Masui. The Japanese journal of anesthesiology
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Case Reports
[Respiratory muscle weakness after prolonged use of hydrocortisone and pancuronium bromide].
A 30-year-old man was admitted because of status asthmaticus. He required 7 days of artificial ventilation and was treated with hydrocortisone 1.2 g.day-1 and bronchodilaters. Pancuronium bromide 0.08 mg.kg-1.hr-1 was given for 64 hours for the ease of artificial ventilation. ⋯ Serum creatine kinase concentration rose to 2178 U.l-1 on day 6 and returned to normal on day 11. Hematurea, hyperpyrexia and metabolic acidosis were never seen during the course. Acute corticosteroid myopathy was suspected to be the cause of the prolonged respiratory muscle weakness.
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Subarachnoid hemorrhage secondary to ruptured intracranial arteriovenous malformation (AVM) during pregnancy, although rare, is a grave complication. We experienced 3 patients with AVM for cesarean section. Case 1: A 24-year-old woman suffered sudden vomiting and headache during the 22nd week of her first pregnancy. ⋯ She was diagnosed as having intracranial hemorrhage. Cesarean section immediately followed by the removal of an intra cranial hematoma under general anesthesia. Better perinatal outcome is expected when AVM rerupture is prevented by first performing cesarean section.
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We conducted a survey to examine surgeons' opinions and criticisms of patient evaluations done by anesthesiologists prior to surgery. We sent questionnaires to 117 departments of general surgery in Japanese university hospitals. We received answers from 77% of the departments. ⋯ It should be made clear to the patient what responsibility each doctor has. It is also important that all explanations given to a patient and the consent to anesthesia given by a patient be properly documented. Japanese anesthesiologists and surgeons need to work far more closely together with regard to pre-anesthetic evaluation and explaining patients about their peri-operative risk.
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Comparative Study Clinical Trial
[Postoperative sore throat and intracuff pressure: comparison among endotracheal intubation, laryngeal mask airway and cuffed oropharyngeal airway].
We studied which device is most useful to reduce postoperative sore-throat. We investigated the relationship between intracuff pressure and postoperative sore-throat in using endotracheal intubation (ET), the laryngeal mask airway (LMA) and the cuffed oropharyngeal airway (COPA) in adult patients. We classified sore-throat into categories; pain at rest, hoarseness and dysphasia. ⋯ Hoarseness was complained by 15 patients in ET group, 2 in LMA group and 4 in COPA group, showing significantly lower incidence of hoarseness in LMA and COPA groups than in ET group. Dysphasia was complained by 3 in ET group, 1 in LMA group and 2 in COPA group, showing no significant difference. These results suggest that LMA is most appropriate to reduce postoperative sore-throat.
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Randomized Controlled Trial Clinical Trial
[Pre-incisional administration of ketamine reduced the postoperative pain].
This study was designed to examine the postoperative analgesic effect of pre-/post-incisional administration of ketamine. Thirty-nine female patients scheduled for transabdominal hysterectomy were randomly allocated into 3 groups. Patients in group-K1 (n = 13) received intravenous ketamine 100 mg before surgical incision and patients in group-K2 (n = 13) received the same after laparotomy. ⋯ VAS and VRS in group-K1 were significantly lower compared with those in group-C, while there was no difference between group-K2 and C. The incidence of side effects and additional use of analgesics were similar among the three groups. In conclusion, pre-incisional administration of ketamine reduced the postoperative pain, but post-incisional ketamine was not effective.