The Japanese Epidemiologic Study for Perioperative Anaphylaxis, a prospective nationwide study: allergen exposure, epidemiology, and diagnosis of anaphylaxis during general anaesthesia.

Background: Diagnosis of perioperative anaphylaxis is often challenging. This study describes the utility of a newly developed tool for identifying patients with a high possibility of anaphylaxis, and aimed to investigate the frequency of anaphylaxis with each drug during the perioperative period in Japan.

Methods: This study included patients with anaphylaxis of Grade 2 or higher severity during general anaesthesia at 42 facilities across Japan in 2019 and 2020.

A practical guide for perioperative smoking cessation.

The perioperative management of patients who are smokers presents anesthesiologists with various challenges related to respiratory, circulatory, and other clinical problems. Regarding 30-day postoperative outcomes, smokers have higher risks of mortality and complications than non-smokers, including death, pneumonia, unplanned tracheal intubation, mechanical ventilation, cardiac arrest, myocardial infarction, and stroke. Given the benefits of smoking cessation and the adverse effects of smoking on perioperative patient management, patients should quit smoking long before surgery.

Choice of desflurane or propofol for the maintenance of general anesthesia does not affect the risk of periprocedural myocardial damage in patients undergoing transfemoral transcatheter aortic valve implantation.

Purpose: This study aimed to reveal whether the occurrence of periprocedural myocardial damage (PMD) decreases in patients who received volatile anesthetics to maintain general anesthesia compared with those who received propofol during transcatheter aortic valve implantation (TAVI).

Methods: We included one hundred and forty adult patients who underwent transfemoral TAVI under general anesthesia from January 2015 to March 2017 in this single-center retrospective review. We compared the rate of patients who developed PMD between those who received desflurane (Group D, n = 72) and propofol (Group P, n = 68) for anesthetic maintenance.

Femoral nerve block with propofol sedation versus general anesthesia in patients with severe cardiac dysfunction undergoing autologous myoblast sheet transplantation.

Purpose: Regional anesthesia is more favorable than general anesthesia in patients with severe comorbidity; however, data on the superiority of peripheral nerve blocks over general anesthesia in patients with severe cardiac dysfunction are lacking. We aimed to demonstrate that peripheral nerve blocks reduce perioperative analgesic requirements and promote faster recovery compared to general anesthesia.

Methods: We retrospectively evaluated intraoperative blood pressure, perioperative medications, and postoperative recovery in patients who underwent skeletal muscle harvesting for autologous myoblast sheet transplantation.

[Pre-operative smoking cessation does not always reduce the incidence of surgical site infection after gastrointestinal surgery].

Background: Centers for Disease Control (CDC) recommend pre-operative smoking cessation to reduce the risk of surgical site infection (SSI). However, whether pre-operative smoking cessation reduces the incidence of SSI for gastrointestinal surgery is unclear. We investigated whether pre-operative smoking cessation reduces the incidence of SSI among patients undergoing gastrointestinal surgery.

Dopamine D2 receptor Taq IA polymorphism is associated with postoperative nausea and vomiting.

Purpose: The dopamine D2 receptor (DRD2) is considered to be involved in the development of postoperative nausea and vomiting (PONV). Our aim was to examine the relationship between DRD2 Taq IA polymorphism and the occurrence of PONV.

Methods: We enrolled 1070 patients who were scheduled to undergo elective surgery under general anesthesia.

[Wound healing in reconstructive head and neck surgery].

Background: Smoking cessation and shorter operative duration are known as factors to improve wound healing in reconstructive head and neck surgery. We investigated the other factors associated with wound healing.

Methods: Informations on age, sex, body mass index, smoking status, serum albumin level, diabetes mellitus, chronic obstructive pulmonary diseases, preoperative steroid therapy, preoperative chemotherapy, preoperative radiation therapy, preoperative starvation care, American Society of Anesthesiologists physical status (ASA-PS), intraoperative administration of prostaglandin E1, operative duration, and type of flap were obtained from the medical records of 370 patients.

[Prophylactic strategies for perioperative pulmonary embolism: the second report; reevaluation of usefulness of combination of elastic stockings and intermittent pneumatic compression].

Background: The incidence of perioperative pulmonary thromboembolism (PTE) has increased in Japan. As the mortality rate of PE is very high, its prophylaxis is important.

Methods: From January 1998 to December 1999 no prophylactic strategies were employed.

[Prophylaxis of perioperative pulmonary thromboembolism in a patient with anti-phospholipid antigen syndrome].

A 68-year-old woman with anti-phospholipid antigen syndrome (APS) was proposed to undergo partial pulmonary resection for lung cancer. She suffered from mild cerebellar ataxia. Exercised 201Tl myocardial scintigraphy was performed due to abnormal Q wave in preoperative electrocardiography and showed old myocardial infarction in inferior-to-posterior area without myocardial ischemia.

Determination of the duration of preoperative smoking cessation to improve wound healing after head and neck surgery.

Background: Preoperative smoking cessation has been suggested to be effective in reducing various postoperative complications. However, the optimal duration of preoperative smoking cessation for reducing wound complications is unclear.

Methods: One hundred eighty-eight consecutive patients who underwent reconstructive head and neck surgery at the authors' institution were included in this retrospective study.

[Short-term bed rest as a cause of deep vein thrombosis in a patient with a huge abdominal tumor].

A 43-year-old female with a huge myoma uteri was scheduled for a simple total hysterectomy. However, there was massive penetration of the tumor into the retroperitoneum, and her first operation failed because we had no advance information on its posterior aspect. Angiography was done to obtain this information.

[Anesthetic management of a patient with squeezed heart by huge sternal tumor].

We experienced perioperative management for excision of a huge sternal chondrosarcoma squeezing the heart. A 46-year-old woman could not sleep due to dyspnea for 6 months. Dyspnea increased in the right decubitus and disappeared in the left decubitus.

[The usefulness of the processed nasal airway for fiberscope guided nasotracheal intubation].

Background: The fiberscopy has become an essential tool for tracheal intubation. As we realized that nasal airway acts like a conduit to guide a fiberscope toward the larynx, we have devised a unique nasal airway named "Osaka airway" which is suitable for fiberoptic naso-tracheal intubation. This airway has two pre-cut line from the head to the tip which can be peeled off easily after the insertion of fiberscope.

[Anesthetic management of two patients with hypertrophic obstructive cardiomyopathy for percutaneous transluminal septal myocardial ablation].

We experienced anesthetic management of two patients with hypertrophic obstructive cardiomyopathy (HOCM) for percutaneous transluminal septal myocardial ablation (PTSMA). PTSMA had been performed more than a year earlier in both cases, and symptoms and exercise tolerance were improved after PTSMA. Laparotomy for suspected ovarian cancer in one patient and thoracotomy for metastatic lung cancer in the other patient were proposed.