Masui. The Japanese journal of anesthesiology
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We often use lidocaine adhesive tape (Penles, Wyeth Lederle Japan, Ltd., Tokyo, Japan) as a topical anesthetic prior to puncturing a vein with a needle. Since the tape is usually in place for a long time, we often experience problems with creasing and flaring when inserting the needle. We attempted to determine the optimal time for application of the tape as well as for vein puncture after its removal by measuring pain sensation in human subjects. ⋯ We concluded that lidocaine tape provided maximum pain relief when applied 4 to 6 hours prior to vein puncture and up to 1 hour after removal.
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Day-case surgery is becoming more popular in Japan. The incidence of postoperative complications and unanticipated hospital admission was evaluated between June 1, 1998 and May 31, 2001. ⋯ Effective pain management and well-chosen anesthetic technique are important for the success of ambulatory surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Postoperative delirium after general anesthesia vs. spinal anesthesia in geriatric patients].
Influence of the type of anesthesia on postoperative delirium was examined in geriatric patients with femoral neck fracture. ⋯ The type of anesthesia, general or spinal, does not affect the postoperative delirium in geriatric patients with femoral neck fracture.
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Case Reports
[Anesthesia for a woman with triplet pregnancy presenting with acute abdomen after the recent epidural blood patch].
We report a case of primipara with triplet pregnancy who underwent combined spinal and epidural anesthesia 10 weeks after epidural blood patch. At 15 weeks of gestation, a woman with triplet gestation underwent Shirodkar operation under spinal anesthesia and subsequent epidural blood patch as a treatment of post-dural puncture headache. At 26 weeks she presented with acute abdomen and laparotomy was scheduled. ⋯ Laparotomy revealed right paraovarian cyst torsion and the right salpingo-paraoophocystectomy was performed. Patient-controlled analgesia with epidural bupivacaine and fentanyl was effectively continued for two days. Postoperative course was uneventful and the triplets were delivered by cesarean section at 35 weeks.
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Case Reports
[Insertion of an epidural catheter from the surgical wound for postoperative analgesia--a case report].
A 62-year-old male was scheduled for discectomy for lumbar disc herniation. He had bronchial asthma, and his asthma was induced by nonsteroidal anti-inflammatory drugs. We decided to use continuous epidural block for postoperative analgesia. ⋯ It was easily placed at L 5-S 1 interspace using a Tuohy needle from the surgical wound, and the contrast medium 5 ml was injected through the epidural catheter to confirm the placement. After the surgery, continuous epidural block with local anesthetics was used for two days. He did not complain of severe pain postoperatively.