Rocuronium-induced respiratory paralysis refractory to sugammadex in Charcot-Marie-Tooth disease.

Purpose: Prolonged postoperative neuromuscular respiratory paralysis after administration of a nondepolarizing neuromuscular blocking agent is a serious concern during anesthetic management of patients with Charcot-Marie-Tooth disease (CMTD). Some recent reports have described rocuronium use without respiratory paralysis in CMTD patients when sugammadex was used for its reversal. We report a case in which an induction dose of rocuronium caused a prolonged respiratory paralysis in a patient with undiagnosed type 1A CMTD (CMT1A).

[Slight Damage to Epidural Catheter Equipped with Tuohy Needle at Time of Insertion Results in Embedded Remnant.].

It is known that a portion of an epidural catheter can remain embedded when the catheter is pulled back at the time of insertion or a longer length than required is used. We report a case in which an epi- dural catheter piece including a metal coil broke off and remained embedded at the time of withdrawal. Because of the presence of the coil, MRI could not be utilized, while CT scanning was useful to locate the remaining portion.

[The incidence of critical arrhythmia related to epinephrine under halogenated inhalational anesthesia--report of the Subcommittee on Drugs, Committee on Patient Safety and Risk Management, and Committee on Administrative Affairs Japanese Society of Anesthesiologists].

The incidences of intra-operative critical arrhythmia related to epinephrine under halogenated inhalational anesthesia were analysed according to questionnaire to 1108 JSA (Japanese Society of Anesthesiologists) Certified Training Hospital. The survey details included prospective (from July 16th, 2008 to Aug 15th, 2008) and retrospective (from Jan 1st, 2007 to Dec 31th, 2007) incidences of critical arrhythmia due to epinephrine under halogenated inhalational anesthesia. Among the 1108 institutions, effective responses were obtained from 583 institutions.

[Perioperative management for cesarean section in a patient with pulmonary thromboembolism due to deep venous thrombosis].

It has been estimated in Japan that Western-life style increases maternal mortality because of pulmonary thromboembolism (PTE). We report a 29-year-old primipara who suffered PTE due to deep venous thrombosis (DVT) in her 29th weeks' gestation. Except for slight tachypnea, she was relatively stable.

[Anesthetic management of renal transplantation for a 15-year-old girl with cerebral palsy].

A 15-year-old girl with severe cerebral palsy underwent renal transplantation. It was difficult to anastomose blood vessels because her inferior limbs were contracted. The clamp time was 67 minites.

[Cesarean section in a patient with severe mitral stenosis after mitral valve replacement].

A 30-year-old woman with mitral stenosis after mitral valve replacement was scheduled for cesarean section at 28 weeks and 6 days of pregnancy. Cesarian section was decided at a conference of obstetrics, cardiac surgery, neonatology and anesthesiology. Anesthesia was successfully managed with epidural block and pulmonary arterial pressure monitoring.

[Anesthesia for anticoagulated patients].

Background: Anticoagulated patients who undergo surgry have been increasing in number. They may develop thrombo-embolic and/or bleeding complications.

Methods: We studied 79 patients retrospectively who had undergone elective surgery from April 2002 through December 2003.

[Epidemiological study of hepatitis B and C in 34,336 patients operated at Hiroshima Prefectural Hospital during the period from 1993 to 2000].

Background: We have many chances to deal with blood transfusion in the operation room, and it is important for us to pay more attention to prevent hospital infection.

Methods: We surveyed epidemiologically the prevalence of hepatitis B virus surface antigen (HBV) and hepatitis C virus antibody (HCV) in 34,336 patients operated at Hiroshima Prefectural Hospital from April 1993 through March 2001.

Results: The prevalence of HBV seropositivity was 1.