All issues
Volume 25 (2005)
- Issue 7 Pages 571-
- Issue 5 Pages 427-
- Issue 4 Pages 331-
- Issue 3 Pages 237-
- Issue 2 Pages 111-
- Issue 1 Pages 1-
Volume 25, Issue 4
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
Original Articles
-
Mitsumasa MATSUDA, Junichi NISHIYAMA, Miho MAEDA, Toshiyasu SUZUKI2005 Volume 25 Issue 4 Pages 331-337
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSThe distance from the skin, the internal diameter and the relationship between the common carotid artery of the internal jugular vein in the supine position, the Trendelenburg position, and the Trendelenburg position holding their breath was measured using ultra-sonic diagnostic device for 60 volunteers. The diameter of the internal jugular vein was the largest in volunteers who were in the Trendelenburg position while holding their breath. The diameter was significantly smaller in the left internal jugular vein compared with the right internal jugular vein. The results of this study suggest that punctures of the left internal jugular vein should be performed carefully.View full abstractDownload PDF (366K) -
Yutaka YAMAZAKI, Atsushi SAITO, Hiromu TAKAHASHI2005 Volume 25 Issue 4 Pages 338-342
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSWe retrospectively compared preoperative, intraoperative and postoperative complications between emergency surgery (emergency group, n=18) and elective surgery (elective group, n=35) in patients over 80 years of age who underwent abdominal surgery. In the emergency group, two patients received norepinephrine because of shock and the other two patients had complications from DIC preoperatively. Five out of seven patients with a P/F ratio of less than 200 mmHg during emergency surgery were in serious condition intraoperatively and had poor prognosis postoperatively. Preoperative, intraoperative and postoperative close management is important to minimize postoperative adverse events in the elderly.View full abstractDownload PDF (298K)
Case Reports
-
Tomoko YOROZU, Kensuke TANAKA, Yasushi KUBOTA, Yusuke KITAHARA, Takehi ...2005 Volume 25 Issue 4 Pages 343-346
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSSeizure-like phenomena occurred twice in a 40-year-old male with myasthenia gravis who underwent mechanical ventilation, sedated with continuous intravenous propofol after thymectomy. The myoclonus in both upper and lower limbs occurred 30 min after the start of the continuous infusion of propofol and lasted for 4 hr. One hour following the termination of the continuous infusion, hypermyotonia in upper limbs occurred and lasted for 8 hr. Propofol has the actions of both pro-and anti-seizure-like phenomena. The former action is due to low blood concentrations of propofol both during the beginning and after the end of propofol infusion, which seemed to be the cause in this case. Moreover, surgical stress and the discontinuity of cholinergic drugs after the thymectomy may alter the sensitivity of neuromuscular junctions. Therefore when propofol is used for the patients with myasthenia gravis, close attention should be paid to possible seizure-like phenomena.View full abstractDownload PDF (282K) -
Chiaki INADOMI, Kazunori YAMASHITA, Masafumi TAKADA, Yoshiaki TERAO, M ...2005 Volume 25 Issue 4 Pages 347-351
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSA 24-year-old woman was scheduled to undergo osteoplasty for facial bone fracture. Rapid anesthesia was induced with thiamylal, and then fentanyl followed by vecuronium to facilitate intubation. It was impossible to easily ventilate the patient manually after the lightwand intubation. The endotracheal tube was removed and found to be occluded in the oropharynx by the gastric contents. After the gastric contents were cleared, an endotracheal tube was intubated successfully using direct-vision laryngoscopy. Continuous peripheral oxygen saturation monitoring was greater than 99% during the surgical procedure. The patient was transferred to the ICU. She recovered without any adverse events such as aspiration pneumonia. She was postoperatively diagnosed as having esophageal achalasia by esophagography. To prevent regurgitation during induction of anesthesia in a patient with preoperatively a undiagnosed esophageal achalasia, it is important that esophageal dilation in chest x-ray as well as symptoms and signs such as dysphagia, regurgitation, chest pain, heartburn and weight loss are carefully assessed preoperatively.View full abstractDownload PDF (352K) -
Kenji HIRAMATSU, Eiji IWASAKI, Megumi YOSHIOKA, Yasuhiro SIOKAWA, Taka ...2005 Volume 25 Issue 4 Pages 352-356
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSA seventeen-month-old female patient presenting with severe wheezing and dyspnea was admitted. She was diagnosed as having status asthmaticus in association with lobar atelectasis on the right side. The hypoxemia did not improve with 100% oxygen inhalation and conventional drug therapy. Mechanical ventilation was started and a mucous plug was removed using a bronchofiberscope. High frequency ventilation (HFV) and inhalation of isoflurane (1%) was initiated and the status asthmaticus improved in 4 to 5 days. However, bronchial hemorrhaging and liver dysfunction were observed during the therapeutic course, but both complications were improved by switching to IMV and terminating the isoflurane inhalation. Inhalation of isoflurane may be useful in the treatment of status asthmaticus. However, prolonged inhalation of isoflurane should be performed cautiously in children, because it has the potential to induce liver dysfunction.View full abstractDownload PDF (355K) -
Koji ISHII, Masakazu YAMAGUCHI, Shunji TAKAHASHI, Hiroaki MOROOKA, Osa ...2005 Volume 25 Issue 4 Pages 357-360
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSWe experienced the anesthetic management of a 41-year-old male patient with Brugada syndrome undergoing subcutaneous implantation of an implantable cardioverter defibrillator (ICD) . He had experienced two episodes of syncope, ten and fifteen years ago. He has no family history of syncope, and sudden death. In the operating room, external defibrillator was set before induction of anesthesia. Anesthesia was maintained with total intravenous anesthesia using propofol and fentanyl. Normocapnia, normal heart rate and normal temperature were maintained during anesthesia. Neostigmine was not used to reverse muscle relaxant because it can cause ventricular fibrillation (Vf) . The operation was concluded uneventfully. The anesthetic management for a patient with Brugada syndrome should be conducted with adequate monitoring including 5-lead electrocardiogram and invasive arterial pressure. A defibrillator should be ready available to treat ventricular fibrillation immediately if necessary.View full abstractDownload PDF (310K) -
Teruko TAJIMA, Nobuyo KURIYAMA, Kazumi KAKUTANI, Osamu UENO, Koji OGAW ...2005 Volume 25 Issue 4 Pages 361-363
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSThree patients older than 65 years with a suspected diagnosis of lumbar spinal canal stenosis (LCS) were referred to our pain clinic for epidural block. Precise examination of the skin revealed the presence of herpetic eruptions along with the lumbar innervation. Herpes zoster in the lumbar nerve regions mimics LCS in geriatric patients. It is important to confirm the type of pain, the presence of eruption, allodynia, and sensory disturbance in the painful regions to make the diagnosis.View full abstractDownload PDF (270K) -
Yoshihisa MIYAMOTO, Hiroko KATO2005 Volume 25 Issue 4 Pages 364-367
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSPneumothorax is a rare complication of laparoscopic surgery. However, once it occurs, it may lead to severe hypoxemia and/or hemodynamic instability. We report a case of carbon dioxide pneumothorax (capno-thorax) , which occurred on emergence from anesthesia for retroperitoneoscopic partial nephrectomy and resulted in rapid spontaneous resolution. Since carbon dioxide is more soluble in water than nitrogen, spontaneous resolution of a capno-thorax is anticipated to be more rapid compared to an air pneumothorax. Therefore, avoiding any invasive procedures such as thoracocentesis or chest tube drainage, expectant management may be appropriate in stable patients with moderate capno-thorax.View full abstractDownload PDF (295K) -
Yuko YOSHIKAWA, Yumi WATANABE, Tadashi AGUNE, Etsuji KUBOTA, Kouichi U ...2005 Volume 25 Issue 4 Pages 368-373
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSA 24-year-old woman undergoing laparoscopic splenectomy was anesthetized with fentanyl, vecuronium, and a mixture of nitrous oxide and sevoflurane. For laparoscopic surgery, carbon dioxide was insufflated using Auto Flator type III ® but with the alarm switch off. During surgery, extremely high abdominal pressure was found because of continuous gas insufflation. The gas was deflated quickly, but bilateral pneumothorax and cervical subcutaneous emphysema developed. Although intraabdominal pressure should be automatically controlled, the control system did not work probably due to external compression of a tube connected to a pressure monitoring site, resulting in over-insufflation. Alarms of laparoscopic devices should be always switched on throughout a surgical procedure.View full abstractDownload PDF (424K)
Column
-
Masakazu ABE, Shinichi SAKAGUCHI2005 Volume 25 Issue 4 Pages 374-376
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSDownload PDF (278K)
Journal Symposium
-
Hitoshi FURUYA2005 Volume 25 Issue 4 Pages 377
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSDownload PDF (116K) -
Yasuhiro MORIMOTO, Shunsuke TSURUTA, Takefumi SAKABE2005 Volume 25 Issue 4 Pages 378-386
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSSubarachnoid hemorrhage (SAH) from rupture of an aneurysm produces significant morbidity and mortality. Cerebral aneurysm has been commonly treated by aneurysm clipping. Recently, endovascular treatment using thrombogenic coils has become an alternative to surgical treatment that is being evaluated vigorously. The first step for anesthetic management is to assess the patient's condition in relation to the SAH, as well as systemic effects. The main point during induction of anesthesia is to reduce the risk of aneurysm rupture by minimizing the transmural pressure while simultaneously maintaining an adequate cerebral perfusion pressure. Formulation of an anesthetic plan to meet the patient's condition based on understanding the effect of anesthetics and other drugs used during surgery on cerebral blood flow and metabolism is essential for maintenance of anesthesia. Prior to aneurysm clipping, induced hypotension had been replaced by temporary clipping to minimize the risk of aneurysmal rupture. Thiopental, mannitol and induced hypothermia have been used as cerebral protection during the temporary clipping. Finally, communication between the surgeon and the anesthesiologist is important for optimal management of the emergence period.View full abstractDownload PDF (437K) -
Itsuo NAKAGAWA2005 Volume 25 Issue 4 Pages 387-394
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSThere are serious cerebral ischemic complications in carotid endarterectomy (CEA) due to internal carotid artery cross clamping and embolism. It is important for anesthetic management of CEA to understand the state of CEA patients before surgery. We evaluated preoperative risk factors and anesthetic management of CEA using intraoperative monitoring. As a preoperative anesthetic risk, the incidence of circulatory organ disease was common, and there was a significant incidence of ischemic heart disease in the patients with bilateral stenosis of internal carotid artery. Regional cerebral vasoreactivity (rCVR) were measured by single-photon emission CT with acetazolamide challenge preoperatively. Preoperative measurement of rCVR and intraoperative measurement of internal carotid artery flow could identify patients at risk for hyperperfusion syndrome after CEA, and in these selected cases, immediate and adequate postoperative circulatory management were needed. To prevent the intraoperative cerebral ischemia, we measured stump pressure, regional cerebral blood flow by near-infrared spectroscopy, transcranial Doppler and jugular bulb oxygen saturation, and we also recorded somatosensory evoked potential. Intraoperative monitoring was beneficial in terms of reducing operative complications, but sensitivity or efficacy was different in each monitoring. For prevention of cerebral ischemic injury, a multi-modality monitoring system is needed.View full abstractDownload PDF (429K) -
Masahiko KAWAGUCHI, Hitoshi FURUYA2005 Volume 25 Issue 4 Pages 395-400
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSSince a reduction in temperature to 33-35 degrees centigrade has been shown to be neuroprotective in a variety of animal models of cerebral ischemia, mild hypothermic therapy has been introduced in the clinical setting. The usefulness of mild hypothermia in patients after ventricular fibrillation has been demonstrated, although other studies failed to show the usefulness of mild hypothermic therapy in patients with head trauma and subarachnoid hemorrhage. Further investigations regarding the indication and methodology of mild hypothermic therapy are required.View full abstractDownload PDF (313K) -
Kiyotaka SATO, Alan A. Artru, Yasuhiro SHIOKAWA, Yoshihisa KOGA2005 Volume 25 Issue 4 Pages 401-408
Published: 2005
Released on J-STAGE: July 29, 2005
JOURNAL FREE ACCESSTo minimize post-operative neurological deficit, awake craniotomy, in which the patient is awaken and brain function is mapped, is chosen when the lesion is located near the eloquent area. The points for the management of awake craniotomy are airway management, control of grand mal seizure and psychological support. A deeper relationship with the patient is required. For the precise monitoring of ECoG and brain functional mapping, all sedatives should be avoided before the procedure. In the OR, the patient is positioned laterally or semilaterally and the airway secured. Propofol infusion is titrated for sedation and analgesia by local anesthetics should be elaborate for painful craniotomy. Recently introduced anesthetics, remifentanil and dexmedetomidine, and improvement of airway devices are making this type of surgery safe and comfortable.View full abstractDownload PDF (377K)
- |<
- <
- 1
- >
- >|