Masui. The Japanese journal of anesthesiology
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We report a case in which spinal anesthesia induced a severe lightning limb pain. A 71-year-old man presented for prostate biopsy. Preanesthetic examinations revealed slight hypesthesia in the L 5-S 1 dermatomal segments in the right leg. ⋯ The spinal anesthesia was uneventfully introduced with a 25 G Quincke needle at the L 3-4 interspace using 2.0 ml 0.3% hyperbaric dibucaine in the left lateral positions. As soon as the patient was put into the supine position, he started to complain about severe lightning pain in the region of his hyposthesic segments. Severe lightning pain completely diminished 4 hours later when the effect of spinal anesthesia disappeared.
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A 30 year-old pregnant woman (36 weeks) had intracranial hemorrhage due to arteriovenous malformation in the left frontal lobe. She underwent an emergency cesarean section under general anesthesia. ⋯ Emergence from anesthesia was uneventful, and no exacerbation of neurological signs and symptoms were recognized. It is important to control hemodynamic changes during anesthesia for a patient with intracranial hemorrhage due to ruptured arteriovenous malformation.
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In malignant hyperthermia (MH) patients, the rate of Ca(2+)-induced Ca2+ release (CICR) from the sarcoplasmic reticulum (SR) has been reported to be enhanced. The effects of amrinone on the Ca(2+)-related functions (CICR, Ca2+ uptake by the SR and Ca2+ sensitivity of the contractile system) of the skeletal muscle were examined using the chemically skinned fiber technique in the extensor digitorum longus of guinea pigs. ⋯ Ca2+ uptake, initial rate of Ca2+ uptake by the SR and Ca2+ sensitivity of the contractile system were not affected at 1 mM of amrinone. These results suggest that amrinone may be clinically safe to use in MH susceptible patients.