Chronic subdural hematoma (CSDH) after spinal anesthesia is a rare complication. We experienced a patient who developed CSDH after postdural puncture headache (PDPH) following combined spinal and epidural anes...
Authors: Yuri Iwase, Manzo Suzuki and Hiroyasu Bito
Subglottic stenosis can lead to life-threatening difficult tracheal intubation during general anesthesia. We report a case of difficult tracheal intubation in an 11-month-old female who had unrecognized subglo...
Authors: Natsuko Ohsima, Fumimasa Amaya, Shunsuke Yamakita, Yoshinobu Nakayama, Hideya Kato, Yumi Muranishi, Toshiaki Numajiri and Teiji Sawa
A scalp block or wound infiltration of local anesthetic is thought to effectively control post-craniotomy pain. However, it can result in local anesthetic toxicity (LAST), which is difficult to distinguish fro...
Authors: Rintaro Hoshino, Yoshinori Kamiya, Yuka Fujii and Tsunehisa Tsubokawa
Glycosylation is one of the major posttranslational modifications of proteins and it is essential for proteins to obtain normal biological functions. Congenital disorders of glycosylation (CDGs) are very rare ...
Authors: Wataru Sakai, Yusuke Yoshikawa, Yasuyuki Tokinaga and Michiaki Yamakage
We describe a patient with biventricular assist devices who had systemic inflammation because of cholecystitis that required open cholecystectomy, and we discuss the anesthetics and monitors that should be use...
Authors: Kenta Okitsu, Takeshi Iritakenishi, Chiyo Ootaki and Yuji Fujino
A pulse oximeter is one of the most important monitors to save patients undergoing anesthesia and monitored sedation. The authors report a case of orthopedic surgery, in which interference of pulse oximetry oc...
Authors: Junichi Saito, Masato Kitayama, Ryutaro Kato and Kazuyoshi Hirota
Patient satisfaction with postoperative pain management is an important quality indicator in patient health care, but its determinants are poorly understood. Here, we examined the contribution of the discrepan...
Authors: Marie Shigematsu-Locatelli, Takashi Kawano, Sonoe Kitamura, Atsushi Nishigaki, Daiki Yamanaka, Bun Aoyama, Hiroki Tateiwa and Masataka Yokoyama
Paravertebral catheters are generally inserted and removed without complications. However, catheter breakage occurs rarely. This is the first report describing breakage of a thoracic paravertebral catheter and...
Authors: Tasuku Fujii, Yasuyuki Shibata and Kimitoshi Nishiwaki
A 36-year-old parturient with a suspicion of placenta accreta under tocolytic therapy with ritodrine infusion underwent emergency cesarean section under general anesthesia with propofol, ketamine, and remifent...
Authors: Daiki Takekawa, Kei Jinushi, Masato Kitayama and Kazuyoshi Hirota
Epidural blood patch (EBP) is a recognized treatment for spontaneous cerebrospinal fluid leak (SCFL) and is typically administered by the interlaminar approach. Here, we report a case of a patient in whom SCFL...
Authors: Aki Fujiwara, Keisuke Watanabe, Keiji Hashizume, Kozue Shinohara, Michiko Fukumoto, Katsuhiro Kimoto and Masahiko Kawaguchi
Although data from several studies support the use of arginine vasopressin (AVP) for the treatment of hypotension concomitant with pulmonary hypertension (PH) in the cardiac surgery setting, to our knowledge, ...
In 1976, Gonzales-Crussi et al. (Am. J. Dis. Child. 130:1015–18, 1976) introduced the first case of bridging bronchus as a rare bronchial branching anomaly; since then, only 14 worldwide cases was described. W...
Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients’ quality of life and frequently refract...
Authors: Daiki Yamanaka, Takashi Kawano, Marie Shigematsu-Locatelli, Atsushi Nishigaki, Sonoe Kitamura, Bun Aoyama, Hiroki Tateiwa, Noriko Kitaoka and Masataka Yokoyama
Tracheal stent is a good way to maintain a patent airway in case of stenosis. Although anesthesia techniques for the placement of a stent in the trachea of patients with tracheal stenosis have been reported, t...
Authors: Yoko Hori, Hiroaki Kishikawa and Atsuhiro Sakamoto
Giant cell myocarditis, characterized by infiltration of multinucleated giant cells in the myocardium, is a rare type of myocarditis. It often progresses rapidly into fulminant heart failure and indicates a po...
Authors: Yusuke Takei, Yutaka Ejima, Hiroaki Toyama, Kana Takei, Takahisa Ota and Masanori Yamauchi
Surgery cancellation results in unavailability of the operating room and loss time. We identified the frequency of and reasons for operation cancellations after patients entered the operating room and assessed...
Authors: Yoko Hori, Ayami Nakayama and Atsuhiro Sakamoto
It has been reported that prolonged intensive care unit (ICU) stay after cardiac surgery is associated with poor patient outcome. In addition, prolonged stay can block the efficient use of ICU beds with an inc...
Posterior reversible encephalopathy syndrome is characterized by reversible neurological symptoms with leukoencephalopathy detectable by computed tomography (CT) and magnetic resonance (MR) imaging.
The occurrence of spinal epidural hematomas associated with the use of epidural catheters is relatively rare. Furthermore, it is unusual for hematoma-associated neurological symptoms to occur within 15 min of ...
Schwartz–Jampel syndrome (SJS) is a rare disorder characterized by micrognathia, kyphoscoliosis, and myotonia. The greatest challenge in the anesthetic management of patients with SJS is performing tracheal in...
A 66-year-old man with thrombocytosis was brought to our hospital to undergo removal of a left ventricular thrombus. He had developed cerebral infarction 6 days before presenting to the hospital and suffered f...
Authors: Mika Nakanishi, Eri Oota, Takehiro Soeda, Kaoru Masumo, Yukihiko Tomita, Takeshi Kato and Toshihiro Imanishi
Cervical nerves block cannot be performed on some patients because of the risk of phrenic nerve paralysis. To overcome this limitation, we discovered the site of selective only supraclavicular nerve block at t...
A solitary iliac aneurysm (SIA) is more uncommon than an abdominal aortic aneurysm. The aneurysm is located in the deep pelvis and is diagnosed when it reaches a large size with symptoms of compression around ...
Authors: Shintaro Doi, Yoshiaki Motoyama and Hiromi Ito
In spinal anesthesia for cesarean section, the addition of fentanyl to the local anesthetic has been reported to improve perioperative analgesia. However, there is only limited knowledge on sedative effects of...
Therapeutic plasma exchange (TPE) is a potentially life-saving procedure which effectively removes donor-specific human leukocyte antigen (HLA) antibodies from the bloodstream, allowing critically ill heart tr...
Authors: Andrew Crabbe, John S. McNeil, Seema P. Deshpande, Zachary Kon, Si M. Pham and Kenichi A. Tanaka
Congenital factor VII (FVII) deficiency is a rare autosomal recessive coagulation disorder that is characterized by prolongation of prothrombin time. Recombinant activated FVII (rFVIIa) is widely used in the m...
Here, we report the case of a patient who developed protamine shock during a transcatheter aortic valve implant (TAVI) procedure, which was diagnosed by intraoperative transesophageal echocardiography (TEE). A...
Authors: Akihisa Kataoka, Yusuke Watanabe, Shutaro Seki, Shintaro Takamura, Hirofumi Hioki, Hiroyuki Kyono, Shigehito Sawamura and Ken Kozuma
Recently, rocuronium with subsequent use of sugammadex was proposed for electroconvulsive therapy (ECT) as an alternative to succinylcholine. Because sugammadex is cleared via the kidney with no metabolism, it...
Authors: Shigeaki Kurita, Katsuyuki Moriwaki, Kazuhisa Shiroyama, Mikako Sanuki, Yukari Toyota and Minoru Takebayashi
Very few studies have investigated the blood flow velocity from the inferior vena cava (IVC) to the pulmonary artery following the Fontan operation using an extra-cardiac conduit (ECC). No studies at all have ...
Infectious endocarditis (IE) with acute heart failure is a medical emergency. In particular, postoperative IE after aortic repair with an artificial vascular graft is a life-threatening matter. We present a ca...
Authors: Toshiyuki Sawai, Junko Nakahira, Manabu Kitano and Toshiaki Minami
Maternal uniparental disomy 14 (UPD(14)mat) is an imprinting disorder. It is a rare disease, but there is the possibility that more undiagnosed patients might exist because the clinical features of UPD(14)mat ...
Authors: Kenta Furutani, Yoshie Kodera, Masataka Hiruma, Hideaki Ishii and Hiroshi Baba
The anesthetic management of centenarians is challenging, since they have loss of functional reserve in all organs. The mortality rate of 25 % is reported in patients over 100 years old who underwent emergency...
Authors: Yoshiyuki Nagamine, Kohei Godai, Hiroshi Oki and Yuichi Kanmura
Mitral valve stenosis (MS) associated with rheumatic disease no longer represents a major heart problem during the perinatal period in Japan. Here we present a case of acute heart failure due to MS after emerg...
In 2005, “anti-N-methyl-d-aspartate (NMDA) receptor encephalitis,” a syndrome with prominent psychiatric symptoms, memory loss, decrease in level of consciousness, and central hypoventilation, was described in yo...
Although brain arteriovenous malformations (AVM) usually remain asymptomatic during pregnancy, they can cause intracranial hemorrhage and lead to serious neurological deficits. Nowadays, it is accepted that tr...
The pin-index medical gas pipeline system, which complies with Japan Industrial Standard (JIS), is considered to be “foolproof” and is widely used in Japan to avoid medical gas misconnections.
Authors: Tatsuhiro Ishimura, Yoshihiro Ikuta and Tatsuo Yamamoto
Ultiva™ contains the potent short-acting μ-opioid receptor agonist remifentanil hydrochloride, and it is commonly administered intravenously during general anesthesia. It is not approved for epidural or intrat...
Authors: Kota Nishimoto, Sachiyo Sakamoto, Makiko Mikami, Kiichi Hirota and Koh Shingu
This report describes a case of transient cardiac arrest in a child with Down syndrome. The cardiac arrest occurred during induction of anesthesia with sevoflurane. To the best of our knowledge, this is the fi...
Authors: Kentaro Nogami, Shogo Taniguchi and Kyoko Togami
Factor XI deficiency is rare but may cause life-threatening bleeding during the perioperative period. The clinical manifestation of factor XI deficiency is characterized by bleeding tendency. This unpredictabl...
Authors: Sachio Yoshikawa, Isao Kumano, Yasushi Satoh and Shinya Yufune
A 71-year-old woman was transported to our hospital due to traumatic bleeding, and an operation was immediately performed for achieving hemostasis. We decided to perform Sonoclot®-guided blood transfusion. Whe...
Authors: Mitsutaka Edanaga, Tomoe Hoshi, Ryu Azumaguchi and Michiaki Yamakage
General theory of anesthetic managements for nontransplant procedures in lung transplant patients was proposed. However, there are few literatures reporting the perioperative management of thoracoabdominal maj...
We report a case of difficult lumbar puncture due to the inability to obtain adequate cerebrospinal fluid (CSF) in a patient later diagnosed with spinal epidural lipomatosis (SEL). A 76-year-old man with a bod...
Authors: Daiki Yamanaka, Takashi Kawano, Marie Shigematsu-Locatelli, Atsushi Nishigaki, Sonoe Kitamura, Bun Aoyama, Hiroki Tateiwa, Noriko Kitaoka and Masataka Yokoyama
Despite several previous reports, there are no established procedures for intraoperative management in moyamoya disease patients requiring cardiac surgery.
Authors: Kazutomo Saito, Hiroaki Toyama, Yutaka Ejima and Masanori Yamauchi
A 48-year-old man who complained of a severe throbbing pain in his right lateral chest was referred to our department. His chest computed tomography (CT) and X-ray, abdominal CT and ultrasonography had reveale...
Barber-Say syndrome (BSS) is a very rare congenital disorder characterized by macrostomia, cutis laxa, and other features. We report our experience of performing general anesthesia on a Japanese child with BSS.
Authors: Eisuke Hamaguchi, Yasuo M. Tsutsumi, Katsuyoshi Kume, Yoko Sakai, Nami Kakuta, Yuta Uemura, Shinji Kawahito and Katsuya Tanaka
Unanticipated difficult airway is a challenging problem for anesthesiologists. Oropharyngeal stenosis (OPS) is a rare complication of upper airway surgery which may cause difficult airway. We present a patient...
Authors: Mina Nishimori, Miyako Matsumoto, Hideki Nakagawa and Noriko Ichiishi
This study investigated plasma concentrations of substance P (SP) in patients undergoing general anesthesia (GA) and postoperative nausea and vomiting (PONV). This prospective, observational, cohort study incl...
Authors: Takako Kadota, Nami Kakuta, Yousuke T. Horikawa, Rie Tsutsumi, Takuro Oyama, Katsuya Tanaka and Yasuo M. Tsutsumi
Malignant hyperthermia (MH) occurred during anesthesia with volatile inhalation anesthetics in a patient under treatment with multiple oral antipsychotic drugs and with a history of multi-acting receptor-targe...
Authors: Yoshiki Hara, Yutaka Hosoya, Ryo Deguchi and Shigehito Sawamura
No successful resuscitation has ever been reported about intraoperative cardiopulmonary resuscitation (CPR) for an extended period of time in the lateral position. Here we report a case of successful resuscita...
Rapid sequence spinal anesthesia is a recently developed technique for the most urgent, category-1 cesarean section. To successfully perform this technique, it is important to multi-disciplinarily discuss with...
Authors: Kotaro Hori, Yutaka Oda, Masayoshi Ryokai and Ryu Okutani
