Masui. The Japanese journal of anesthesiology
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Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and fatigability. Women with MG have increased risk of pregnancy-related complications and an adverse pregnancy outcome. Maternal changes in pregnancy can also affect MG. ⋯ In addition to her usual medications, we performed plasmapheresis to improve her condition for the operation not with fresh frozen plasma but with albumin solution just before the operation. No obvious abnormality of coagulation system was observed, and combined spinal and epidural anesthesia was performed with no adverse outcome. We managed her perioperative period free from myasthenic crisis.
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Case Reports
[The use of "laryngospasm notch" in two patients whose oxygen saturations dropped after tracheal extubation].
In 1998, Dr. Larson described the technique of applying pressure to the "laryngospasm notch" as the best treatment for laryngospasm. Yet, there are no case reports of using this technique in the literature. ⋯ In both cases, the patients began to breathe spontaneously shortly after using this technique and oxygen saturation increased to 100%. The incidence of laryngospasm is higher after tracheal extubation. The "laryngospasm notch" method is a good technique to treat this condition.
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Pain of the leg ulcer significantly decreases patients' QOL, and pain control is an important treatment as the ulcer treatment. Continuous epidural block is often selected, but we can not provide enough continuous epidural block because of oral anticoagulant treatment and infection because of long-term indwelling catheter. ⋯ We obtained approvals not only from patients but also from plastic surgeons and dermatologists. We suggest that continuous popliteal block can be a usual method of the general pain control procedure.