Economic Burden of Venous Thromboembolism in Patients Undergoing Major Abdominal Surgery.

Background: Venous thromboembolism (VTE) is a serious complication that arises after major abdominal surgery. VTE poses risks of negative outcomes and health care burden. The literature on the cost of VTE in Japanese surgical patients, however, is scarce.

[Continuous wound infiltration for upper abdominal surgery: 3 case reports].

We report three cases of continuous wound infiltration (CWI) for postoperative analgesia in upper abdominal surgery using the multi-holed epidural catheter. Ropivacaine 0.2% at a rate of 8 ml x hr(-1) was administered through the catheters after surgery.

[Glidescope: a comparison of percentage of glottic opening score between middle size and large size handles].

Background: The aim of the present study was to compare the percent of glottic opening score between middle-size (#3) and large-size (#4) handles during laryngoscopy using the GlideScope videolaryngoscope (GVL) in Japanese women.

Methods: In 80 Japanese women receiving general anesthesia for surgical procedures, laryngoscopy was performed using GVL #3 handle and GVL #4 handle. We compared the percentage of glottic opening score between the two handles on each patient.

[Case of unexpected difficult intubation caused by asymptomatic congenital laryngeal web].

We report a case of unexpected difficult intubation in a patient with an asymptomatic congenital laryngeal web. A 44-year-old female with left ovarian tumor and endometrial polyp was scheduled for abdominal hysterectomy and left salpingo-oophorectomy under general anesthesia. With aid of laryngoscopy using Macintosh laryngoscope, we attempted to place a tracheal tube (ID 7.

Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial.

Purpose: In many countries, patients are generally allowed to have clear fluids until 2-3 h before surgery. In Japan, long preoperative fasting is still common practice. To shorten the preoperative fasting period in Japan, we tested the safety and efficacy of oral rehydration therapy until 2 h before surgery.

Comparison of the analgesic effects of continuous extrapleural block and continuous epidural block after video-assisted thoracoscopic surgery.

Design: A prospective, randomized, open study. The regional technique used was not blinded.

Setting: A university teaching hospital.

Laparoscopic-assisted proximal gastrectomy in an obese patient with gastric cancer and myasthenia gravis.

The patient is a 61-year-old man who had previously undergone an extended thymectomy for myasthenia gravis. Endoscopic examination during a routine follow-up visit revealed early gastric cancer in the proximal portion of the stomach. To undergo resection the patient received general and epidural anesthesia.

[Use of sugammadex in a patient with limb girdle muscular dystrophy].

Limb girdle muscular dystrophy, a chronic progressive muscular atrophic disease, leads to high sensitivity to depolarizing and non-depolarizing neuromuscular blocking agents. We report the successful use of the sugammadex in a patient with limb girdle muscular dystrophy (dysferlinopathy, Miyoshi distal myopathy) to reverse rocuronium-induced neuromuscular block. After neuromuscular recovery to a train-of-four ratio = 43%, we administered 3.

[Use of Parker Flex-Tip tracheal tube in a patient with Kniest dysplasia].

A 37-year-old man with Kniest dysplasia and thoracic myelopathy was scheduled for T3-12 laminectomy. Kniest dysplasia is a severe chondrodysplasia characterized by short trunk and limbs. Awake fiberoptic intubation was attempted to prevent airway obstruction because we had predicted his difficult airway.

[Distortion of the anterior airway anatomy and cervical spine motion during laryngoscopy with GlideScope videolaryngoscope: a comparison of mid-size blade vs large blade].

Background: GlideScope videolaryngoscope (GVL) is a novel indirect laryngogoscope for tracheal intubation. Both mid-size and large blades of the GVL are available for adult patients. The distortion of the anterior airway anatomy and cervical spine motion using the mid-size GVL is unknown.

[Successful tracheal intubation using the pediatric Airtraq optical laryngoscope in a pediatric patient with Robin sequence].

We report a successful use of pediatric Airtraq optical laryngoscope in a pediatric patient with Robin sequence. Robin sequence accompanies a characteristic facies and its clinical presentation is marked by micrognathia, retrognathia, glossoptosis, and respiratory obstruction. A 1-year-5 month-old boy with Robin sequence was scheduled for palate repair under general anesthesia.

[Case report of endotracheal intubation using AirWay Scope (Pentax-AWS) in a Forestier's disease patient].

A Forestier's disease patient was scheduled for endoscopic mucosal resection under general anesthesia, because of his hypoxic episode during gastric endoscopy. Endotracheal intubation was planned while awake, because he was suspected as a case of difficult airway. By using AWS, we could easily confirm his larynx and aditus of trachea in spite of his narrow pharynx caused by Forestier's disease.

[Airtraq optical laryngoscope: clinical assessment of its performance in 100 children].

Background: The aim of the present study was to evaluate the suitability of Airtraq optical laryngoscope for the tracheal intubation in children.

Methods: Endotracheal intubation was performed using the Airtraq optical laryngoscope in 100 pediatric patients undergoing general anesthesia. The time to complete tracheal intubation and optimizing procedures were recorded.

[Nasotracheal intubation using GlideScope videolaryngoscope or Macintosh laryngoscope by novice laryngoscopists].

Background: We compared the performance of GlideScope videolaryngoscope with that of the conventional Macintosh laryngoscope for nasotracheal intubation by non-anesthesia residents.

Methods: Forty patients requiring nasal endotracheal intubation for surgical convenience were allocated to intubation with the GlideScope videolaryngoscope or Macintosh laryngoscope. Each intubation was performed by non-anesthesia residents.

[A case report of successful treatment of a child with respiratory distress using non-invasive continuous positive airway pressure via helmet].

Helmet is a new device of non-invasive continuous positive airway pressure (CPAP). Few cases have been described about usage of the helmet in children. We describe successful treatment of a child with respiratory distress using the helmet-delivered non-invasive CPAP.

[Anesthesia for cesarean section: a retrospective analysis at the Center for Perinatal and Neonatal Medicine in Jichi Medical University Hospital].

Background: To evaluate obstetric and anesthetic problems relating to cesarean delivery, we investigated parturients who had undergone cesarean section at the Center for Perinatal and Neonatal Medicine in Jichi Medical University Hospital.

Methods: Obstetric and anesthetic data were gathered from January 2007 to December 2007 for all cesarean sections.

Results: In all, 607 parturients received cesarean section during the period.

[Inadvertent arterial misplacement of a large-caliber cannula during jugular vein catheterization].

We report a case of inadvertent arterial misplacement of a large-caliber cannula during jugular vein catheterization. A tip of a 9F cannula was inadvertently placed into the brachiocephalic trunk via the subclavian artery. The arterial trauma was managed by cannula removal and external compression without secondary traumas.

[Incidence and clinical characteristics of perioperative pulmonary thromboembolism in Japan in 2008--results from the annual study of Japanese Society of Anesthesiologists, Committee on Patient Safety and Risk Management, Perioperative Pulmonary Thromboembolism Working Group].

Background: The Japanese Society of Anesthesiologists (JSA) has maintained records of the annual incidence and characteristics of perioperative pulmonary thromboembolism (perioperative PTE) since 2002. The aim of this paper was to provide recent results of the JSA annual study conducted in 2008, and to determine the current factors that tend to prevent perioperative venous thromboembolism (VTE) in Japan.

Methods: A comprehensive questionnaire designed by the JSA PTE working group was mailed to all institutions certified as teaching hospitals by JSA.

[Airtraq optical laryngoscope: clinical assessment of its performance in 300 surgical patients].

Background: The Airtraq optical laryngoscope allows visualization of the glottis through a non-line-of sight view. The aim of the present study was to evaluate the suitability of this device for the tracheal intubation of surgical patients.

Methods: The Airtraq was used for the endotracheal intubation in 300 surgical patients.

Distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope.

Purpose: A non-line-of-sight view is expected to cause less movement of the anterior airway anatomy and cervical spine during laryngeal visualization. Reduced distortion of anterior airway anatomy during laryngoscopy with the GlideScope videolaryngoscope (GVL), compared with the Macintosh laryngoscope, could explain the relatively easier nasotracheal intubation with the GVL. The purpose of this radiographic study was to compare the degree of anterior airway distortion and cervical spine movement during laryngoscopy with the GVL and the conventional Macintosh laryngoscope.

Prolonged activated partial thromboplastin time in thromboprophylaxis with unfractionated heparin in patients undergoing cesarean section.

Aim: Hemorrhage is an important complication of heparin-thromboprophylaxis after surgery. We attempted to clarify the incidence rate of prolonged activated partial thromboplastin time (APTT), representative of hemorrhagic tendency, in Japanese women who received thromboprophylaxis with unfractionated subcutaneous heparin administration after cesarean section (CS). We also determined factors which affected postoperative APTT.

[Work load of anesthesiologists at the Central Surgical Unit of the Jichi Medical University Hospital].

Background: Since the diagnosis procedure combination (DPC) for health insurance plans in Japan was started in medical practice, the number of surgical procedures is increasing at teaching hospitals.

Methods: We retrospectively surveyed 8,672 surgical procedures performed at the central surgical unit of the Jichi Medical University Hospital from April 1, 2007 to March 31, 2008.

Results: Of the 8,672 surgical procedures, 6,922 operations were performed under the management of anesthesia staffs, and 1,904 procedures (27.

[Case of ischemic heart disease resulting from persistent diuresis after giant ovarian tumor resection].

A patient with a giant ovarian tumor weighing about 7 kg was successfully removed by operation. However, her ECG demonstrated ischemic changes after the operation. We report a case of ischemic heart disease due to persistent diuresis after giant ovarian tumor resection.

GlideScope videolaryngoscope reduces the incidence of erroneous esophageal intubation by novice laryngoscopists.

The purpose of this study was to evaluate the performance of the GlideScope videolaryngoscope for tracheal intubation by novice laryngoscopists compared with that of the Macintosh laryngoscope. Under supervision by staff anesthetists, non-anesthesia residents performed tracheal intubation using either the GlideScope videolaryngoscope (n = 100) or Macintosh laryngoscope (n = 100). The time required for airway instrumentation, the number of attempts required until successful intubation, and erroneous esophageal intubation were investigated.

Primary immune system responders to nucleus pulposus cells: evidence for immune response in disc herniation.

Although intervertebral disc herniation and associated sciatica is a common disease, its molecular pathogenesis is not well understood. Immune responses are thought to be involved. This study provides direct evidence that even non-degenerated nucleus pulposus (NP) cells elicit immune responses.