Masui. The Japanese journal of anesthesiology
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We experienced the anesthetic management of 10 Jehovah's Witness patients. Some patients accepted either blood products, autologous blood transfusion with closed circuit, or Cell Saver. ⋯ It would be desirable to clear up an acceptable standard and write out it in each medical institution to avoid conflicts with the patient and families. Prior agreement is required among medical staffs on refusal of blood transfusion.
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One case of prenatally diagnosed congenital diaphragmatic hernia was reviewed in terms of the anesthetic managements. Concentrations of diazepam, pancuronium and fentanyl were measured in maternal, fetal and umbilical serum. As expectedly, the transition of diazepam through the placenta was large and the concentration of diazepam in the fetal serum was equal to that of maternal serum, but only a small amount of pancuronium was transferred.
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A retrospective study of the lumbar and thoracic epidural anesthesia (catheterization) in infants and children younger than 12 years was undertaken in children's hospitals in Japan. Seventeen institutions replied to our questionnaire and 10 institutions experienced these procedures in the year preceding September 1994. The total number of the lumbar and thoracic epidural anesthesia performed was 324, with average of 32.4 +/- 31.1, and maximum of 113 and the minimum of 2. ⋯ The patient had herpes zoster. On the other hand, several institutions cast doubt on the necessity of epidural anesthesia in infants and children. The long-term influence on the developing nervous system should be investigated.
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We report the anesthetic management of a patient with cardiac sarcoidosis. Cardiac sarcoidosis is characterized by a high incidence of complete atrioventricular block, right bundle branch block, and ventricular arrhythmias. Cases of sudden death during stable cardiac function have been reported. ⋯ Anesthesia was induced with midazolam and vecuronium, and the trachea was intubated. Anesthesia was maintained with nitrous oxide, sevoflurane in oxygen. Anesthetic method adapted to prevent severe complications including sudden death resulted in good condition of the patient during the perioperative period.
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Review Case Reports
[Bronchospasm during anesthesia in a patient with Prader-Willi syndrome].
A patient with Prader-Willi syndrome developed bronchospasm during anesthesia. The patient was a 9-year-old boy and was scheduled for orchiopexy. His psychomotor development was delayed, and at 12 months of age he was diagnosed as Prader-Willi syndrome by chromosomal examination. ⋯ The bronchospasm was improved gradually and surgery was finished. Prader-Willi syndrome is an uncommon disease first reported by Prader in 1956 and characterized by hypotonia, hypomentia, hypogonadism and obesity. In the perioperative management for a patient with Prader-Willi syndrome, special attention must be paid to the abnormalities in the upper and lower respiratory systems.