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
Neutrophils are the first line of defense against invasive microorganisms during and after surgery. There is a possibility that different opioid analgesics used during surgery have different effects on the leu...
Spinal anesthesia is popular for endoscopic urological surgery. Many patients undergoing urological surgery are elderly. It is important to limit the dose to reduce any resultant hemodynamic effect. We present...
Authors: Yoshimichi Namba, Michiaki Yamakage and Yoshinori Tanaka
Epicardial pacemaker wire insertion is standard following cardiothoracic surgery. However, undersensing of pacing wires may cause the R-on-T phenomenon, which induces ventricular fibrillation. We report a case...
Authors: Yuki Nakamori, Takuma Maeda and Yoshihiko Ohnishi
We report a case of unexpectedly difficult intubation in a patient with a huge but asymptomatic choanal polyp. A 77-year-old man with invasive bladder cancer was scheduled for total cystectomy under general an...
Authors: Yoko Hori, Kana Taniguchi, Tadashi Okabe and Atsuhiro Sakamoto
Regional cerebral oxygen saturation (rSO2) and the bispectral index (BIS) are used to detect cerebral perfusion abnormalities. However, whether rSO2 and BIS values change during ligation of the internal jugular v...
Ossification of the anterior longitudinal ligament (OALL), also called Forestier’s disease or diffuse idiopathic skeletal hyperostosis, is characterized by anterior bridging osteophytes of unknown etiology. OA...
Authors: Miki Iida, Kumiko Tanabe, Shuji Dohi and Hiroki Iida
We encountered cardiac arrest induced by 0.375 % ropivacaine 7 ml administered via a catheter for continuous thoracic paravertebral block (TPVB) in a 6-year-old female who underwent pacemaker implantation for ...
The patient was a 67-year-old woman with a history of worsening dyspnea over several months. Cardiac echocardiography showed a large, mobile left atrial myxoma. Emergency surgery was performed. Cardiac arrest ...
Authors: Takuma Maeda, Ryo Sakurai and Yoshihiko Ohnishi
A 32-year-old gravida 2, para 1 woman without structural cardiac disease was scheduled for her second cesarean section under combined spinal and epidural anesthesia (CSEA). She had stable hemodynamics after de...
Authors: Mika Nakanishi, Kaoru Masumo, Takako Oota, Takeshi Kato and Toshihiro Imanishi
We report a patient who developed drug-eluting stent (DES) thrombosis induced by discontinuation of dual antiplatelet therapy (DAPT) and subsequently had a massive surgical site bleed caused by restarting hepa...
Left ventricular assist devices (LVAD) are a currently established destination and bridge therapy until cardiac transplantation; hence, this patient population continues to increase. Here, we present the first...
Authors: Koko Adachi, Toshihiro Wagatsuma, Takuya Shiga, Hiroaki Toyama and Masanori Yamauchi
A 2-year-and-7-month-old boy underwent an emergent reconstruction surgery of the right ventricle-pulmonary artery (RV-PA) conduit. Although he was successfully weaned from cardiopulmonary bypass (CPB) after re...
Authors: Mariko Ishihara, Yoshikazu Miyamoto, Akihiro Taniguchi and Keiko Kinouchi
We report a patient who developed sustained hypotension during craniotomy; further, owing to a mediastinal mass, critical tracheal stenosis and brain edema were observed after craniotomy, despite the absence o...
Authors: Shota Sonobe, Satoki Inoue, Kazuaki Atagi and Masahiko Kawaguchi
Thoracic paravertebral block (TPVB) is used to reduce pain after breast cancer surgery (BCS), but the pain-reduction effects more than 1 year after surgery are unclear.
Authors: Hiroki Shimizu, Yoshinori Kamiya, Hironobu Nishimaki, Sadahei Denda and Hiroshi Baba
We retrospectively reviewed the anesthesia records of infants < 1 year of age for elucidating the incidence of difficult intubation and airway management in a single general hospital. The electronic data recor...
A 12-year-old girl receiving chemotherapy for acute myeloid leukemia had a fever of unknown origin in spite of administration of micafungin. Her respiratory condition suddenly deteriorated. Her trachea was int...
Authors: Hideki Matsuura, Satoki Inoue, Kazuaki Atagi and Masahiko Kawaguchi
We report three cases of airway management with elective surgical cricothyroidotomy (SCT) for anesthetic management during surgical repair of maxillofacial injury involving basal skull fracture or nasal-bone f...
Acute postoperative pain is an integral risk factor in the development of chronic pain after breast cancer surgery (BCS). Pectoral nerve block (PECSB) has been recently reported as an analgesic method for BCS....
Authors: Harue Morioka, Yoshinori Kamiya, Takayuki Yoshida and Hiroshi Baba
Miller–Dieker syndrome (MDS) is a rare disorder characterized by type I lissencephaly and a distinctive facial appearance that may include prominent forehead, bitemporal hollowing, and micrognathia. MDS is ass...
Authors: Chiaki Wakiguchi, Kohei Godai, Keika Mukaihara, Tetsuya Ohnou, Tamotsu Kuniyoshi, Mina Masuda and Yuichi Kanmura
Supraclavicular brachial plexus block is a common anesthetic technique performed for surgery of the upper extremities. We experienced a case of acute hypercapnic respiratory distress with loss of consciousness...
Authors: Yuka Sakuta, Naoko Kuroda, Masatsugu Tsuge and Yoshihisa Fujita
Accelerated idioventricular rhythm (AIVR) during anesthesia has been described in several drug toxicity such as from cocaine, halothane, desflurane, and propofol. We present the case of a man who developed epi...
Authors: Mika Nakanishi, Kaoru Masumo, Takako Oota, Takeshi Kato and Toshihiro Imanishi
