Immediate alleviation of chronic pain by bone drilling and probable involvement of bone tissue in pain sensitisation.

Three patients presented with severe spontaneous pain, allodynia and numbness on the lateral side of the left heal, foot and/or toe due to L5 and/or S1 root injury, as a result of repeated failed back surgeries including Love's surgery and laminaectomy (failed back surgery syndrome). The neuropathic pain in the lower extremities did not respond to somatic nerve block, lumbar-sympathetic ganglion block, spinal cord stimulation, and/or medications. At the spots in the foot showing the most severe allodynia, bones were drilled with fluoroscopic assistance.

[Four cases of latent aortic aneurysm--preoperative screening of aortic pathology is necessary for elderly patients].

We report four cases of latent aortic aneurysm revealed by contrast computed tomography (CT) before operations. The incidence of aortic diseases has not been publicized in Japan. However, the report of autopsies demonstrated that the elderly has a high incidence of aortic aneurysm and aortic dissection.

[Awake intubation using lightwand technique under conscious sedation with remifentanil].

We experienced two cases of difficult airway due to deformities in the oral cavities. The first patient was a 62-year-old woman with a large benign soft palate tumor and the second was a 64-year-old woman with macroglossia secondary to acromegaly. Both patients were evaluated difficult to ventilate via face mask and presenting serious risks for tracheal intubation under general anesthesia.

[Case of postoperative pulmonary embolism after tonsillectomy in a healthy young woman].

An 18-year-old healthy woman with no previous history of coagulation disorders underwent general anesthesia for tonsillectomy. The procedure was uneventful. After the surgery, she was ordered to rest on bed overnight.

Pulmonary atelectasis manifested after induction of anesthesia: a contribution of sinobronchial syndrome?

A 31-year-old man underwent general anesthesia for sinus surgery. Anesthesia was induced with midazolam and butorphanol, and an endotracheal tube was orally placed with a bronchoscope, due to difficulty with temporomandibular joint opening. Ventilation difficulty and increased peak inspiratory pressure were noticed shortly after tracheal intubation, and bronchoscopy was performed for diagnosis.

[Tension pneumothorax manifested after extubation in a patient who underwent total gastrectomy].

A patient developed tension pneumothorax immediately after extubation. The patient was a 53-year-old man, who underwent total gastrectomy under general anesthesia combined with epidural anesthesia. The posterior mediastinum drainage tube was placed near the site of esophago-jejunum anastomosis.

[Perioperative cerebral ischemia and the possibility of neuroprotection by inhalational anesthetics].

Deteriorated neurological outcome is not rare after major surgeries. With aging of the surgical population in Japan, an increasing frequency of perioperative cerebral ischemia is expected. To avoid neurological deterioration after surgery and general anesthesia, especially in high-risk patients, it is important to provide appropriate CNS-oriented anesthesia management.

[A case of postoperative palsy of the brachial plexus and facial nerve caused by use of cervical collar during lung surgery].

We report a case of palsy of the brachial plexus and facial nerve manifested after surgery for lung cancer in a 77-year-old female who also had a retroodontoid pseudotumor. Lobectomy was conducted with the patient in a left lateral position. For the purpose of cervical stabilization, the orthopedic surgeon recommended the use of a cervical collar.

Vecuronium directly inhibits hypoxic neurotransmission of the rat carotid body.

Unlabelled: Previous studies have suggested that partial neuromuscular blockade by vecuronium may inhibit the chemoreceptor neural response to hypoxia. Because acetylcholine and its receptors are critically involved in the hypoxic neurotransmission of the carotid body, we examined whether vecuronium interferes with nicotinic processes in the carotid body and inhibits the chemoreceptor neural response to hypoxia. The carotid body was harvested from anesthetized adult Wister rats.