continuous infusion of propofol and remifentanil, and intermittent supplementation of fentanyl. ⋯ The extent of unanticipated increase might be compatible with the duration of surgical procedure using dental air turbine. Therefore, the noise from surgical device might induce unpredictable change in bispectral index values.
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The risk factors for postoperative myasthenic crisis (MC) in patients with myasthenia gravis (MG) receiving preoperative corticosteroids were unknown. ⋯ Based on this study, we concluded that the existence of preoperative bulbar symptoms seems to be a predictor for the development of postoperative-MC in patients with MG undergoing a transsternal thymectomy.
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We describe anesthetic management of a patient with airway stenosis due to a tracheal tumor involving the carina. A 68-year-old man developed dyspnea and was scheduled for YAG laser surgery under general anesthesia. ⋯ The operation was completed successfully without any adverse events, and PCPS was not used. In this patient, preservation of spontaneous breathing using remifentanil was found to be useful for airway management.
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Coagulation disorders often occur perioperatively and monitoring of blood coagulation should be fast and adequate to treat these disorders to protect patients from massive bleeding. Control of hemostasis is one of the main issues in major surgeries. Coagulation test results from a central laboratory may delay making such a perioperative decision. ⋯ Both prothrombin time (PT) and activated clotting time (ACT) are very useful and popular, but also criticized because they can be monitored only until fibrin formation. On the other hand, viscoelastic monitorings of whole blood, are able to estimate fibrin formation, clot fixation, platelet function and fibrinolysis. In this review article, among variable perioperative POCMs of blood coagulation, three thromboelastographic monitorings, such as TEG ROTEM, and Sonoclot as well as PT and ACT, are described along with their utilities and limits to examine perioperative coagulation.