Masui. The Japanese journal of anesthesiology最新文献_第9页

[Two Cases of Tension Pneumothorax during Posterior Spinal Fusion -Diagnosis and Decision on Emergency Drainage-]. [后路脊柱融合术中张力性气胸2例诊断及急诊引流的决定]。

Masui. The Japanese journal of anesthesiology Pub Date : 2017-02-01

Makie Morita, Maria Ikegami, Keiko Tajima, Toru Akune

{"title":"[Two Cases of Tension Pneumothorax during Posterior Spinal Fusion -Diagnosis and Decision on Emergency Drainage-].","authors":"Makie Morita, Maria Ikegami, Keiko Tajima, Toru Akune","doi":"","DOIUrl":"","url":null,"abstract":"We experienced two cases of tension pneumothorax during posterior spinal fusion. Case 1 : A 67-year-old female underwent posterior thoracic-lumbar spinal fusion. One hour after the operation had started, a sudden elevation of airway pressure and decreased Pa02 were observed. Then occasional decrease in blood pressure, tachycardia, and premature ventricular contractions followed. SpO2 re- mained stable throughout the surgery. Case 2 : A 57-year-old female underwent posterior thoracic-lumbar spinal fusion. During the surgical pro- cedure, a sudden decrease in SpO₂ accompanied by an air leak from pleura occurred. No remarkable change was observed in hemodynamics. Immediately after the operation had finished, chest X-ray on supine position revealed tension pneumotho- rax in both cases. Patients were extubated after effec- tive lung expansion by insertion of thoracic drainage tube. Tension pneumothorax is a potentially lethal compli- cation during anesthesia, resulting in cardiac arrest Though rapid diagnosis is crucial, physical examination and assessment are limited in patients on prone posi- tion. The possibility must be considered that several conditions as increased airway pressure, impaired oxy- genation and hemodynamics suggest tension pneumo- thorax. Image diagnosis using radiography or ultra- sound can be of value. If once patient on prone position develops cardiac arrest, resuscitation is extremely difficult Emergency drainage should be considered in case of highly im- paired hemodynamics.","PeriodicalId":18254,"journal":{"name":"Masui. The Japanese journal of anesthesiology","volume":"66 2","pages":"145-148"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36622767","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

[Hemodynamic Management of a Patient at Risk for Stroke Using Regional Cerebral Oxygen Saturation Monitoring and an Arterial Pressure-based Cardiac Output and Stroke Volume Measuring System]. [使用区域脑氧饱和度监测和基于动脉压力的心输出量和卒中容量测量系统对卒中风险患者的血流动力学管理]。

Masui. The Japanese journal of anesthesiology Pub Date : 2017-02-01

Miyuki Takesue, Kenji Kayashima

{"title":"[Hemodynamic Management of a Patient at Risk for Stroke Using Regional Cerebral Oxygen Saturation Monitoring and an Arterial Pressure-based Cardiac Output and Stroke Volume Measuring System].","authors":"Miyuki Takesue, Kenji Kayashima","doi":"","DOIUrl":"","url":null,"abstract":"An 88-year-old man, 155 cm in height and 45 kg in weight, was scheduled for total stomach extirpation. Partial cerebral infarction and cerebral arterial stenosis were diagnosed 20 days before the operation. The patient's mean arterial pressure was 80 mmHg. Regional brain 0₂ saturation (rSO₂) obtained via non- invasive monitoring using the INVOS™ system was above 65% on both sides, and these were used as con- trol values before anesthesia induction. Anesthesia was induced with propofol 50 mg and rocuronium 40 mg intravenously after thoracic epidural catheter placement. Throughout the operation, mean blood pressure was over 70% of the control value. Stroke volume variation (SVV) was tracked during the operation by arterial pressure-based continuous cardiac output monitoring (FloTrac™); SVV values under 13 were maintained using vasopressors and fluid loading. The rS0₂ levels were consistently above control values on both sides. The operation was completed as a gas- tric-bypass surgery and the patient was discharged from the hospital without complications. Using the INVOS™ and FloTraTM systems to maintain mean pressure over 70% of the control value may have prevented a new cerebral ischemic event This potentially useful application of the INVOS™ and FloTrac™ systems should be validated in future stud- ies.","PeriodicalId":18254,"journal":{"name":"Masui. The Japanese journal of anesthesiology","volume":"66 2","pages":"157-159"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36622770","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

[Anesthesia for an Eleven Year Old Girl with Sjögren-Larsson Syndrome]. [一名患有Sjögren-Larsson综合征的11岁女孩的麻醉]。

Masui. The Japanese journal of anesthesiology Pub Date : 2017-02-01

Yasuyoshi Sakurai, Michiko Uchida

引用次数: 0

[Anesthetic Management of the Patient with an Anterior Mediastinal Tumor]. 前纵隔肿瘤患者的麻醉处理。