Successful Double-lumen Tube Intubation in the Lateral Position for a Patient with a Giant Superior Mediastinal Tumor.

Objective: Anesthetic management of patients with giant mediastinal tumors is challenging from the perspective of both cardiovascular and respiratory management, and airway assessment is important for both concerns. We report the successful induction of general anesthesia and double-lumen tube intubation in the right lateral position for a patient with a giant mediastinal tumor with tracheal compression, using pre-operative chest radiograph imaging to minimize tracheal compression during induction.

Methods: A 41-year-old man required thoracoscopic giant superior mediastinal tumor resection.

Airtraq DL and AWS-200 for Double-lumen Endotracheal Tube Intubation: A Prospective Randomized Clinical Trial.

Objective: This prospective randomized study aimed to assess the usefulness of two videolaryngoscopes with a side channel, the Airtraq DL and the AWS-200, for intubation with a double-lumen tube (DLT).

Methods: In 60 patients with an American Society of Anesthesiologists physical status of 1-3 who were not expected to have difficult airway, the Airtraq DL and the AWS-200 were randomly used for DLT intubation. The primary outcome was intubation time.

Successful Intubation Using the Airtraq Double Lumen with the Universal Adapter for Smartphones in a Case of Intubation Difficulty.

Objective: The Universal Adapter for Smartphones c an record s till images and movies during intubation using the monitor display and recording functions of a smartphone. Here, we describe the successful use of the Airtraq Double Lumen with the Universal Adapter for Smartphones for airway management during anesthesia in a patient with intubation difficulty.

Methods: A 78-year-old man required thoracoscopic upper lobectomy for a pulmonary tumor.

Usefulness of the Universal Adapter for Smartphones in a Mannequin Study.

Objective: Because of the shape of a double-lumen tube (DLT), it is more difficult to use for intubation than an ordinary endotracheal tube. We prospectively investigated the usefulness of the Airtraq DL attached to the Universal Adapter for Smartphones for DLT intubation.

Method: At Tokai University Hachioji Hospital, anesthesiologists with ≥ 5 years' clinical experience intubated a tracheal intubation training mannequin with DLTs using the Airtraq DL (Airtraq-alone phase) and the Airtraq DL attached to the Universal Adapter for Smartphones (adapter phase), and the time required was measured.

Evaluation of the antinociceptive activities of several sodium channel blockers using veratrine test in mice.

An important role of voltage-gated sodium channels (VGSCs) in many different pain states has been established in animal models and humans wherein sodium channel blockers partially ameliorate pain. However, behavioral tests for screening analgesics that exhibit pharmacologic action by acting on VGSCs are rarely reported, and there are no studies on antinociception using veratrine as a nociceptive agent. The aim of the present study was to examine the amount of nociceptive behavior evoked by subcutaneous administration of veratrine into the hind paw and investigate whether veratrine can be used as a VGSC agonist to test the pharmacological properties of candidate analgesics via sodium channel blockade.

Pharmacotherapy for Neuropathic Pain in Japan.

Neuropathic pain (NeP) results from injury to, or disease of, the peripheral or central components of the neural systems involved in pain. In contrast to inflammatory pain, NeP can persist after healing from the initial injury has resolved. Antipyretic agents, such as non-steroidal anti-inflammatory drugs, steroids, and acetaminophen are ineffective, while specific agents such as gabapentinoids, antidepressants, antiepileptics, and opioids are effective in treating NeP.

[The Future of Peripheral Nerve Block from the Perspective of Medical Economics].

Increasing healthcare costs have pressured govern- ment finances and threatened the sustainability of the national health insurance program introduced by the government, namely the Diagnosis Procedure Combi- nation/Per-Diem Payment System (DPC/PDPS) estab- lished in 2003, a prospective payment system for inpa- tients as part of changes to the provider reimburse- ment system to ensure the long-term sustainability of the healthcare insurance program. Under the DPC/ PDPS system, anesthesiologists can help reduce medi- cal costs by applying peripheral nerve blocks (PNB), because many databases have verified that they improve surgical outcomes and reduce hospital stays. These outcomes confer a considerable advantage upon healthcare insurance, demand for which has surged due to rapid population aging and significant progress in medicine.

[Management of Adverse Effects Associated with Nonsteroidal Anti-inflammatory Drugs and COX-2 Inhibitor].

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used groups of drugs. NSAIDs are divided into two major groups : cyclooxy- genase (COX)-2-selective inhibitors (COXIBs) and non- selective NSAIDs based on the mechanism of action. The analgesic and anti-inflammatory effects of NSAIDs are produced through the prevention of prostaglandin production by inhibition of COX activity.

Multi-Acupuncture Point Injections and Their Anatomical Study in Relation to Neck and Shoulder Pain Syndrome (So-Called Katakori) in Japan.

Katakori is a symptom name that is unique to Japan, and refers to myofascial pain syndrome-like clinical signs in the shoulder girdle. Various methods of pain relief for katakori have been reported, but in the present study, we examined the clinical effects of multi-acupuncture point injections (MAPI) in the acupuncture points with which we empirically achieved an effect, as well as the anatomical sites affected by liquid medicine. The subjects were idiopathic katakori patients (n = 9), and three cadavers for anatomical investigation.

[Duloxetine for chronic pain management: pharmacology and clinical use].

The purpose of this article is to provide an overview of some of the important information related to safety and tolerability of duloxetine. Duloxetine, a potent reuptake inhibitor of serotonin and noradrenaline, is effective for the treatment of major depressive disorder, anxiety disorder, and painful diabetic neuropathy (PDN). Duloxetine is safe and well-tolerated across indications, with few reported serious side effects.

Lumbar epidural block for 'painful legs and moving toes' syndrome: a report of three cases.

We report the effective use of epidural block in three patients with 'painful legs and moving toes' syndrome, which is characterized by involuntary movements of the toe (and sometimes of the foot) and excruciating pain in the leg. Several treatments had been unsuccessful in the management of the three patients reported including baclofen, benzodiazepines, carbamazepine and antidepressants. In two patients, lumbar sympathetic block was performed, the symptoms being alleviated temporarily in one patient.