Unusual severe hypoxemia due to unilateral pulmonary edema after conventional cardiopulmonary bypass salvaged by veno-venous extracorporeal membrane oxygenation: a case report.

Background: We report a case in which veno-venous extracorporeal membrane oxygenation (V-V ECMO) saved the life of a patient who developed severe hypoxemia due to unusual unilateral pulmonary edema (UPE) after cardiopulmonary bypass (CPB).

Case Presentation: A 69-year-old man underwent aortic valve replacement and coronary artery bypass grafting. Following uneventful weaning off CPB, he developed severe hypoxemia.

Neuropathies Following an Ultrasound-Guided Axillary Brachial Plexus Block.

Purpose: Ultrasound-guided brachial plexus block (UGBPB) has interscalene, supraclavicular, infraclavicular, and axillary approaches. The axillary block is considered to be the safest and with fewer adverse events compared to the interscalene (eg, phrenic nerve block, spinal cord or vertebral artery puncture) and supraclavicular (eg, pneumothorax). However, with regard to postoperative neurological symptoms (PONS), it is controversial whether its incidence after an axillary block was higher than that after non-axillary approaches".

Lateral Femoral Cutaneous Nerve Block for Postoperative Pain Control After Total Hip Arthroplasty Using the Direct Anterior Approach: A Single-blinded Randomized Control Trial.

Background: Total hip arthroplasty (THA) employing the direct anterior approach (DAA) is increasingly performed as a less invasive procedure with faster recovery than other approaches. Unlike other approaches, the skin incision is made on the lateral thigh, distal to the inguinal ligament. However, the effectiveness of ultrasound-guided lateral femoral cutaneous nerve (LFCN) block for postoperative analgesia after THA using DAA has not been investigated.

Postoperative Heart Failure with Preserved Ejection Fraction Induced by Flumazenil Administered for Remimazolam Antagonism.

Remimazolam is an ultrashort-acting benzodiazepine intravenous anesthetic characterized by rapid awakening after anesthesia. However, the method for administering remimazolam in clinical practice remains unclear. Here, we report a case of postoperative heart failure with preserved ejection fraction (HFpEF) after antagonizing remimazolam with flumazenil.

Fixation of intracapsular fracture of the femoral neck using combined peripheral nerve blocks and transthoracic echocardiography in a patient with severe obstructive hypertrophic cardiomyopathy: a case report.

Background: Hypertrophic obstructive cardiomyopathy (HOCM) is a type of hypertrophic cardiomyopathy associated with left ventricular outflow tract stenosis. The increased pressure gradients across the left ventricular outflow tract in patients with HOCM could lead to circulatory collapse. We describe our experience with perioperative management under femoral nerve block (FNB), lateral femoral cutaneous nerve block (LFCNB), and transthoracic echocardiography (TTE) monitoring during open reduction and internal fixation of a femoral neck fracture in a patient with severe HOCM.

Perioperative management of patients with atrial fibrillation receiving anticoagulant therapy.

The number of patients with atrial fibrillation (AF) and the number of patients indicated for anticoagulant therapy have been increasing because AF would affect patient survival due to thromboembolism. Once AF develops, following the disappearance of pulsation, the circumstances within the atrium become prothrombotic and thrombus formation within the left atrium occurs in patients with AF. In recent years, not only warfarin but also new oral anticoagulants were introduced clinically and have become used as oral anticoagulants.

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

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

Case Presentation: We describe a patient in whom respiratory failure, which was caused by impending tension pneumothorax after EPP, was successfully treated via normal suction pressure of the chest drain. A lower suction pressure (- 7 cmHO) was chosen as an alternative to the setting typically used for postoperative drainage (- 15 cmHO).

[With the Characteristics of Chronic Pain Patients, Can the Therapeutic Effect of Antidepressant Duloxetine be Predicted?].

Background: Duloxetine, an antidepressant, is used for treatment of pain, but the factors related to its effectiveness are not well known, and therefore we have performed a retrospective study.

Methods: Over a 22-month period from June 2012 patients with pain lasting for 3 months or more, with an NRS of 4 or higher, and given duloxetine within 3 months from their first diagnosis, were extracted from the medical records. These patients were compared and studied regarding their scores of the HADS (hos- pital anxiety and depression scale) at the time of first visit, duration of the disease, type of patient, and treat- ment effect after 1 month.

[Complications of Epidural Block and Nerve Root Block].

The two major complications clinicians should pay attention to when providing regional anesthesia or nerve block treatment are infection and hematoma. While epidural block is a commonly employed treat- ment method, its complications including epidural abscess and hematoma may require surgical interven- tion to control, and clinicians should perform such blocks with meticulous care. Because early diagnosis and appropriate treatment greatly affect the prognosis from epidural abscess or hematoma, clinicians must have sufficient knowledge of these complications.

Possible involvement of activated locus coeruleus-noradrenergic neurons in pain-related sleep disorders.

The locus coeruleus (LC) is a noradrenergic brainstem structure that is considered to play a role in promoting arousal. To further clarify the role of LC noradrenergic neurons, we performed an optogenetic assay by injecting AAV-channelrhodopsin-2 (ChR2) into the LC of cre-tyrosine hydrolase (TH) mice. We found here that the specific activation of LC noradrenergic neurons produced a significant increase in wakefulness and a significant decrease in non-rapid eye movement (NREM) sleep during photostimulation.

Changes in circadian rhythm for mRNA expression of melatonin 1A and 1B receptors in the hypothalamus under a neuropathic pain-like state.

Several clinical reports on neuropathic pain of various etiologies have shown that it significantly interferes with sleep. Inadequate sleep due to neuropathic pain may contribute to the stressful negative consequences of living with pain. It is generally recognized that melatonin (MT) system in the hypothalmus is crusial for circadian rhythm and sleep-wake transition.

[A case of intraoperative cardiac arrest in a patient with mitochondrial encephalomyopathy undergoing lung resection].

We report a case of intraoperative cardiac arrest in a patient with mitochodorial encephalomyopathy undergoing pulmonary wedge resection. The patient is a 50-year-old female who had been diagnosed as progressive external ophthalmoplegia at the age of 44 and underwent resection of mediastinal tumor 11 months before without major events. The patient was found to have lung cancer in the left lung and scheduled for wedge resection.

[Successful anesthetic management of a postpartum patient with amniotic fluid embolism].

We report a case of amniotic fluid embolism (AFE) after cesarean section (C/S). A 35-year-old primigravida with placenta previa and myoma underwent C/S because of nonreassuring fetal status caused by medical induction of labor. C/S was performed smoothly under general anesthesia and the baby had no problems.