Masui. The Japanese journal of anesthesiology
-
A 58-year-old man with hypertension underwent laparoscopic distal gastrectomy under general and epidural anesthesia. Preoperative laboratory date revealed a normal platelet count and normal coagulation profile. Epidural puncture was successfully performed at the T9-10 intervertebral space on the first attempt without bleeding. ⋯ Ten minutes later, paraplegia disappeared spontaneously. It is suggested that the spinal cord of the patient was subjected to transient pressure hematoma. A decline in blood pressure may have caused the blood to spread through the epidural space, such that the neurologic symptoms disappeared.
-
The present study was conducted to determine the relationship between magnesium concentration in cerebrospinal fluid (CSF) and delayed cerebral ischemia (DCI) in patients with subarachnoid hemorrhage (SAH). ⋯ The results indicate that preoperative hypomagnesemia within the CSF might play a role in the development of DCI in patients with SAH; however, further studies will be necessary to confirm this observation.
-
Takotsubo cardiomyopathy is a cardiac syndrome characterized by transient left ventricular dysfunction. A 79-year-old woman was scheduled for posterior lumbar interbody fusion for spinal compression fracture. ⋯ Emergent transthoracic echocardiography revealed excessive contraction of the base and severe hypokinesis of the apex suggesting Takotsubo cardiomyopathy. Chronic hypovolemia and electrolyte disorder due to habitual glycerin enema were considered to be causes of this sudden cardiac collapse.
-
A 49-year-old female with mitochondrial encephalomyopathy underwent laparoscopic cholecystotomy. She had some characteristic clinical symptoms, including muscle weakness, deafness, hemianopia and elevation of lactic acid level in the blood. It has been considered that problems of anesthesia for patient with mitochondrial encephalomyopathy are relevant to malignant hyperthermia, respiratory depression due to muscle weakness and probability of hyperlactacidemia. ⋯ Arterial blood gases and pH were checked and acetated electrolyte solution was infused mainly during surgery. No complications occurred during anesthesia and this patient showed smooth recovery from anesthesia. Her postoperative course was uneventful.
-
Comparative Study
[Comparative study of oral tracheal tube extubation force in a baby manikin model: taping methods and tube diameters].
Adhesive tape is the standard method for securing tracheal tubes. There have been several studies about extubation forces in adult models. However, there have been few in pediatric models. Therefore, we examined the force required to extubate tracheal tube from a manikin using three methods. ⋯ To fix a tracheal tube securely, adhesive tape should be wider and the contact area between the tube and the tape should be larger. In this regard, "puttee style" fixation seems to be effective.