Masui. The Japanese journal of anesthesiology
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Case Reports
[Prolonged apnea from rocuronium in a patient with hypermagnesemia after cesarean section: a case report].
A patient developed prolonged apnea after emergency cesarean section. The patient was a 38-year-old primiparous woman with myoma uteri and her body weight was 44.8 kg. She received intravenous magnesium sulfate 1 g x hr(-1) as tocolytic agent for threatened premature delivery. ⋯ After the operation which was finished in 65 minutes, the effect of rocuronium remained for more than 100 minutes after its administration probably due to hypermagnesemia. Rocuronium shows rapid onset, and several studies indicate that it can be used for rapid sequence induction instead of suxamethonium. But rocuronium should be used carefully and its effect should be monitored in a patient with hypermagnesemia.
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We report a pregnant woman who developed non-traumatic spinal subdural and epidural hematoma. A 31-year-old woman at 28 weeks of gestation developed progressive ascending paralysis. ⋯ An emergency cesarean section followed by spinal decompression was performed 60 hours after the onset. The patient's neulogical function recovered completely after the surgey.
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We evaluated Disposable Crystal Laryngoscope Blades in terms of preventing infection. Most anesthesiologists were satisfied with the view offered by the Disposable Crystal Laryngoscope Blade; however more force is necessary to lift the epiglottis during intubation. It may be more difficult to use by residents, inexperienced anesthesiologist, or emergency medical technicians, although the Disposable Crystal Laryngoscope blade is useful for preventing infection.
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Brachial plexus block (BPB) frequently accompanies phrenic nerve palsy (PNP). ⋯ These results suggest that BPB with the modified supra costal approach provides sufficient analgesia with a significantly lower degree of PNP. We suppose that distribution of local anesthetics is altered by changing the location of the needle-tip on the 1st lib. Amounts of local anesthetics distributing around the phrenic nerve can be reduced by the modified supra costal approach, leading to the significantly less reduction in FVC after BPB.
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Case Reports
[Arytenoid cartilage dislocation caused by endotracheal intubation which resolved spontaneously].
Arytenoid cartilage dislocation following tracheal intubation is a rare complication. A 48-year-old man underwent an operation for laparoscopic cholecystectomy under general anesthesia. Although no anaesthetic or operative problem had occurred, hoarseness was noticed after the operation, continuing beyond 25 days thereafter. ⋯ About four weeks later, the arytenoid cartilage dislocation resolved spontaneously. Other findings suggest that spontaneous reduction can be expected in many patients with anterior arytenoid dislocation. Patients suffering from arytenoid cartilage dislocation should be observed for several weeks if possible because there exist some reports in the literature describing spontaneous resolution after its dislocation.