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Volume 29 (2009)
- Issue 7 Pages 749-
- Issue 5 Pages 563-
- Issue 4 Pages 341-
- Issue 3 Pages 229-
- Issue 2 Pages 109-
- Issue 1 Pages 1-
Volume 29, Issue 2
Displaying 1-16 of 16 articles from this issue
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Journal Symposium (1)
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Hideko ARITA2009 Volume 29 Issue 2 Pages 109
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSDownload PDF (113K) -
Masako ISEKI, Masataka IFUKU, Yoshihito MORITA, Yoshitaka NAKAMURA2009 Volume 29 Issue 2 Pages 110-119
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSThere have been reports that nerve block treatments, in addition to the WHO-recommended drug therapy, are useful for pain relief and QOL improvement. In order to gain insight into the general perception of the usefulness among doctors involved in palliative care medicine as well as to obtain constructive feedback, a survey was conducted targeting those doctors who are considered influential in the field of palliative care. Among the doctors, thirty percent responded that they would consider nerve block treatments after providing drug therapies. They also have high regard for subarachnoid or epidural continuous infusion and expressed expectations regarding anesthesiologists' role in the practice. Overall, it was suggested anesthesiologists should actively educate doctors in other medical fields on various aspects of the nerve block treatment including situations where such treatment may be indicated.View full abstractDownload PDF (538K) -
Keisuke YAMADA2009 Volume 29 Issue 2 Pages 120-126
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSSpinal metastases cause very severe pain upon motion, which is difficult to control with strong oral opioids alone. At Kanazawa University Hospital, surgery, radiation therapy, and percutaneous vertebroplasty are performed to alleviate pain upon motion due to spinal metastases. In surgery, including preoperative arterial embolization, anesthesiologists conduct perioperative pain treatment, with intravenous patient-controlled analgesia (PCA) . In radiation therapy, anesthesiologists conduct pain treatment to maintain body position during radiation therapy with intravenous PCA and epidural or intrathecal block. In percutaneous vertebroplasty, anesthesiologists cooperate with radiologists and orthopedists to cope rapidly with any complications that may arise.View full abstractDownload PDF (675K) -
Akitaka YOSHIZAWA, Yasuaki GYOUDA, Toshihiko ISHIGURO2009 Volume 29 Issue 2 Pages 127-130
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSThe advantage of involving an anesthesiologist in palliative home care is that he/she is an expert in pain control, which is highly advantageous for palliative home care; in addition, an anesthesiologist is also qualified to plan and coordinate medical care in the palliative home care setting.View full abstractDownload PDF (451K)
Journal Symposium (2)
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Takae KAWAMURA2009 Volume 29 Issue 2 Pages 131
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
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Hiroyuki IKEZAKI, Junya MATSUMURA, Sangho KIM, Akihiro NABUCHI, Atsuhi ...2009 Volume 29 Issue 2 Pages 132-142
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSOver the past two decades, cardiac surgery has been greatly advanced and cardiac anesthesiology fully adapted to this progress, which has brought us the contemporary practice of cardiac anesthesia. Improved techniques in anesthesia, surgery and cardiopulmonary bypass management have made it possible to free surgical patients from postoperative mechanical ventilation much earlier (Fast-Track Cardiac Anesthesia) . Small doses of fentanyl, remifentanil, concomitant use of sevoflurane and/or epidural analgesia have been utilized for Fast-Track Cardiac Anesthesia. Sevoflurane has the advantage of protecting the ischemic heart by pre- and post-conditioning of the heart. Also, application of thoracic epidural analgesia in cardiac surgery has been reported to decrease postoperative sympathetic tone and to decrease the inflammatory responses of surgical patients ; however, the best practical method for anesthesia of the cardiac surgical patient has not been well established. The practice of cardiac anesthesia is strongly connected to cardiology, anesthesiology and intensive care, and continues to be very challenging. Thus, further investigations and daily practices to seek the best standards for cardiac anesthesia are warranted.View full abstractDownload PDF (612K) -
Takayuki KUNISAWA2009 Volume 29 Issue 2 Pages 143-151
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSA larger variety of monitors are used for cardiac anesthesia than for other types of anesthesia. Discussion concerning the indication for and selection of monitors is needed, and it is also necessary to obtain accurate information from the monitors and use this information for clinical purposes. Each monitor must be used with an understanding of its characteristics and principles and an understanding of its pitfalls and disadvantages. A comprehensive judgment of the information obtained from intraoperative monitors for cardiac anesthesia based on a thorough knowledge of the functions of the monitors is required. A TEE monitor is one of the most useful monitors and can provide an abundance of information. A sufficient understanding of the various monitors used for cardiac anesthesia, including the TEE monitor, and effective utilization of TEE is required.View full abstractDownload PDF (648K)
Educational Articles
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Masaki KITAHARA2009 Volume 29 Issue 2 Pages 152-159
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSUtilizing the appropriate assessment techniques of pain is critical in making the correct diagnosis and prescribing the appropriate treatment. Because pain is always subjective, as is defined in the terminology of pain by the International Association for the Study of Pain, clinicians have to rely on the self-report of patients to assess their pain. The physician's role, in addition to evaluating the pain, is also to assess the multiple components of functioning, including behavior, mood, and satisfaction, because pain often has a negative impact on these various domains. Most assessment tools of health status were developed in English-speaking countries and have been used in Japan, but without undergoing an appropriate translation and validation process. Assessment tools, which are adjusted and validated for Japanese society, need to be developed in order to improve the quality of clinical treatments as well as research of pain in Japan; pain behavior is inevitably affected by language and culture, and the Japanese culture is significantly different from that of the English-speaking countries.View full abstractDownload PDF (413K) -
Ritsuko MASUDA2009 Volume 29 Issue 2 Pages 160-170
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSNeuraxial analgesia using opioid and local anesthetic provides synergic and high quality analgesia in perioperative states, acute pain control, and palliative care settings. Postoperative analgesia using a neuraxial route facilitates earlier recovery than using systemic route, however, neuraxial analgesia requires appropriate technique, indication decision and management for minimizing serious complications. In this article, we reconfirm the proper indication, system management and risk management of neuraxial analgesia in postoperative and palliative pain control.View full abstractDownload PDF (731K) -
Yoshihiro FUJIWARA, Hiroshi ITO, Nobuhisa KANDATSU, Toru KOMATSU2009 Volume 29 Issue 2 Pages 171-176
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSAnesthesia is regarded as a symbol of humanitarianism, by which many patients suffering from pain due to surgery are relieved. Recently, many anesthesiologists all over the world are focusing on ultrasound-guided nerve block, as an effective and safe analgesic tool. This technique is potentially applicable to emergency and critical care medicine. Unreasonable failure to treat pain may be viewed world-wide as an abrogation of a fundamental human right. We, anesthesiologists, have responsibilities not only to provide the best analgesia possible, but also to inform medical practitioners working in other specialties about effective and safe analgesic techniques.View full abstractDownload PDF (455K) -
Yoshiki IMAMURA, Akiko OKADA2009 Volume 29 Issue 2 Pages 177-188
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSTrigeminal system has a unique pathway of noxious signals. Nociceptive fibers reach the junction of the medulla and the cervical spine. Fibers from head, face and the neck converge on a second order neuron and therefore, the location of the pain origin is improperly recognized in a certain condition. Practitioners should be aware of heterotropic pain that patients often complain of. The most frequently affected tissue as an origin of the referred pain is masticatory muscles and the cause of the muscle tenderness usually lies in the sustained muscle contraction due to nonfunctional tooth contact. Thorough palpation of the masticatory muscles discloses myofascial trigger points in the taut bands and pressing a myofascial trigger point provokes the pain reference. In trigeminal nerve injury, a focused treatment with sympathetic nerve block should be considered very soon after the damage. The etiology of burning mouth syndrome is still unclear, and the psychosocial component of the condition is believed to have an important role in the onset and aggravation of the condition. Tympanic nerve damage is currently supposed to be a potent mechanism of burning mouth syndrome and further investigation is expected for better understanding of this condition.View full abstractDownload PDF (612K) -
Tetsuya HARA, Koji SUMIKAWA2009 Volume 29 Issue 2 Pages 189-198
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSPrevention and treatment of myocardial ischemia/reperfusion injury are critical issues in the perioperative management. Ischemic preconditioning (IPC) is the potent and consistently reproducible method of reducing the myocardial ischemia/reperfusion injury. Adenosine triphosphate-sensitive potassium (KATP) channels, mitochondrial permeability transition pore, opioid receptors, reactive oxygen species, multiple protein kinase and nitric oxide are involved in the intracellular mechanism of IPC. Volatile anesthetics and nicorandil effectively mimic IPC through activation of KATP channels (pharmacological preconditioning: PPC) . PPC exerts myocardial protection against infarction, stunning and arrhythmia in the experimental and clinical settings. However, there are some controversies on the efficacy of PPC in the aged or diseased myocardium and in patients received drugs affecting the activity of KATP channels. Concomitant administration of some potent KATP channel openers, such as volatile anesthetics and nicorandil, may exert more reliable myocardial protection and improve the cardiovascular outcome in patients with high risk of cardiovascular complications.View full abstractDownload PDF (537K)
Original Articles
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Mutsuko MATSUMOTO, Toshiaki KURASAKO, Takae NIGUMA, Yutaka YAIDA, Nori ...2009 Volume 29 Issue 2 Pages 199-203
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSThis retrospective study was aimed to find the best ways to relieve postoperative pain after pediatric inguinal herniorrhaphy.
One hundred and seventy children aged 1-7 who underwent the inguinal herniorrhaphy were studied. Postoperative pain was treated with one of the following regimens: Group (1)Ilio-inguinal nerve block with 1% lidocaine (n=22) , Group (2)Ilio-inguinal nerve block + flurbiprofen 1mg/kg iv (n=24) , Group (3)Ilio-inguinal nerve block + acetoaminophen 10mg/kg suppository (n=28) , and Group (4)Local anesthesia (0.2% ropivacaine) at the incision site + acetoaminophen 10mg/kg suppository (n=96) . Outcomes (post-operative pain, bad-temper, additional analgesics and vomiting) were estimated until discharge, the day after the operation.
The number of patients for each parameter, Group (1) were 16 (73%) , 6 (27%) , 1 (4.5%) , Group (2)were 10 (42%) , 8 (33%) , 0, Group (3) were 8 (29%) , 1 (3.5%) , 0, and Group (4) were 10 (10%) , 1 (1%) , 1 (1%) , respectively.
The combination of infiltration of long-acting local anesthetic agents at the incision site and acetoaminophen suppository (Group (4)) was most effective in reducing the postoperative pain in the four groups we studied.View full abstractDownload PDF (266K)
Case Reports
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Yumiko OE, Katsuyuki TERAJIMA, Masayuki FURUICHI, Hiroaki KISHIKAWA, A ...2009 Volume 29 Issue 2 Pages 204-213
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSAbnormally invasive placentation is a rare condition in which the placenta abnormally attaches to or invades into the myometrium with a partial or complete absence of the decidua basalis. The degree of myometrial invasion of the chorionic villi distinguishes (focal) placenta accreta from placenta increta and placenta percreta, in which the placenta actually perforates the uterus and can even perforate into surrounding organs. There is a substantial risk of uterine rupture, catastrophic haemorrhage, hysterectomy causing serious maternal morbidity and loss of future fertility. With the growing number of cesarean deliveries, the frequency of abnormally invasive placentation is increasing. However, there is, as yet, no completely perioperative management for these conditions. We present 2 cases of pregnant patients with abnormal placentation and review the current state- of-the-art obstetric and anesthetic management of these conditions.View full abstractDownload PDF (765K) -
Go KUSUMOTO, Keiichi NITAHARA, Kazuo HIGA, Yasuyuki SUGI, Shinjiro SHO ...2009 Volume 29 Issue 2 Pages 214-216
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSWe managed a 51-year-old man with a laryngeal polyp who also had markedly atrophied muscles due to associated Kennedy-Alter-Sung syndrome. Anesthesia was induced with propofol, fentanyl, and sevoflurane. The trachea was intubated solely after hyperventilation with sevoflurane. Anesthesia was maintained with sevoflurane. No neuromuscular blocking agent was used throughout the anesthesia and surgery. The trachea was extubated after full recovery of swallowing reflex. There was no perioperative respiratory complication.View full abstractDownload PDF (256K) -
Shinichi KONO, Hidekazu HIGASHI, Yasuhiro KOJIMA, Hirokazu UEHARA, Shi ...2009 Volume 29 Issue 2 Pages 217-221
Published: January 15, 2009
Released on J-STAGE: April 11, 2009
JOURNAL FREE ACCESSWe experienced the perioperative management of a 37-year-old man with bilateral bullous emphysema, giant bullae, and severe respiratory dysfunction. Initially, the patient was admitted to the ER complaining of dyspnea with loss of consciousness. A chest X-ray at that time showed a right tension pneumothorax, and thoracic drainage was performed. Three weeks later, he underwent bilateral video-assisted thoracic surgery (VATS) to both lungs. Anesthesia was maintained with air, oxygen, sevoflurane, fentanyl, and thoracic epidural analgesics. Postoperatively, he developed methicillin-resistant Staphylococcus aureus (MRSA) pneumonia and severe asthma. He was extubated on the 13th postoperative day, and discharged about 4 months postoperatively.
With epidural analgesia may be helpful, even in a patient of bilateral VATS with extreme respiratory dysfunction.View full abstractDownload PDF (504K)
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