Masui. The Japanese journal of anesthesiology
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We reviewed anaesthesia training program in Australia. Anaesthetists in Australia and New Zealand need to obtain the Diploma of Fellowship of the Australian and New Zealand College of Anaesthetists (FANZCA) to be recognised as specialists. The training sequence approved by ANZCA encompasses an initial two-year Prevocational Medical Education, Training (PMET) period, and the five-year period of ANZCA Approved Training, which included two-year Basic Training and three-year Advanced Training. ⋯ There are a number of specific goals to be achieved during training. ANZCA accredits Hospital Departments of Anaesthesia and other training institutions across Australia, New Zealand, and South-East Asia, to provide approved training in anaesthesia for ANZCA trainees. Accreditation requires an onsite review by the College in order to assess a hospital's ability to provide training and supervision of the required standard, and its degree of compliance with ANZCA Professional Documents.
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Case Reports
[Anesthetic management for emergency laparotomy in an adult patient with Eisenmenger syndrome: a case report].
There are few clinical reports concerning anesthetic management for patients with Eisenmenger syndrome requiring non-cardiac surgery. The risk of morbidity and mortality associated with non-cardiac surgery in patients with Eisenmenger syndrome is considerable. During anesthetic management for these patients, careful circulatory and respiratory managements to avoid several factors related to surgery and anesthesia that can potentially increase right to left shunt flow are required. ⋯ For this purpose, combination of intravenous administration of inotropes such as milrinone and dobutamine, and vasopressors such as norepinephrine, might have clinical efficacy. Here we describe an anesthetic management for a 50-year-old woman with a ventricular septal defect and Eisenmenger syndrome undergoing emergency laparotomy. We considered that sufficient fluid therapy and adequate administration of inotropes and vasopressors, based on strict hemodynamic assessment using direct arterial and central venous pressure monitoring, arterial blood gas analysis, and transesophageal echocardiography during general anesthesia, might have contributed to the uneventful perioperative course of the patient.
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This report shows a rare case of muscle rigidity by remifentanil just before the end of surgery. A 71-year-old man was scheduled for microvascular decompression to cure trigeminal neuralgia. ⋯ After giving muscle relaxants, the patient was uneventful. We should pay attention to muscle rigidity even using low doses of remifentanil.
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Case Reports
[Anesthetic management of caesarean section following the Fontan procedure by using TaskForce Monitor].
The Fontan procedure is performed for patients with a corrected transposition of great arteries, and pregnancies following this surgery are likely to increase in number. We present a parturient with the Fontan physiology. In this case, we used thoracic bio-impedance cardiac output monitoring system "TaskForce Monitor". It was shown that the cardiovascular management by using TaskForce Monitor was useful because of the non-invasive beat-to-beat cardiac output monitoring.
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A 47-year-old woman with postdural puncture headache suffered from transient paralysis and paresthesia immediately after the epidural blood patch. After one and a half hour, these symptoms disappeared spontaneously. ⋯ With passing of time, the viscous blood spread through the epidural space, and neurological symptoms improved. Although the risks of epidural blood patch are relatively low, we should closely pay attention to unexpected side effects.