Publications by authors named "Isosu T"

Background: The use of pressure-controlled ventilation (PCV) for anesthesia management is becoming more commonly used. Chest drainage is commonly performed after thoracic surgery, and the negative pressure it generates might affect the transpulmonary pressure (TPP). In the present study, we investigated how chest drainage could affect ventilating conditions during PCV.

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  • The case presented involves a 70-year-old man undergoing lower lobectomy with pressure-controlled ventilation (PCV) during one lung ventilation (OLV) to avoid high airway pressure.
  • After placing a chest drainage tube, there was a dramatic drop in tidal volume (TV) from 450 ml to 250 ml, prompting a switch to volume-controlled ventilation to maintain the target TV.
  • The subsequent re-thoracotomy revealed no significant issues, suggesting that the decrease in TV could be attributed to increased negative pressure in the chest cavity affecting lung volume post-surgery.
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Background: The SedLine sensor processes (Masimo Corporation; Irvine, CA, USA) raw electroencephalogram (EEG) signals and displays the depth of sedation as a Patient State Index (PSi). Reliance on standard processed EEG data and failure to recognize age-related effects can lead to an erroneous interpretation that low-amplitude EEG findings in an older patient signify an insufficient depth of anesthesia presented as abnormally high PSi values (AHPSi). We hypothesized that the incidence of AHPSi would decrease with the use of the recently-updated version of the SedLine sensor, in which the Bispectral Index (BIS) values were used to titrate anesthesia.

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The Oxygen Reserve Index (ORi™) is a non-invasive variable that reflects oxygenation continuously. The aims of this study were to examine the relationship between arterial partial pressure of oxygen (PaO) and ORi during general anesthesia, and to investigate the usefulness of ORi as an indicator to avoid hyperoxia. Twenty adult patients who were scheduled for surgery under general anesthesia with arterial catheterization were enrolled.

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To retrospectively investigate the effects of indigo carmine intravenous injection on oxygen reserve index (ORi™) in 20 patients who underwent elective gynecologic surgery under general anesthesia. The study subjects were patients who underwent elective gynecologic surgery under general anesthesia between April 2016 and January 2017, and were administered a 5-ml intravenous injection of 0.4% indigo carmine for clinical purposes during surgery with ORi monitoring.

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The oxygen reserve index (ORi™) is a new parameter for monitoring oxygen reserve noninvasively. The aim of this study was to examine the usefulness of ORi for rapid sequence induction (RSI). Twenty adult patients who were scheduled for surgical procedures under general anesthesia were enrolled.

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  • A 77-year-old man with a severe urinary infection developed life-threatening hemorrhage after Foley catheterization due to prostatic hyperplasia and septic disseminated intravascular coagulation.
  • Despite surgical interventions, complete hemostasis could not be achieved due to fragile tissue around the prostatic urethra.
  • The patient eventually recovered following organized treatments, emphasizing the risks associated with Foley catheter placement in similar medical conditions.
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  • A study evaluated how intravenous indigo carmine affects noninvasive and continuous total hemoglobin (SpHb) measurement in 18 patients undergoing gynecologic surgery.
  • Patients received a 5 mL injection of 0.4% indigo carmine during surgery, and their SpHb levels were measured before and after the injection.
  • The results showed no significant change in SpHb concentrations after the injection, indicating that the Revision L sensor effectively measured hemoglobin levels without interference from indigo carmine.
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  • The study examined how an intravenous injection of indigo carmine affects noninvasive total hemoglobin (SpHb) measurements in 21 patients undergoing gynecologic surgery.
  • Results showed a decrease in SpHb from 10 g/dL to a minimum of 8.3 g/dL, with the lowest level reached 4 minutes after the injection, and recovery to normal levels took about 15 minutes.
  • The decrease was more pronounced in patients with a perfusion index (PI) lower than 1.4, highlighting the need for caution when assessing SpHb following indigo carmine administration.
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We carried out a retrospective investigation on the effect of obesity on dexmedetomidine (DEX) requirements when administered with fentanyl (FEN) during mechanical ventilation after major surgeries. After Institutional Review Board approval, 14 obese patients with a body mass index (BMI) ≥ 30 kg/m(2) and the same number of non-obese patients with similar backgrounds to the obese patients were selected from medical records. Doses of DEX in the first 48 h or until the end of sedation or extubation were calculated for comparison.

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Here we describe a rare case of a pregnant patient with a ruptured aneurysm of the distal anterior choroidal artery(AChA)that was embolized using n-butyl cyanoacrylate(NBCA). The 32-year-old patient was 24 weeks pregnant. She suddenly suffered from headache and vomiting.

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Ultrasound-guided subcostal transversus abdominis plane block (TAPB) is widely used for abdominal surgery; however, arterial plasma concentration of the anesthetic ropivacaine after the blockade is still unclear. We evaluated ropivacaine concentration after subcostal TAPB in adult patients undergoing upper abdominal surgery. Twelve patients with American Society of Anesthesiologists physical status 1-2 were enrolled.

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  • A 59-year-old woman with an ovarian tumor, marked by massive ascites and slight pleural effusion, underwent a scheduled radical hysterectomy under general anesthesia despite experiencing some respiratory issues prior to surgery.
  • During the operation, her oxygenation worsened significantly after ascites was suctioned, leading to increased airway pressure, but it was temporarily managed by raising the fraction of inspired oxygen (FI(O2)).
  • Post-surgery, a chest X-ray revealed bilateral massive pleural effusion, which was drained, resulting in improved oxygenation and allowing for the removal of the endotracheal tube; highlighting the importance of careful anesthetic management and regular assessments in similar patients.
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  • * Using microdialysis, researchers found that midazolam significantly decreased acetylcholine levels and kept them lower even after stopping, while propofol also lowered levels but they rebounded quickly after its infusion stopped.
  • * Dexmedetomidine reduced acetylcholine release, but this effect wasn't significant; overall, midazolam has a longer-lasting impact on acetylcholine levels compared to propofol, despite both causing sedation.
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We evaluated the accuracy of noninvasive and continuous total hemoglobin (SpHb) monitoring with the Radical-7(®) Pulse CO-Oximeter in Japanese surgical patients before and after an in vivo adjustment of the first SpHb value to match the first reference value from a satellite laboratory CO-Oximeter. Twenty patients undergoing surgical procedures with general anesthesia were monitored with Pulse CO-Oximetry for SpHb. Laboratory CO-Oximeter values (tHb) were compared to SpHb at the time of the blood draws.

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Purpose Of The Study: The measurement of stroke volume variation (SVV) using the FloTrac™ system (Edwards Lifescience, USA) is useful to estimate cardiac preload. We evaluated the benefits of SVV monitoring for adjusting fluid supplementation during laparoscopic adrenalectomy under anesthesia in patients with pheochromocytoma.

Subjects And Methods: Among 10 patients who underwent laparoscopic adrenalectomy for pheochromocytoma in our institution from June 2004 to December 2009, SVV was not monitored in 5 patients (group I) and in the other 5 patients (group II), SVV monitoring was performed.

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There is difficulty in airway management during intratracheal operation. We experienced airway obstruction during resection of an intratracheal carcinoid tumor using YAG laser. A 65-year-old woman was diagnosed with an intratracheal carcinoid tumor.

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This article introduces the operating room disaster manual of our hospital. When "The 2011 Off the Pacific Coast of Tohoku Earthquake of magnitude 9" occurred, the 9 operations were being performed in our hospital. Among these, general and regional anesthesia had been induced in 8 cases, and as for one, patient was just leaving the operation room.

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We report the use of ultrasound-guided bilateral brachial plexus block in a patient with bilateral radius fractures. An axillary block was performed on the patient's right and a supraclavicular block on her left using an in-plane (long-axis) needle insertion technique. Into each side was injected 20 ml 0.

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We investigated the differences between males and females in the reversal effect of neostigmine on neuromuscular blockade. Thirty male and 30 female patients undergoing elective general anesthesia were studied. Vecuronium was given in all patients anesthetized with nitrous oxide, oxygen, and sevoflurane.

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