Monitored anesthesia care based on ultrasound-guided subcostal transversus abdominis plane block for continuous ambulatory peritoneal dialysis catheter surgery: case series.

Planning safe perioperative management for patients undergoing continuous ambulatory peritoneal dialysis (CAPD) catheter surgery (insertion and extraction of the catheter) is often difficult because many of these patients not only have renal insufficiency but also have co-existing disorders, such as heart diseases. As increased indications for perioperative anticoagulation therapy have limited the choice of anesthesia, selecting an appropriate anesthetic method, particularly for patients with poor systemic conditions, is becoming more challenging. We report seven cases of CAPD catheter surgery successfully managed by monitored anesthesia care using subcostal transversus abdominis plane (TAP) block with additional local anesthetic infiltration and analgesics.

A prospective, randomized comparison between single- and multiple-injection techniques for ultrasound-guided subgluteal sciatic nerve block.

Background: It is believed that local anesthetic injected to obtain circumferential spread around nerves produces a more rapid onset and successful blockade after some ultrasound-guided peripheral nerve blocks. However, evidence demonstrating this point is limited only to the popliteal sciatic nerve block, which is relatively easy to perform by via a high-frequency linear transducer. In the present study, we tested the hypothesis that multiple injections of local anesthetic to make circumferential spread would improve the rate of sensory and motor blocks compared with a single-injection technique for ultrasound-guided subgluteal sciatic nerve block, which is considered a relatively difficult block conducted with a low-frequency, curved-array transducer.

[The importance of preanesthetic evaluation: malignant tumors discovered on preoperative chest radiography, in patients scheduled for operation of benign tumors].

Preanesthetic evaluation is essential for the perioperative period. We report 2 preoperative patients with benign disease, whose preoperative chest radiography revealed intrathoracic malignant tumors. Case 1: A woman in her eighties with vascular necrosis of the femoral head was scheduled for bipolar hip arthroplasty under general anesthesia.

[Detectors of fluid absorption during transurethral resection of prostate using saline as irrigant solution].

Background: Although transurethral resection of prostate (TURP) using saline as irrigant solution (TURis) is reported to reduce intraoperative hyponatremia, careful management during operation is needed to avoid complications caused by possible massive absorption of irrigant solution.

Methods: To find out the detectors of fluid absorption during TURP using TURis system, intraoperative data of hemodynamics and serum electrolytes in 11 patients who had TURP using TURis system were retrospectively collected and statistically analyzed.

Results: During TURP using TURis system, serum chloride (s-Cl) significantly increased (before/60 min after beginning of operation: 99.

Prolonged cardiac arrest unveiled silent sick sinus syndrome during general and epidural anesthesia.

Patients who have silent sick sinus syndrome (SSS) can show various unexpected arrhythmias during surgery. The severity of these bradyarrythmias is affected by anesthetic methods. We report a unique case of a patient with silent SSS who developed 40 s of asystole under combined general and epidural anesthesia.

[Two cases of TURP syndrome with severe cardiovascular depression].

We report two cases of TURP (transurethral resection of prostate) syndrome showing severe cardiovascular depression without any neurological disturbances. One patient developed hypotension (62/42 mmHg) and ST segment depression (-2.7 mm) on ECG during TURP.