Masui. The Japanese journal of anesthesiology
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A 32-year-old pregnant woman diagnosed with aplastic anemia was admitted for emergent caesarean delivery of 26th week of the gestation due to PIH (pregnancy-induced hypertension) and NRFS (non-reassuring fetal status). After compensating platelets counts to 5.3x10(4) microl-1, general anesthesia was induced with propofol and rocuronium. Anesthesia was maintained with O2 and sevoflurane until delivery and with modified-NLA after delivery. ⋯ She survived perioperative period and was to be treated for aplastic anemia. Her baby was discharged neurologically free. We should be ready to respond to anesthetic requirement for urgent cases of aplastic anemia.
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The author joined the emergency health operation of the International Red Cross for Haiti earthquake as one of Japanese Red Cross delegates for about one month in May, 2010. Althought I was not expected to offer the skills and experiences as an anesthesiologist, but those of a general practicing, I learned many valuable things from seeing local people, especially about the characteristic diseases and symptoms after disasters caused by living in the camp which was not an ideal environment to be in so long. It is difficult to know much about such typical problems through our usual work as an anesthesiologist. If we want to join these kinds of mission, we have to have some extra knowledge for helping people after such disasters.
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Amyotrophic lateral sclerosis (ALS) is a degenerative disease involving motor neurons. The anesthetic problem is increased susceptibility to non-depolarizing muscle relaxants and the feasibility of spinal and epidural anesthesia. An 86-year-old man with ALS underwent colostomy to the ileus. ⋯ Post-operative course was uneventful. Our anesthetic management of ALS patient using sugammadex was successful. Further evidence is required to establish appropriate use of sugammadex for ALS patients.
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We report a case of acute subdural hematoma which occurred following cerebrospinal fluid (CSF) drainage during thoracic endovascular aortic repair (TEVAR) surgery. A 63-year-old woman was scheduled to receive TEVAR for thoracic-abdominal aneurysm extending from the descending aorta (T10) to 15 mm above the celiac trunk. Before the TEVAR operation, a lumbar cerebrospinal drain was inserted at L4-5. ⋯ The benefits of CSF drainage for spinal cord protection is well established, and ischemia of Adamkiewicz artery is prevented by careful control of CSF pressure. However, the use of CSF drainage has been associated with the risk of acute subdural hematoma. Careful observation for amount of CSF drainage is necessary during thoracoabdominal aortic aneurysm repair.
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We report the results of reviews by pharmacists of clerical errors in drugs used in the operating room by anesthesiologists from August 2005 to March 2007 at Fukuoka University Hospital. During the period, 9907 surgical patients were managed by anesthesiologists. ⋯ One medication error was detected by the review. The review of used drugs in the operating room by pharmacists can prevent financial loss and improve patients' safety.