Masui. The Japanese journal of anesthesiology
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Intracranial subdural hematoma (SDH) occurred in a 58-year-old female after laparoscopy-assisted distal gastrectomy under general and thoracic epidural anesthesia. On postoperative day 2, she complained of headache in sitting position, but there were no remarkable neurological defect and nausea. On postoperative day 5, her headache subsided and she could walk by herself. ⋯ Her condition improved and was discharged on postoperative day 17 without subsequent complications. SDH after epidural anesthesia is rare, but diagnosis in early stage has a decisive influence on its prognosis. It is crucial to exclude the possibility of SDH and observe closely if the patient complains of severe headache or another unexplained symptom only with postdural puncture headache.
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According to Wikipedia, translational research is scientific research that facilitates the translation of findings from basic science to practical applications that enhance human health and well-being. In this special issue, the topic of translational research in anesthesiology was featured. Six subtopics including 1) adaptation of induced pluripotent stem (iPS) cells to central nerve injury, 2) signaling of granulocyte macrophage colony stimulating factor and its clinical application: host-defense and organ protection, 3) molecular mechanisms of chronic pain and its therapeutic strategy, 4) endoplasmic reticulum stress and opioid tolerance, 5) relationships of damage-associated molecular patterns and organ injury, and 6) translational research in omics science to clinical anesthesia, are presented and discussed in detail. Anesthesiologists always keep in mind that the goal of translational research is to improve our health through research and that there would be no bright future in anesthesiology without the fruits of translational research.
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The transversus abdominis plane (TAP) block is a newly described technique introducing a local anesthetic agent between the internal oblique and the transversus abdominis muscles of the abdominal wall, which is safer and more reliable analgesia in recent years by ultrasound technique. We report the perioperative management of transversus abdominis plane block with catheterization for a patient with severe cardiac dysfunction and chronic kidney failure, who underwent bilateral inguinal hernioplasty. ⋯ During the operation, the patient received a target-controlled infusion of 0.4-0.6 microg x ml(-1) propofol. The perioperative courses were uneventful and there was no adverse effect including central nervous system (CNS) symptoms.
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Case Reports
[Successful internal jugular venipuncture in an infant with a high risk of puncturing the vertebral artery].
A five-month-old baby girl, 61.8 cm in height and weighing 4.9 kg, underwent ventricular septal defect repair under general anesthesia. Authors checked for small vessels around the IJV using an ultrasound echo apparatus with a 5/10-MHz probe (TiTAN, SonoSite Co., Tokyo, Japan) at a point 28 mm from the clavicle over the IJV. We observed a 3.8-mm-wide and 8.7-mm-deep vertebral artery 1.3 mm behind the 5.5-mm-wide IJV with color Doppler flow imaging for CVC. ⋯ The operator punctured the IJV carefully using real-time ultrasound guidance with a 24 G plastic puncture needle (Jelco Plus, Smith Medical, Tokyo, Japan), and avoided puncturing the vertebral artery. The CVC was successful, and no after-effect was observed following the operation. Before inserting the puncture needle each time, one should check for small arteries behind the IJV with color Doppler flow imaging.
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The goal of this investigation was to evaluate the details of preformed pediatric endotracheal tubes (PPETTs, I. D. 3.0-6.0 mm). ⋯ There are no uniformity in the details of PPETTs. The details of PPETTs including those with high volume low pressure cuff should be updated.