JA Clinical Reports最新文献_第2页

Ultrasound-guided radial vein cannulation for general anesthesia in cases with difficult peripheral venous access: a report of two cases 超声引导下桡动脉插管用于外周静脉入路困难的全身麻醉：两例病例报告

IF 0.9

JA Clinical Reports Pub Date : 2024-09-19 DOI: 10.1186/s40981-024-00743-y

Hironori Motoyama, Joho Tokumine, Yukiko Saito, Kiyoshi Moriyama, Tomoko Yorozu

引用次数: 0

Novel technique of switching TIVA and sevoflurane during epilepsy surgery for combined intraoperative motor evoked potentials monitoring and electrocorticography: an illustrative case report 在癫痫手术过程中切换 TIVA 和七氟醚以进行术中运动诱发电位监测和皮层电图检查的新技术：一份说明性病例报告

IF 0.9

JA Clinical Reports Pub Date : 2024-09-19 DOI: 10.1186/s40981-024-00740-1

Yoko Mukoyama, Junko Ichikawa, Makiko Komori, Mitsuharu Kodaka, Suguru Yokosako, Yuichi Kubota

{"title":"Novel technique of switching TIVA and sevoflurane during epilepsy surgery for combined intraoperative motor evoked potentials monitoring and electrocorticography: an illustrative case report","authors":"Yoko Mukoyama, Junko Ichikawa, Makiko Komori, Mitsuharu Kodaka, Suguru Yokosako, Yuichi Kubota","doi":"10.1186/s40981-024-00740-1","DOIUrl":"https://doi.org/10.1186/s40981-024-00740-1","url":null,"abstract":"During epilepsy surgery, it is equally important to record electrocorticography (ECoG) for detecting epileptogenic activity and guiding brain resection, and to evaluate neuromonitoring data, particularly motor evoked potentials (MEP), for avoidance of postoperative neurological complications. However, sevoflurane, which is commonly used during recording of ECoG, may attenuate the MEP response. It enforces anesthesiologists and neurosurgeons to select one anesthetic agent over another, facilitating either ECoG or MEP monitoring. In the presented case of a 20-year-old man, who underwent surgery for temporal lobe epilepsy, a novel technique of neuroanesthesia was introduced, integrating initial induction of the total intravenous anesthesia (TIVA) with propofol (effect-site concentration, 2.3–3.0 μg/ml), its subsequent switching to sevoflurane (end-tidal concentration, 2.5%) for ECoG recording, and further change back to TIVA for MEP monitoring during brain resection. Intraoperative switch of anesthetic agents according to specific intraoperative requirements may be useful for cases of brain surgery requiring both ECoG recordings and MEP monitoring.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Usefulness of bilateral cerebral regional oxygen saturation measurements in determining selective cerebral perfusion flow rate in a pediatric patient with aortic arch stenosis: a case report 双侧大脑区域血氧饱和度测量在确定主动脉弓狭窄儿科患者选择性脑灌注流速中的作用：病例报告

IF 0.9

JA Clinical Reports Pub Date : 2024-09-17 DOI: 10.1186/s40981-024-00742-z

Junichi Saito, Shino Ichikawa, Reiko Kudo, Kurumi Saito, Masayo Kiyokawa, Tetsuya Kushikata

{"title":"Usefulness of bilateral cerebral regional oxygen saturation measurements in determining selective cerebral perfusion flow rate in a pediatric patient with aortic arch stenosis: a case report","authors":"Junichi Saito, Shino Ichikawa, Reiko Kudo, Kurumi Saito, Masayo Kiyokawa, Tetsuya Kushikata","doi":"10.1186/s40981-024-00742-z","DOIUrl":"https://doi.org/10.1186/s40981-024-00742-z","url":null,"abstract":"We report a pediatric case where bilateral regional oxygen saturation (rSO2) measurements were useful in determining the selective cerebral perfusion (SCP) flow rate. A 9-year-old Japanese boy, 128 cm tall and weighing 25.6 kg, was scheduled for aortic arch reconstruction due to a 90–100 mmHg pressure gradient. Pediatric-sized oximetry sensors were attached to the bilateral forehead area. The rSO2 levels were 70–80% on the right and 80–90% on the left during cardiopulmonary bypass. Immediately following deep hypothermic circulatory arrest with the body temperature cooled to 25 °C, SCP was initiated from the right brachiocephalic artery at 10 mL/kg/min. As the rSO2 decreased steeply to 43–45% on the right and to 32–38% on the left, the SCP flow was increased to 15 mL/kg/min. The right rSO2 increased promptly to 50–60%, but the left rSO2 remained at 30–40%. After the SCP flow was increased to 20 mL/kg/min, bilateral rSO2 levels of 50–60% were obtained, and the SCP flow rate was maintained. The patient was transferred to the ICU postoperatively and extubated on the second postoperative day with no neurological abnormalities. Bilateral rSO2 measurements are essential even for a pediatric patient undergoing SCP, despite the limited forehead area.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142250594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anticoagulation management for cardiopulmonary bypass using TEG® 6 s in a patient receiving both heparin and dabigatran. 使用 TEG® 6 s 对同时接受肝素和达比加群治疗的患者进行心肺旁路术的抗凝管理。

IF 0.8

JA Clinical Reports Pub Date : 2024-09-04 DOI: 10.1186/s40981-024-00739-8

Yu Kawada, Nobuyuki Katori, Keiko Kaji, Shoko Fujioka, Tomoki Yamaguchi

{"title":"Anticoagulation management for cardiopulmonary bypass using TEG® 6 s in a patient receiving both heparin and dabigatran.","authors":"Yu Kawada, Nobuyuki Katori, Keiko Kaji, Shoko Fujioka, Tomoki Yamaguchi","doi":"10.1186/s40981-024-00739-8","DOIUrl":"10.1186/s40981-024-00739-8","url":null,"abstract":"Background: It is difficult to evaluate adequate dose of heparin for cardiopulmonary bypass (CPB) by activated clotting time (ACT) in a patient receiving both heparin and dabigatran because dabigatran can also prolong ACT. We evaluated the effect of dabigatran by thromboelastography (TEG) to determine adequate heparin dose for CPB.Case presentation: An 81-year-old woman receiving both heparin and dabigatran was scheduled for an emergency surgical repair of iatrogenic atrial septal perforation. Although ACT was prolonged to 419 s, we performed TEG to distinguish anticoagulation by dabigatran from heparin comparing R in CK and CHK. As the results of TEG indicated residual effect of dabigatran, we reversed dabigatran by idarucizumab and then dosed 200 U/kg of heparin to achieve adequate anticoagulation for CPB by heparin.Conclusions: TEG could help physicians to determine need for idarucizumab and also an adequate dose of heparin to establish appropriate anticoagulation for CPB.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on: "Treatment-resistant hiccups during general anesthesia possibly caused by remimazolam: a case report"-a reply. 评论"可能由瑞咪唑安定引起的全身麻醉期间的治疗抵抗性打嗝：一份病例报告"--回复。

IF 0.8

JA Clinical Reports Pub Date : 2024-09-04 DOI: 10.1186/s40981-024-00738-9

Yusuke Matsui, Tomonori Takazawa

引用次数: 0

Hiccups during general anesthesia with remimazolam. 使用瑞马唑仑进行全身麻醉时打嗝。

IF 0.8

JA Clinical Reports Pub Date : 2024-09-04 DOI: 10.1186/s40981-024-00727-y

Koh Mizutani, Masahiko Tsuchiya

引用次数: 0

Causes, risk factors, and complications of accidental intra-arterial administration of medications in a children's hospital: a case series. 儿童医院意外动脉内给药的原因、风险因素和并发症：病例系列。

IF 0.8

JA Clinical Reports Pub Date : 2024-09-02 DOI: 10.1186/s40981-024-00728-x

Yuki Kunioku, Rie Minoshima, Yutaro Chida, Shinichi Nishibe

{"title":"Causes, risk factors, and complications of accidental intra-arterial administration of medications in a children's hospital: a case series.","authors":"Yuki Kunioku, Rie Minoshima, Yutaro Chida, Shinichi Nishibe","doi":"10.1186/s40981-024-00728-x","DOIUrl":"10.1186/s40981-024-00728-x","url":null,"abstract":"Background: Accidental intra-arterial administration of a medication can lead to serious iatrogenic harm. Most studies have discussed single cases of accidental intra-arterial administration of a medication, but only a few have described multiple cases occurring in a single, pediatric hospital setting.Methods: The subjects were pediatric patients with an accidental intra-arterial administration of a medication. After obtaining approval from the institutional review board, the relevant cases were extracted from incident reports submitted to the patient safety office of the study center between November 2016 and April 2023.Results: A review of 18,204 incident reports yielded 10 cases (patient age: 27 days to 13 years) of accidental intra-arterial administration of a medication. The most common site of the cannulation was the dorsum of the foot followed by the dorsum of the hand. The medications administered were narcotics, sedatives, muscle relaxants, antibiotics, and crystalloids. No serious adverse events occurred after injection. In some cases, the accidental arterial cannulation was not discovered immediately (53 min to 26 days). Seven patients had difficult intravenous access; in two of these, ultrasound-guided peripheral venous cannulation was used.Conclusions: We experienced 10 cases of accidental intra-arterial administration of a medication. The dorsalis pedis artery and the radial artery around the anatomical tobacco socket were common sites of unintentional arterial cannulation. Difficult intravenous (IV) access may be associated with unintentional arterial cannulation. If IV access is difficult or the free IV drip is sluggish, strict vigilance and repeated confirmation are needed to prevent unintentional arterial cannulation.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports. 为接受紧急开腹手术的严重肺动脉高压患者实施神经麻醉：两份病例报告。

IF 0.8

JA Clinical Reports Pub Date : 2024-09-02 DOI: 10.1186/s40981-024-00737-w

Shuhei Yamada, Yoshiaki Takise, Yuri Sekiya, Yuya Masuda, Yoshi Misonoo, Kenta Wakaizumi, Tomohiro Suhara, Hiroshi Morisaki, Jungo Kato, Takashige Yamada

{"title":"Neuraxial anesthesia for patients with severe pulmonary arterial hypertension undergoing urgent open abdominal surgeries: two case reports.","authors":"Shuhei Yamada, Yoshiaki Takise, Yuri Sekiya, Yuya Masuda, Yoshi Misonoo, Kenta Wakaizumi, Tomohiro Suhara, Hiroshi Morisaki, Jungo Kato, Takashige Yamada","doi":"10.1186/s40981-024-00737-w","DOIUrl":"10.1186/s40981-024-00737-w","url":null,"abstract":"Background: There is no consensus regarding the choice of anesthetic method for patients with pulmonary hypertension (PH). We report two cases in which neuraxial anesthesia was safely performed without general anesthesia during open abdominal surgery in patients with severe PH.Case presentation: Case 1: A 59-year-old woman had an atrial septal defect and a huge abdominal tumor with a mean pulmonary arterial pressure (PAP) of 39 mmHg and pulmonary vascular resistance (PVR) of 3.5 Wood units. Case 2: A 23-year-old woman who had hereditary pulmonary artery hypertension (mean PAP, 65 mmHg; PVR, 16.45 Wood units). Both patients underwent open abdominal surgery under neuraxial anesthesia without circulatory collapse with intraoperative administration of vasoconstrictors.Conclusion: Although anesthetic care must be personalized depending on the pathology and severity of PH, neuraxial anesthesia may be an option for patients with severe PH undergoing abdominal surgery.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delayed recovery of consciousness from anesthesia due to exacerbation of hydrocephalus caused by a ventriculoperitoneal shunt malfunction during general anesthesia in the prone position: a case report. 俯卧位全身麻醉期间脑室腹腔分流术故障导致脑积水加重，麻醉后意识恢复延迟：病例报告。

IF 0.8

JA Clinical Reports Pub Date : 2024-08-20 DOI: 10.1186/s40981-024-00736-x

Yosuke Miyamoto, Takashi Kawasaki, Shingo Nakamura, Naoyuki Hirata

{"title":"Delayed recovery of consciousness from anesthesia due to exacerbation of hydrocephalus caused by a ventriculoperitoneal shunt malfunction during general anesthesia in the prone position: a case report.","authors":"Yosuke Miyamoto, Takashi Kawasaki, Shingo Nakamura, Naoyuki Hirata","doi":"10.1186/s40981-024-00736-x","DOIUrl":"10.1186/s40981-024-00736-x","url":null,"abstract":"Background: Dysfunction of ventriculoperitoneal (VP) shunts can lead to decreased levels of consciousness. We report a case of delayed emergence from anesthesia due to the malfunction of a VP shunt during neurosurgery in the prone position.Case presentation: A 75-year-old male with a history of VP shunt for a fourth ventricle obstruction underwent cerebral vascular anastomosis in the prone position. His preoperative level of consciousness was clear. The surgery under general anesthesia was completed without any particular issues. After discontinuation of anesthesia, the patient did not awaken for over an hour. Postoperative CT revealed exacerbated hydrocephalus, likely from VP shunt occlusion. After pumping the reservoir of the VP shunt, the patient regained consciousness. He was extubated and discharged from ICU on the second postoperative day with no neurological issues.Conclusion: For surgical patients with a VP shunt, anesthesia management must consider the risk of shunt malfunction due to patient positioning.","PeriodicalId":14635,"journal":{"name":"JA Clinical Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Right-to-left shunt due to iatrogenic atrial septal defect manifested by aorto-caval fistula: a case report. 因先天性房间隔缺损导致的右向左分流，表现为主动脉腔瘘病例报告。

IF 0.8

JA Clinical Reports Pub Date : 2024-08-15 DOI: 10.1186/s40981-024-00735-y

Takuya Kimura, Takuya Okada, Norihiko Obata, Yasushi Motoyama, Masaharu Nagae

引用次数: 0