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Volume 33 (2014)
- Issue 3 Pages 123a-
- Issue 2 Pages 59-
- Issue 1 Pages 1-
Volume 33, Issue 1
Japanese Journal of Reanimatology Vol.33 no.1
Displaying 1-6 of 6 articles from this issue
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Hidemi Harima, Toru Kaneda, Yoshiki Nakajima, Toshiyasu Suzuki2014 Volume 33 Issue 1 Pages 1-5
Published: April 15, 2014
Released on J-STAGE: May 02, 2014
JOURNAL FREE ACCESS56 years old female who had the past history of malignant hyperthermia（MH）, was planned a laminectomy. Muscle biopsy was also performed during the operation because she hoped full examination about the MH. As a result, it was cleared that she had the high incidence for MH. And the fact was shared among her family. So, her son could tell his family history of MH to the doctors when he would be performed the emergency operation caused his head injury. Therefore, he was managed in a safe without having MH during his anesthesia. It can say that MH may be more likely to develop at the time of his operation if there is no recognition for his family history of MH.
The enlightenment action that the patient and its families recognized enough about MH was very important. And more, it is important duty for us.View full abstractDownload PDF (1655K)
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Fumihiko Shimada2014 Volume 33 Issue 1 Pages 6-9
Published: April 15, 2014
Released on J-STAGE: May 02, 2014
JOURNAL FREE ACCESSIn Japan, the role of emergency medical technicians (EMT) has increased. Due to this rise, anesthesiologists have also become increasingly responsible for teaching EMTs, despite the shortage of anesthesiologists in Japan. However, I have questioned whether the increased role of EMTs contributes to improvements in the rate of cardiovascular resuscitation and the social rehabilitation. Indeed, there is no evidence an improvement in these rates. Therefore, is it right that Japanese anesthesiologists should devote so many hours to teaching EMTs?
I have taught tracheal intubation to many EMTs. Here, I introduce the current situation of cardiovascular resuscitation, based on my experience training EMTs for tracheal intubation and on the reports made by my district's medical control conference. By presenting my opinions, I hope to raise questions concerning the future of anesthesiologists.
How should anesthesiologists deal with the increased role of emergency medical technicians?View full abstractDownload PDF (1122K)
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Pulmonary aspiration during induction of anesthesiain a patient with a past history of esophagectomyKoji Sato, Takashi Horiguchi, Toshiaki Nishikawa2014 Volume 33 Issue 1 Pages 10-12
Published: April 15, 2014
Released on J-STAGE: May 02, 2014
JOURNAL FREE ACCESSPulmonary aspiration of gastric contents during induction of anesthesia is a serious complication. A 61-year-old male who had previously undergone esophagectomy, was scheduled resection of hypopharyngeal tumor under endoscopy. He was directed to abstain from food 16 hours and clear liquids 4 hours, respectively, before entering the operating room. Just after loss of consciousness on injection of propofol, the patient coughed before bag-mask ventilation, and administration of a volatile anesthetic and a neuromuscular blocking drug. As pulmonary aspiration was suspected, tracheal intubation was performed at once without the use of a neuromuscular blocking drug. Just after tracheal intubation, a large volume of brownish liquid was discharged through the tracheal tube with cough reflex, and the liquid was immediately removed. Arterial blood gas analysis showed hypercapnia without hypoxia. After operation, the patient was not extubated and aminophylline was administered, because hypercapnia persisted postoperatively. Because PaCO2 gradually decreased to normal range after administration of aminophylline, the patient was extubated 18 hours after induction of anesthesia. In conclusion, a patient with a past history of esophagectomy is likely to be at high risk of pulmonary aspiration during induction of anesthesia irrespective of 16 hour-preoperative fasting.View full abstractDownload PDF (990K) -
Ryohei Kudo, Go Nagasaki, Takashi Horiguchi, Toshiaki Nishikawa2014 Volume 33 Issue 1 Pages 13-17
Published: April 15, 2014
Released on J-STAGE: May 02, 2014
JOURNAL FREE ACCESSWe report a case of successful treatment for acute aortic dissection in a pregnant patient with Marfan syndrome. A 30-year-old woman at 29 weeks of gestation was admitted to our emergency department with sudden chest and back pain. She was previously diagnosed as Marfan syndrome. Enhanced computed tomography and cardiac ultrasonography revealed Stanford type A acute aortic dissection with annulo-aortic ectasia. Cesarean section and abdominal total hysterectomy were initially performed on day 9, followed by aortic replacement on day 20. The postoperative course of both the infant and the mother was uneventful. We conclude that a two-stage operation should be performed for the pregnant patient with acute aortic dissection in order to avoid massive bleeding after heparinization for cardiopulmonary bypass, when she is not in cardiac or hypovolemic shock state.View full abstractDownload PDF (2056K) -
Shuichi Nosaka, Hiromi Ueno, Hirotoshi Kitagawa, Takashi Chihara2014 Volume 33 Issue 1 Pages 18-20
Published: April 15, 2014
Released on J-STAGE: May 02, 2014
JOURNAL FREE ACCESSA 83-year-old man was scheduled for emergency abdominal aortic aneurysm repair under general anesthesia. Total intraoperative blood loss was about 25,670ml. Intraoperative blood salvage, packed red blood cells, fresh frozen plasma and platelets were used. However, albumin was not required. The hemodynamic course of the patient during the latter half of the operation was unstable and in hypovolemic shock despite transfusion and vasopressors. Collaboration between surgical and anesthesia teams was required to minimize blood loss. Three anesthesiologists and two non-anesthesia personnel were involved as manpower in the case. Intraoperative anesthesia practice according to the guidelines developed by the Japanese society of anesthesiologists may improve the outcome following massive bleeding. After the operation, no neurological deficit was found. We could not prevent intraoperative hypothermia. However, the mild hypothermia might have been efficacious for protecting the brain against ischemia in the case.View full abstractDownload PDF (968K) -
Rumi Oshibuchi, Hiroya Wakamatsu, Norimasa Matsuda, Satoshi Matsumoto, ...2014 Volume 33 Issue 1 Pages 21-25
Published: April 15, 2014
Released on J-STAGE: May 02, 2014
JOURNAL FREE ACCESSMeasuring the intracompartmental pressure is often done for the diagnosis and treatment of the compartment syndrome. If the intracompartmental pressure increases, oxygen delivery to the lesion may decrease. Therefore, it may be more important to evaluate tissue oxygenation at the lesion. To evaluate tissue oxygenation, we measured intracompartmental regional saturation of oxygen (rSO2) in two cases of compartment syndrome that required fasciotomy. Each rSO2 level at the lesion was showed low before fasciotomy. We measured rSO2 after the surgery in one case and found increased rSO2 compared to the value before the surgery. Measuring rSO2 may be useful for the diagnosis of compartment syndrome.View full abstractDownload PDF (1640K)
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