Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report.

Pulmonary hypertension is characterized by higher-than-normal pulmonary arterial pressures. This case report describes the perioperative management of a male patient with idiopathic pulmonary hypertension and a history of vasovagal syncope during previous dental extractions with local anesthesia. He underwent successful extraction of a single tooth with intravenous moderate sedation using dexmedetomidine and midazolam as well as prilocaine with felypressin for local anesthesia.

Real-time monitoring of cortical brain activity in response to acute pain using wide-area Ca imaging.

Previous human and rodent studies indicated that nociceptive stimuli activate many brain regions that is involved in the somatosensory and emotional sensation. Although these studies have identified several important brain regions involved in pain perception, it has been a challenge to observe neural activity directly and simultaneously in these multiple brain regions during pain perception. Using a transgenic mouse expressing G-CaMP7 in majority of astrocytes and a subpopulation of excitatory neurons, we recorded the brain activity in the mouse cerebral cortex during acute pain stimulation.

Intercristal line determined by palpation in parturients in the sitting and the lateral decubitus positions: a prospective observational study.

Purpose: We aimed to investigate intersected vertebral level changes in the palpated intercristal line (PI-line) when shifting from a sitting to a lateral decubitus position in parturients.

Methods: We consecutively enrolled parturients with a gestational age of ≥36 weeks. The attending anesthesiologists palpated the superior aspects of the posterior iliac crests bilaterally in a sitting position and then in a lateral decubitus position.

Anesthetic considerations for cesarean delivery in a parturient with hereditary hemorrhagic telangiectasia: a case report.

Background: Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant disorder characterized by mucocutaneous telangiectasia and arteriovenous malformations (AVMs). There are some anesthetic considerations for cesarean delivery in a parturient with HHT.

Case Presentation: A 27-year-old parturient with pulmonary hemorrhage was admitted to our tertiary perinatal center.

Perioperative management of thyroglossal duct cystectomy in a pediatric patient: A case report.

Thyroglossal duct on the dorsum of the tongue in the pediatric patient can cause a difficult airway due to the large mass and risk of airway obstruction associated with a swollen tongue after surgery.

The first national survey of anesthesia techniques for fetal therapies in Japan.

Purpose: The aim of this study was to survey the frequency of various anesthetic techniques used in the anesthetic management of both the mother and fetus during fetal therapies in Japan.

Methods: We sent a postal survey to the institutions with physicians who held membership of the Japan Society of Fetal Therapy to describe maternal and fetal anesthetic management during fetal therapies performed from January 2016 to March 2017. The therapies included were thoracoamniotic shunting (TAS), intrauterine transfusion (IUT), radiofrequency ablation (RFA), fetoscopic laser photocoagulation (FLP), fetoscopic endotracheal occlusion (FETO), and ex utero intrapartum treatment (EXIT).

Postoperative renal function in parturients with severe preeclampsia who underwent cesarean delivery: a retrospective observational study.

Although postoperative renal dysfunction is relatively rare after cesarean delivery, preeclampsia is considered as the high-risk population. On the other hand, hydroxyethyl starch (HES) administration for preventing maternal hypotension induced by spinal anesthesia for cesarean delivery is a common practice. However, the effect of HES administration during cesarean delivery on postoperative kidney function in parturients with severe preeclampsia is not well investigated.

Outcomes of labor epidural analgesia among women aged over 40: A single-institution retrospective study.

Aim: The purpose of this study was to investigate the effects of labor epidural analgesia (LEA) on maternal and neonatal outcomes among parturients aged 40 years or older.

Methods: We retrospectively reviewed medical records of all laboring, singleton and cephalic deliveries at ≥36 weeks' gestation at the Saitama Medical Center from April 2003 to September 2012. Women aged ≥40 years who received LEA (≥40 with LEA group) were compared with women aged ≥40 years who delivered without LEA (≥40 without LEA group) and women <40 years who received LEA (<40 with LEA group).

Acute transverse myelitis arising after combined general and thoracic epidural anesthesia.

Acute transverse myelitis after surgery is a rare condition, but this complication is devastating. The relationship between anesthetic procedures and acute transverse myelitis is controversial. A 46-year-old woman was scheduled a colostomy closure, and general anesthesia with thoracic epidural anesthesia was performed.

Successful resuscitation of amniotic fluid embolism applying a new classification and management strategy.

Amniotic fluid embolism (AFE) is a rare but life-threatening maternal emergency caused by the entry of amniotic fluid contents into the maternal circulation. The clinical manifestations of AFE are heterogeneous, leading to misdiagnosis or treatment delay. Kanayama and colleagues distinguished the cardiopulmonary collapse type (or classic type) from the disseminated intravascular coagulation (DIC) type of AFE on the basis of the presence of uterine atony and DIC in the latter prior to cardiopulmonary failure.

Success rate and challenges of fetal anesthesia for ultrasound guided fetal intervention by maternal opioid and benzodiazepine administration.

Objective: The safe and effective methods of fetal anesthesia/analgesia during ultrasound guided direct fetal procedure are yet to be determined. The authors investigated whether maternal diazepam/fentanyl administration meets this purpose.

Methods: The medical/anesthesia records were retrospectively reviewed in cases between 2001 and 2010 at a tertiary perinatal center.

Regional anesthesia and non-preeclamptic thrombocytopenia: time to re-think the safe platelet count.

Background And Objectives: Although regional anesthesia is widely used for pain control in obstetrics, it may not be appropriate for patients with thrombocytopenia due to the risk of neuraxial hematoma. There is no strong evidence to suggest the minimum platelet count that is necessary to ensure the safe practice of regional anesthesia. The purpose of this study was to review the safety of regional anesthesia in non-preeclamptic thrombocytopenic parturients at our institution over a 5-year period.

Sonoanatomy of the lumbar spine in patients with previous unintentional dural punctures during labor epidurals.

Background And Objectives: Preprocedural lumbar ultrasound is a valuable tool to assess anatomical landmarks and predict the depth of the epidural space. Variations of the ligamentum flavum sonoanatomy are occasionally observed; however, no literature is available as to their incidence or clinical significance. We hypothesize that abnormal sonoanatomy of the lumbar spine detected by ultrasound can be associated with an increase in unintentional dural punctures.