Masui. The Japanese journal of anesthesiology
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With recent changes in surgical procedures and perioperative management, there has been a growing interest in peripheral nerve blocks of the trunk in patients undergoing thoracic and breast surgery. Tho- racic truncal blocks include paravertebral, pecs, intercostal, and retrolaminar blocks. Previous studies have demonstrated that paravertebral block provides similar analgesic effects and better hemodynamic stability compared with epidural analgesia. ⋯ The novel ultrasound-guided techniques for intercostal nerve blocks have also been reported. Although some case series support that these pecs and intercostal nerve blocks appear to be safe and effective, prospective randomized studies to confirm their clinical usefulness are lacking. Whether to con- duct these thoracic truncal blocks or not will become a standard clinical practice for thoracic and breast sur- gery is yet to be determined.
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Macewen, who was the first to perform tracheal intubation in a patient undergoing surgery under gen- eral anesthesia, described four people (Desault Bou- chut, Schrötter and Trendelenburg) who had per- formed tracheal intubation (without general anesthe- sia), before Macewen. Literature search indicates that tracheal intubation had been performed before Desault (ca. 1790), with different aims. In this article, I describe several people who developed tracheal intuba- tion for cardiopulmonary resuscitation of the drowned: Alexander Monro Secundus (tracheal intubation was estimated to be performed during 1767-1774), William Cullen (1767-1774), Charles Kite (1784-1786) and Edward Coleman (1786-1791).
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Patients undergoing abdominal surgery can experi- ence severe pain due to the abdominal wall incision. Epidural anesthesia has been considered as the gold standard for perioperative analgesia in abdominal sur- gery. However, currently, many patients receive pro- phylactic anticoagulation therapy preoperatively with potential complications. ⋯ The use of ultrasound ren- ders these block techniques safe and reliable. Cur- rently, a new abdominal peripheral nerve block, qua- dratus lumborum block, is gaining attention because it is thought to have a wider range of analgesia and a longer duration of effect As the analgesic properties of these blocks are limited in extent and duration, it is important to select the appropriate approach. Ultrasound-guided abdominal trunk block can con- tribute to perioperative multimodal analgesia.
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Case Reports
[Efficacy of Go-rei-san for Pain Management in Four Patients with Intractable Trigeminal Neuralgia].
Go-rei-san is a Japanese traditional medicine that is used to treat motion sickness, nausea, and vomiting. We report here four patients for whom Go-rei-san was effective in treating pain associated with intractable trigeminal neuralgia. Three patients could not continue carbamazepine due to drug-induced rash, liver damage, and gastrointestinal injury, and suffered from pain. ⋯ All patients exhibited symptoms of water poisoning on their tongues. All patients experienced significant pain relief without major complications after daily adminis- tration of 7.5 g Go-rei-san. Our findings suggest that Go-rei-san can effectively alleviate pain associated with intractable trigeminal neuralgia without major compli- cations.
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Randomized Controlled Trial Comparative Study
[A Randomized Control Study Comparing the Effects of Tracheal Intubation Performed either via the McGRATH® MAC or the Macintosh Laryngoscope].
The McGRATH® MAC (McGRATH) laryngoscope is a newly developed video device, which enables us to perform tracheal intubation minimally invasive. The aim of this study is to evaluate and com- pare the hemodynamic changes triggered by intuba- tion using either the McGRATH or the Macintosh laryngoscope. ⋯ The McGRATH laryngoscope is less invasive for hemodynamic parameters than the Macin- tosh laryngoscope. These findings suggest that the McGRATH laryngoscope may enable us to perform tracheal intubation less invasively.