Masui. The Japanese journal of anesthesiology
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Although we reported the perioperative mortality to be 4.41 (per 10000 cases) and morbidity to be 18.0% with the pulmonary thromboembolism (PTE) in Japan based on the research conducted by the Japanese Society of Anesthesiologists (JSA), the characteristics of these patients have not yet been assessed. ⋯ The results of this study indicate the clinical characteristics of patients with perioperative PTE in Japan, the predictors of perioperative mortality, and the changes observed between the results of the researches carried out in 2002 and 2003.
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Auditory evoked potentials (AEPs) are an electrical manifestation of the brain response to an auditory stimulus. The waveform represents the passage of electrical activity provoked by auditory stimuli from the cochlea to cortex. The waves represented by I-VII are generated mainly in the brainstem. ⋯ When the concentration of anesthetics is increased, the amplitudes of the MLAEP's peaks are decreased and their latencies are elongated. Commercially developed A-line AEP monitor or aepEX can extract the AEPs waveform in a short period and automatically analyze the changes in the MLAEPs. These AEP based monitors may be superior to bispectral index (BIS) in detecting the transition from unconsciousness to consciousness.
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Subcutaneous patient-controlled analgesia (PCA) may be an alternative method for pain control in patients without an epidural catheter. The authors evaluated the efficacy and safety of subcutaneous PCA using pentazocine for postoperative analgesia after major abdominal surgery. ⋯ Subcutaneous PCA of pentazocine is a simple, safe, and effective method to control postoperative pain after major abdominal surgery. Effectiveness of subcutaneous PCA of pentazocine did not depend on age of patients.
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Motor dysfunction following spinal surgery and thoracoabdominal aortic surgery remain as one of their devastating complications. Since the development of postoperative motor dysfunction can deteriorate quality of life of patients, the prevention of such complications is an important clinical challenge. ⋯ Anesthesiologists are therefore required to properly understand MEPs and to manage anesthesia carefully. We summarize the methods for monitoring of myogenic MEPs and anesthetic techniques during intraoperative MEP monitoring.
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Xeroderma pigmentosum (XP) is a rare autosomal recessive disease, which is characterized by hypersensitivity of the skin to ultraviolet (UV)-radiation and progressive neurological complications. Patients with XP show a failure to properly repair UV-induced DNA lesions by the nucleotide excision repair (NER) mechanism. This results predominantly in a high frequency of UV-induced skin tumors at an early age. ⋯ Both surgical procedures were performed uneventfully except for delayed awakening. A number of precautions must be taken in the perioperative management of XP patients, which include proper shielding from damaging light, avoidance of all drugs that harm DNA such as halothane and careful evaluation of neurological abnormalities. There is a possibility of difficult endotracheal intubation or prolonged effect of muscle relaxation due to skin atrophy and joint contracture.