Masui. The Japanese journal of anesthesiology
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Case Reports
[Case report : Severe anaphylactic shock followed by positive skin-prick-test to multiple vasoconstrictors].
A 71-year-old woman was scheduled for revision of total hip replacement under general anesthesia. Twenty minutes before entering the operating room, slight urticaria was caused by drop infusion of cefotiam. It was stopped immediately and the patient entered the operating room without any symptoms. ⋯ We decided to stop the operation, and the patient was moved to the intensive care unit (ICU). A few hours after entering the ICU, she was extubated and moved to the general ward next day. Skin-prick-tests performed 14 days later indicated that she was allergic to ephedrine, methoxamine, epinephrine, dopamine and a few more drugs.
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Comparative Study
[Ultrasound guided T2 intercostal nerve block: a comparison with stellate ganglion block under the blind technique and ultrasound guided technique].
The aim of this study is to compare the efficacy of stellate ganglion block, performed by ultrasound guided technique and blind technique, and ultrasound guided T2 intercostal nerve block. ⋯ Compared to stellate ganglion block (blind technique), ultrasound guided stellate ganglion block and T2 ultrasound-guided intercostal nerve block provided a similar efficacy.
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A morbidly obese woman with a huge ovarian tumor was scheduled to undergo tumor resection under general anesthesia. Under slight sedation with midazolam and fentanyl, a tracheal tube was inserted smoothly using Pentax-AWS Airway Scope, and general anesthesia was thereafter maintained by sevoflurane. ⋯ Then resection of the ovarian tumor and abdominal wall tissue was performed in supine position. Periooperative course was uneventful.
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Williams syndrome is caused by the deletion of genetic material from chromosome 7, including the elastin gene. Affected individuals frequently have connective tissue disorders and skeletal hypoplasia, resulting in micrognathia and mandibular retrusion. These conditions hinder adequate visualization of the larynx and render intubation difficult. ⋯ After 8% lidocaine spray to the larynx, and then 4% lidocaine spray to the vocal cords and trachea using a bronchoscope, we accomplished awake, fibreoptic-guided orotracheal intubation easily and quickly on the first attempt using a Parker Flex-Tip tube. Difficult tracheal intubation should be anticipated in Williams syndrome patients. Awake, fibreoptic-guided technique is easier and safer than direct laryngoscopy for intubating such patients.
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Antiemetic drugs, which are usually prescribed with opioids, occasionally induce extrapyramidal symptoms(EPS). ⋯ EPS were found in 6 of 109 patients during palliative care. We concluded that it was important not to forget the appearance of antiemetic-induced EPS when prescribing antiemetic drugs in palliative