Masui. The Japanese journal of anesthesiology
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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.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Premedication in children: a comparison of oral midazolam and rectal bromazepam].
Seventy-seven children for minor surgery of less than 90 minutes in duration were divided into two groups; one group received midazolam syrup and the other received bromazepam suppository. The sedative effect before or after the induction of the anesthetic, the effect on the circulatory system, and the prolongation of the sedative effect after surgery were studied. ⋯ In children under 4 years of age, the sedative effect during the induction was obtained by administering midazolam syrup before the surgery. It is indicated that midazolam syrup is superior to the bromazepam suppository in children under 4 years of age.
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Comparative Study Clinical Trial
[Incidence of nausea and vomiting after cholecystectomy performed via laparotomy or laparoscopy].
Postoperative nausea and vomiting (PONV) are commonly observed adverse effects of general anesthesia. In a retrospective study of laparoscopy group (101 patient) and laparotomy group (101 patient), we evaluated the incidence of PONV after laparoscopic cholecystectomy. ⋯ The risk of PONV was greater in laparoscopy group in female patients (23.4% versus 9.3% in laparotomy group, P < 0.05) and in obese patients (25.0% versus 0% in laparotomy group, P < 0.01) during the first postoperative hour. We conclude that laparoscopic cholecystectomy increases the incidence of PONV in early postoperative period probably by the effect of residual stretching and irritation of the peritoneum, and the risk is increased in female and obese patients.
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Randomized Controlled Trial Clinical Trial
[Usefulness and radiopacity of the two radiopaque epidural catheters].
We evaluated the radiopacity and usefulness of the two radiopaque epidural catheters, one by Portex CO. Ltd., and the other Flex Tip Plus with a stainless coil by Arrow Japan Co. Ltd. ⋯ The course of the catheter was identified easily in 1 case of Group A and 4 cases of Group B but was not identified at all in 10 cases of Group A and 8 cases of Group B. There were no differences between the two groups in the number of patients in whom the catheter was easily inserted, identified, or placed straight. Therefore, the usefulness of the two catheters in terms of insertion and identification of its course was not different.
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To make the most of the blood products, we have introduced maximum surgical blood order schedule (MSBOS) as well as Type and Screen (T&S) into Nagahama City Hospital. As the hospital dose not have blood transfusion service unit, we, anesthesiologists set up MSBOS and the procedure of blood preparations for elective surgery. The results of two year's experience demonstrate that there was no trouble by reducing the blood preparation. The cross-match to transfusion ratio (C/T ratio) in surgical procedures and that of red cell products in our hospital have decreased, the effective use of red cell products has been promoted, and the outdating of the blood product has been reduced.