Masui. The Japanese journal of anesthesiology
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The Japanese Society of Anesthesiologists (JSA) has investigated the incidence of postoperative pulmonary thromboembolism (PTE) for several years. ⋯ Our data suggest that the actual incidence of postoperative PTE in Japan may be far greater than that reported by the JSA.
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We report an obese patient who developed rhabdomyolysis after prolonged surgery in lateral decubitus position. A 55-year-old woman, with a body mass index of 29.3 kg x m(-2), underwent removal of an acoustic neurinoma in lateral decubitus position which lasted 20 hours. ⋯ There were elevated levels of serum creatinine phosphokinase, AST, ALT, and myoglobin in the urine. CT of the abdomen taken two days after the surgery suggested the presence of rhabdomyolysis of the transverse abdominal muscles.
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We report a case where "laryngospasm notch" technique was used in a patient to initiate spontaneous respiration during general anesthesia. The patient was a 43-year-old woman who underwent conization. A Pro-Seal laryngeal mask airway was inserted after induction of general anesthesia. ⋯ Surgical course was uneventful until the patient became unable to breathe towards the end of surgery. Positive-pressure ventilation was applied, but the patient could not be ventilated. "Laryngospasm notch" technique was performed by applying digital pressure in front of the tragus of the ears, and the patient began to breathe spontaneously. We describe our experience with the "laryngospasm notch" technique applied to the front of the tragus of the ears to treat laryngospasm.
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We report a case of a 3-year-old boy who had undergone total cavopulmonary connection for repair of corrected transposition of the great arteries (cTGA), and developed intractable supraventricular tachyarrhythmia. The patient was in cardiogenic shock and did not respond to antiarrhythmic drugs and cardioversion, and we used extracorporeal life support (ECLS) to maintain hemodynamics. ⋯ No recurrence was observed. In conclusion, dexmedetomidine might be useful for intractable supraventricular tachyarrhythmia after pediatric congenital heart surgery.
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Randomized Controlled Trial Comparative Study
[Comparison of intraoperative stress hormones release between propofol-remifentanil anesthesia and propofol with epidural anesthesia during gynecological surgery].
Remifentanil recently comes to be used for intraoperative analgesia instead of epidural anesthesia in gynecological surgery. It seems to offer the same stability in vital signs, but stress response during remifentanil anesthesia has not been evaluated. Therefore, we compared remifentanil anesthesia with epidural anesthesia regarding stress hormones. ⋯ The inhibition of stress hormone secretion during operation was less in R than E. Regarding stress response, total intravenous anesthesia with remifentanil seems to be a proper method, but to have less potency than general anesthesia using epidural block.