Articles

A case of chronic hepatitis B merged with acute fatty liver of pregnancy with severe coagulopathy

Acute fatty liver of pregnancy (AFLP) is a life-threatening disorder, and its relevance to viral hepatitis B (HB) remains unknown. This case presents an initial experience of treating a patient with HB progres...

Authors: Risa Fukushima, Kotoe Kamata, Fumiko Ariyoshi, Masashi Yanaki, Minoru Nomura and Makoto Ozaki

Successful perioperative management of living-donor liver transplantation for a patient with severe methylmalonic acidemia: a case report

Methylmalonic acidemia (MMAemia) is a rare hereditary disease affecting organic acid metabolism. It causes recurrent metabolic acidosis and secondary mitochondrial dysfunction, resulting in a poor prognosis. L...

Authors: Akiko Hirotsu, Eriko Kusudo, Natsumi Mori, Yoshimitsu Miyai, Kengo Suzuki, Shuji Kawamoto and Kazuhiko Fukuda

Epidural anesthesia combined with sedation with dexmedetomidine for appendectomy in a patient with amyotrophic lateral sclerosis: a case report

Patients with amyotrophic lateral sclerosis (ALS) present increased risks for anesthesia-related complications. We present a case of epidural anesthesia combined with sedation with dexmedetomidine for open app...

Authors: Mikako Kusakai, Atsushi Sawada, Natsumi Kii, Yasuyuki Tokinaga, Naoyuki Hirata and Michiaki Yamakage

Use of remifentanil in general anesthesia for neonatal non-cardiac surgery: a case series

This case series aimed to summarize our experience in usage of remifentanil in neonates undergoing non-cardiac surgery.

Authors: Trisana Soontrakom, Mineto Kamata and Norifumi Kuratani

Lusutrombopag (Mulpleta®) treatment in a patient with thrombocytopenia complicated by cirrhosis prior to continuous epidural anesthesia during renal artery embolization: a case report

The oral thrombopoietin (TPO) receptor agonist lusutrombopag (Mulpleta®) was developed to improve thrombocytopenia in patients with chronic liver disease prior to elective invasive medical procedures. Mulpleta...

Authors: Tomoko Sasaguri, Naomi Hirakawa and Satoko Uemura

Effectiveness of arginine vasopressin for the management of refractory hemorrhagic shock in a patient with autonomic dysreflexia caused by spinal cord injury

Arginine vasopressin has been used for the management of refractory vasodilatory shock. However, it is still unclear whether arginine vasopressin is useful for hypotension in patients with spinal cord injury.

Authors: Tsukasa Shimauchi, Jun Maki, Jun Yoshino, Naoyuki Fujimura and Sumio Hoka

Anesthetic considerations for cesarean section in a parturient complicated by Scimitar syndrome-like pathophysiology

Pre-existing poor respiratory function is a significant challenge for women to successfully continue pregnancy and accomplish delivery.

Authors: Satoshi Kurokawa, Keiko Hirooka, Mirei Nagai, Makoto Ozaki and Minoru Nomura

Peripheral nerve block combined with general anesthesia for lower extremity amputation in hemodialysis patients: case series

Anesthetic management of lower extremity amputation in chronic hemodialysis (HD) patients can be challenging because of their poor cardiovascular status. As previously reported, peripheral nerve block (PNB) ma...

Authors: Hitomi Takemura, Daisuke Fujita, Megumi Matsuda, Kazuko Fujita, Masahiro Sakaguchi and Fumimasa Amaya

Predicting extubation readiness by monitoring the electrical activity of the diaphragm after prolonged mechanical ventilation: a pediatric case report

The intensity of the electrical activity of the diaphragm (Edi) correlates with inspiratory effort. The ratio of tidal volume to the Edi is known as neuroventilatory efficiency (NVE) and is used as an index fo...

Authors: Yusuke Naito, Yoshiyuki Shimizu, Takeshi Hatachi, Yu Inata, Kazue Moon, Kazuya Tachibana and Muneyuki Takeuchi

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Although various agents are used during anesthesia for surgical resection of pheochromocytoma, application of desflurane has rarely been reported. We report the use of desflurane in a case receiving resection ...

Authors: Yutaka Oda, Takahisa Adachi, Ryushi Komatsu, Motoko Shimada and Yukio Tanaka

A case of combined cranial nerve palsy after general anesthesia

Authors: Chiho Uneda, Toshiyuki Yano and Takashi Imaizumi

The eutectic mixture local anesthetics (EMLA) cream is more effective on venipuncture pain compared with lidocaine tape in the same patients

Although venous cannulation is imperative during perioperative period, it inevitably causes venipuncture pain. Eutectic mixture local anesthetics (EMLA) has been used to reduce this pain, and various studies h...

Authors: Tomomi Matsumoto, Tomohiro Chaki, Naoyuki Hirata and Michiaki Yamakage

Anesthetic management of a patient with congenital insensitivity to pain with anhidrosis by coadministration of remifentanil

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disease characterized by unexplained fever, systemic insensitivity to pain, anhidrosis, and mental distress. Anesthetic man...

Authors: Yoko Takeuchi, Yoshihito Fujita, Takeshi Shimomura, Shuji Kurokawa, Hiroki Noguchi and Yoshihiro Fujiwara

Anesthetic management of a patient with methylmalonic acidemia: a case report

Methylmalonic acidemia (MMA) is a metabolic disorder of organic acids and is characterized by the accumulation of methylmalonic acids.

Authors: Yuta Uemura, Nami Kakuta, Katsuya Tanaka and Yasuo M. Tsutsumi

Dexmedetomidine attenuates the positive chronotropic effects of intravenous atropine in patients with bradycardia during spinal anaesthesia: a retrospective study

Dexmedetomidine is a sedative used during spinal anaesthesia. However, it frequently induces bradycardia. Although intravenous atropine is often used for treating bradycardia during regional anaesthesia, the r...

Authors: Emi Fujii, Sachiko Tanaka-Mizuno, Kazunori Fujino, Masashi Fujii, Masae Furuno, Yasushi Sugimoto, Satoshi Takabuchi and Yutaka Eguchi

Skin burn related to pulse oximetry during photodynamic therapy using talaporfin sodium

Authors: Yuka Ino, Midori Nakashima, Tomonori Morita, Yoko Hori, Hiroaki Kishikawa, Nobutoshi Hagiwara, Takeshi Matsutani, Tsutomu Nomura and Atsuhiro Sakamoto

Delayed re-bleeding after removal of a radial arterial cannula

Authors: Natsumi Hatanaka, Kumiko Tanabe, Mayuko Yamada and Hiroki Iida

The Surgical Apgar Score can help predict postoperative complications in femoral neck fracture patients: a 6-year retrospective cohort study

The postoperative mortality rate following a femoral neck fracture remains high. The Surgical Apgar Score (SAS), based on intraoperative blood loss, the lowest mean arterial pressure, and the lowest heart rate...

Authors: Atsushi Kotera

Factors associated with anesthetic satisfaction after cesarean delivery under neuraxial anesthesia

Evaluating patient satisfaction with anesthesia is critical for improving their experiences. We investigated perioperative anesthetic satisfaction and associated predictive factors in patients receiving cesare...

Authors: Mitsuru Ida, Junko Enomoto, Yumiko Yamamoto, Hiroki Onodera and Masahiko Kawaguchi

Visualization of injectate spread of intercostal nerve block: a cadaveric study

Intercostal nerve block and neurolysis are widely used procedures, but their injectate spread has not been well understood. Previous studies have reported unexpected outcomes (paravertebral or epidural anesthe...

Authors: Yuichi Ohgoshi, Yosuke Usui, Satoshi Terada, Yoshimasa Takeda, Aiji Ohtsuka, Kenjiro Matsuno and Yasuhisa Okuda

Transient oxygen-rich air from air outlets promptly detected by failure of end-tidal control anesthesia

Authors: Takashi Suzuki, Naoki Otsuka, Yuuya Kohzuka, Shin-Ya Kimura and Sayaka Ohara

Transient obturator nerve block with fascia iliaca compartment block following local infiltration for open inguinal herniorrhaphy

Ilioinguinal nerve block is effective for analgesia after open inguinal herniorrhaphy. However, transient femoral nerve palsy can happen after the block. The ambulatory patients sometimes cannot discharge from...

Authors: Takeshi Murouchi

Anesthetic management of a child with Kagami-Ogata syndrome complicated with marked tracheal deviation: a case report

Kagami-Ogata syndrome (KOS) is a rare congenital imprinting disorder. The problems related to the anesthetic management of patients with KOS are respiratory distress and difficult endotracheal intubation.

Authors: Kazuaki Yamagata, Atsushi Kawamura, Satomi Kasai, Mai Akazawa, Michiru Takeda and Kazuya Tachibana

Bacterial contamination upon the opening of injection needles

Two opening methods are used for injection needle products: the “peel-apart method” where the adhesive surface of the packaging mount is peeled off, and the “push-off top method,” where the needle hub is press...

Authors: Shintaro Abe, Isao Haraga, Fumiaki Kiyomi, Hitomi Kumano, Akira Gohara, Shigehiro Matsumoto and Ken Yamaura

Erector spinae plane block for low back pain in failed back surgery syndrome: a case report

Patients with failed back surgery syndrome (FBSS) experience chronic back pain following spinal surgery, and effective treatment is difficult because of multiple contributing factors.

Authors: Hidemasa Takahashi and Takeo Suzuki

Effect of sex and polymorphisms of CYP2B6 and UGT1A9 on the difference between the target-controlled infusion predicted and measured plasma propofol concentration

To examine whether sex and polymorphisms of cytochrome P450 (CYP) 2B6 and UDP-glucuronosyltransferase (UGT) 1A9 affect the difference between predicted and measured plasma propofol concentration during continu...

Authors: Ai Fujita, Kengo Hayamizu, Tatsuya Yoshihara, Masayoshi Zaitsu, Fumie Shiraishi, Hisatomi Arima, Kazumasa Matsuo, Kanako Shiokawa, Hidekazu Setoguchi and Toshiyuki Sasaguri

A case of delirium in Tolosa-Hunt syndrome during corticosteroid therapy

Corticosteroid therapy is useful for the resolution of pain and paresis in Tolosa-Hunt syndrome; however, there is no definitive protocol for appropriate dosing, route of administration, or duration of therapy...

Authors: Rie Ishikawa, Yuhei Ishikawa, Takeshi Kubota and Kumi Shirahama

The effects of intravenous anesthetics on QT interval during anesthetic induction with desflurane

This study aimed to determine the effects of the interaction between intravenous anesthetics and desflurane on the QT interval.

Authors: Shozo Tominaga, Yoshiaki Terao, Shigehiko Urabe, Maki Ono, Natsuko Oji, Makito Oji, Makoto Fukusaki and Tetsuya Hara

Efficacy and safety of sugammadex in patients undergoing renal transplantation

Sugammadex reverses rocuronium by encapsulating it, creating a stable complex that is mainly excreted by the kidneys. Nonetheless, in view of exposure to sugammadex during renal transplantation, current safety...

Authors: Yasumasa Ono, Yoshihito Fujita, Takahiro Kajiura, Hazuki Okawa, Juntaro Nakashima, Hideo Isobe and Yoshihiro Fujiwara

Implantation of ventricular assist device for systemic right ventricular failure in a patient with transposition of the great arteries and post-Mustard procedure: a case report

Ventricular assist device (VAD) is usually attached by an inflow cannula to the apex of the systemic left ventricle (LV), but very few cases with implantation of the VAD in the morphologic right ventricle (RV)...

Authors: Kazutomo Saito, Hiroaki Toyama, Nozomu Abe, Azusa Sunouchi, Yutaka Ejima and Masanori Yamauchi

Ventricular tachycardia without preceding electrocardiogram change after hypertonic mannitol administration: a case report

Mannitol is widely used during neurosurgery, but it has a serious complication including lethal arrhythmia due to mannitol-induced hyperkalemia.

Authors: Akira Gohara, Sumi Okamatsu-Kifuji, Shinjiro Shono, Midoriko Higashi and Ken Yamaura

Acute arterial occlusion due to left ventricular thrombus of Takotsubo cardiomyopathy in a young adult: a case report

Thromboembolism is a rare complication of Takotsubo cardiomyopathy. Importantly, an acute arterial occlusion needs rapid diagnosis and urgent treatment to help save the patient’s life. Here, we report a case o...

Authors: Yuudai Horiguchi, Takuo Hoshi, Aya Yoshimatsu and Mika Yoshida

Conservative management for iatrogenic gastric perforation by transesophageal echocardiography

Though several cases of upper gastrointestinal tract injury caused by transesophageal echocardiography (TEE) have been reported, gastric perforation is very rare. Herein, we report the case of TEE-associated g...

Authors: Masaya Oshiro, Hirotsugu Kanda, Akane Oshiro, Kenta Kure, Megumi Kanao-Kanda, Hiroyuki Kamiya and Takayuki Kunisawa

Ventilation failure after lateral jackknife positioning for robot-assisted lung cancer surgery in a patient after lingula-sparing left upper lobectomy

Ventilation failure commonly occurs when a standard left-sided double-lumen tube is used in patients after left upper lobectomy having remarkable angulation of the left main bronchus. We present a female witho...

Authors: Izumi Kawagoe, Masakazu Hayashida, Daizoh Satoh, Kenji Suzuki and Eiichi Inada

Successful perioperative management of a patient with erythropoietin-producing uterine myoma

Erythropoietin-producing uterine myoma can cause various complications such as arterial or venous thrombosis and bleeding. Therefore, caution is required in the anesthetic management of affected patients.

Authors: Masato Kobayashi, Masahiko Akatsu, Yoshihisa Fujita and Koichi Nishikawa

Sugammadex and amino acid infusion can contribute to safe anesthetic management of variegate porphyria

Variegate porphyria (VP) is an inherited type of porphyria characterized by cutaneous manifestations and/or acute neurovisceral attacks. We report successful anesthetic management of VP.

Authors: Yoshitaka Aoki, Kazuyuki Atsumi, Makiko Kora, Naoko Koh and Junichiro Yokoyama

Successful use of regional anesthesia in non-intubated video-assisted thoracic surgery in patients with cardiopulmonary failure: two case reports

One-lung ventilation under general anesthesia is necessary for thoracic surgery, but this procedure is often difficult in surgery for patients with cardiopulmonary failure. Non-intubated video-assisted thoraci...

Authors: Satoru Kayama, Haruna Yamamoto and Shigehito Sawamura

A case of spinal myoclonus in a patient with elective cesarean section

Transient myoclonic involuntary movements, typically referred to as spinal myoclonus (SM), rarely develop in the extremities following neuraxial anesthesia (NA). NA indications in patients with history of SM f...

Authors: Tohru Shiratori, Kunihisa Hotta, Masaaki Satoh, Naoko Kondo, Junji Ikeda and Shinji Sasao

Risk factors for bradypnea in a historical cohort of surgical patients receiving fentanyl-based intravenous analgesia

The use of both pulse oximetry (SpO₂) and respiration rate (RR) monitoring is recommended to prevent the development of respiratory deterioration, particularly after extubation and narcotic analgesic use for pain...

Authors: Takashi Shiota, Hideaki Kawanishi, Satoki Inoue, Junji Egawa and Masahiko Kawaguchi

Respiratory failure caused by impending tension pneumothorax after extrapleural pneumonectomy: a case report

Cardiac herniation is a serious postoperative complication of extrapleural pneumonectomy (EPP) and is reportedly preventable by reducing the suction pressure of the chest drain.

Authors: Sonoko Sakuraba, Takeshi Omae, Izumi Kawagoe, Keito Koh and Eiichi Inada

Unusually large ephedrine-induced blood pressure increases due to cardiac sympathetic denervation supersensitivity in a patient with Parkinson’s disease

Parkinson’s disease (PD) patients often suffer from cardiac sympathetic denervation, a hallmark of which is orthostatic hypotension. Denervation supersensitivity to sympathomimetic drugs is also seen in such p...

Authors: Toru Shirai, Atsuhiro Kitaura, Keiji Uehara, Tomohisa Uchida, Masaki Fuyuta, Tatushige Iwamoto, Kenji Hiramatsu and Shinichi Nakao

Airway obstruction due to a laryngeal polyp following insertion of a laryngeal mask airway

Laryngeal mask airway (LMA) insertion contributes to airway protection in patients with a laryngeal tumor around the glottis. There has been no report of LMA insertion itself exacerbating airway obstruction in...

Authors: Satoshi Fuseya, Takashi Ichino, Satoshi Tanaka, Kumiko Ishida, Takashi Ishida and Mikito Kawamata

A case report of seizure during emergence from general anesthesia after lumbar spinal surgery—common cases can develop potentially life-threatening adverse intracranial events

Adverse intracranial events after spinal surgery were related with intracranial hypotension due to surgical injury of dura mater.

Authors: Junko Matsuhiro, Rumi Kariyazono, Koh Mizutani, Akinori Hinotsume and Masahiko Tsuchiya

Unsuccessful tracheal intubation in a patient with Kniest dysplasia undergoing repeated general anesthesia: a case report

Kniest dysplasia is a type of chondrodysplasia characterized by severe craniofacial abnormalities including tracheomalacia, midface hypoplasia, and cleft palate.

Authors: Maiko Hasegawa-Moriyama, Tomonori Iwasaki, Keika Mukaihara, Mina Masuda and Yuichi Kanmura

A case of failed awake craniotomy due to progressive intraoperative hyponatremia

Perioperative seizure control is correlated with a better surgical outcome for awake craniotomy, but some anticonvulsants can induce hyponatremia. Mannitol has also been reported to be hyponatremic.

Authors: Suguru Yamamoto, Hanayo Masaki, Kotoe Kamata, Minoru Nomura and Makoto Ozaki

Iatrogenic tension pneumothorax developed during ventriculo-peritoneal shunt surgery and detected shortly before extubation

Authors: Yoshiyasu Hattammaru, Tomasz Hascilowicz, Isao Utsumi, Yuichi Murakami and Oumi Sachiko

Successful anesthetic management during abdominal wall-lifting laparoscopic cholecystectomy in a patient with hereditary angioedema

Hereditary angioedema is a rare genetic disorder resulting from an inherited deficiency or dysfunction of the C1-esterase inhibitor. In the anesthetic management of such patients, special caution should be exe...

Authors: Masashi Fujii, Takayuki Higashiguchi, Nobuaki Shime and Yasuyo Kawabata

Anesthetic management with subcostal transversus abdominis plane block in recessive dystrophic epidermolysis bullosa for peritoneal dialysis catheter replacement: a case report

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare, hereditary mucocutaneous disorder that can involve renal insufficiency. If a vascular access for hemodialysis is unavailable, peritoneal dialysis ca...

Authors: Katsuhiro Aikawa, Nobuhiro Tanaka and Yuji Morimoto

In-hospital mortality does not increase in patients aged over 85 years after hip fracture surgery. A retrospective observational study in a Japanese tertiary hospital

Hip fracture is a common and serious orthopedic injury among the geriatric population, necessitating surgical treatment. We tested whether age is a significant risk factor for in-hospital mortality after surge...

Authors: Yoshihisa Fujita, Kumi Shimada, Tomohiko Sato, Masahiko Akatsu, Koichi Nishikawa, Atsuko Kanno and Toshitake Aizawa

Intraoperative hemodynamics monitoring in a patient with pheochromocytoma multisystem crisis: a case report

Pheochromocytoma is a rare catecholamine-secreting tumor. To evaluate the intraoperative hemodynamics with precision is difficult.

Authors: Atsuko Kato, Hisayoshi Tamai, Kanji Uchida, Takamitsu Ikeda and Yoshitsugu Yamada