Masui. The Japanese journal of anesthesiology
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We experienced anaphylactic shock after introduction of the general anesthesia twice in the same patient. After the first incidence of anaphylactic shock, we judged that the allergen was a latex. ⋯ After the first incidence, it was necessary to retrieve the antigen from all the agents used. When we encounter the anaphylactic shock, it is necessary to examine all the medicines, and should have two or more suspectible medicines in mind.
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We report successful management of anesthesia in two cases of knee arthroscopic surgery of meniscal lesions using ultrasound-guided combined femoral-obturator nerve block with inhalation anesthesia. The blocks were performed with 30 ml of 0.5% ropivacaine under ultrasonographic visualization. The perioperative courses were uneventful and there was no complaint about postoperative pain. ⋯ Our technique relieved postoperative pain effectively because knee joint is innervated by the femoral and obturator nerves in great measure. Ultrasound-guided femoral and obturator nerve block is easier and more successful than sciatic nerve block. General anesthesia with combined femoral-obturator nerve block could be a useful technique with less complication for knee arthroscopic surgery.
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Case Reports
[Anesthetic management of an adult patient with Fontan circulation for laparoscopic surgery].
Advances in the surgical and medical management of children with congenital heart disease have decreased the mortality of these patients. As a result, more patients are surviving into adulthood and are presenting for noncardiac surgery. We experienced a case of anesthetic management of an adult patient with Fontan circulation for laparoscopic surgery. ⋯ Throughout the operation, including the period of pneumoperitoneum, the hemodynamic status remained stable, and adequate oxygenation and ventilation were maintained. The surgery ended uneventfully, and the trachea was extubated in the operating room. In anesthetic management of patients with Fontan circulation for laparoscopic surgery, it is important to understand the physiology of the circulation, and consider the influence of the pneumoperitoneum on the hemodynamics.
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The backward, upward and rightward pressure (BURP) maneuver and cricoid pressure (CP) are easily confused because of their similarities. We surveyed nurses to determine their knowledge and skills regarding these maneuvers. ⋯ We found that the nurses are confused with the BURP and CP maneuvers. Unless applied correctly, these maneuvers may interfere with tracheal intubation. Constant education and training are essential for effective and safe implementation of these maneuvers.
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Multicenter Study
[Long-term efficacy and safety of pregabalin in patients with postherpetic neuralgia: results of a 52-week, open-label, flexible-dose study].
The efficacy of pregabalin was demonstrated in a randomized double-blind placebo-controlled 13-week trial in 371 Japanese patients with postherpetic neuralgia (PHN). In this study, we evaluated the long-term efficacy and safety of pregabalin for relief of PHN. ⋯ These results suggest that long-term treatment of pregabalin may be beneficial in patients with PHN.