Individual indicators of appropriate hypnotic level during propofol anesthesia: highest alpha power and effect-site concentrations of propofol at loss of response.

Background: Electroencephalogram (EEG) waveforms vary widely among individuals, this decreases the usefulness of BIS™ monitors for assessing the effects of propofol. Practically, anesthesia is only seen as too deep when evidence of burst-suppression is seen. We designed an experiment to help towards better assessment of individual anesthetic needs.

[Anesthetic Management of Three Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy].

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronically progressing or relapsing disease caused by immune-mediated peripheral neuropathy. We report the anesthetic management of three CIDP patients who underwent elective orthopedic surgeries. Owing to the risk of neuraxial anesthetics triggering demyelination, general anesthesia was selected to avoid epidural or spinal anesthesia or other neuraxial blockade.

Proposal of bioinstrumentation using flex sensor for amputated upper limb.

We previously proposed a new bioinstrumentation using the shape deformation of the amputated upper limbs without using the myoelectricity generated on the skin of the upper limbs. However many electronic parts were required owing to a bridge circuit and multi-amplifier circuits so as to amplify a tiny voltage of strain gages. Moreover, the surplus heat might occur by the overcurrent owing to low resistance value of strain gages.

Proposal of bioinstrumentation using shape deformation of amputated upper limb.

Some upper limb amputees have been annually supplied with myoelectric prostheses by social rehabilitation promotion services. However, the persons supplied with the prostheses have been limited because a supply system has not been established yet. Accordingly, we propose a new bioinstrumentation using the shape deformation of the amputated upper limbs without using the myoelectricity generated on the skin of the upper limbs.

The impact of nitrous oxide on electroencephalographic bicoherence during isoflurane anesthesia.

Background: We previously reported that electroencephalographic (EEG) bicoherence, the degree of phase coupling among the frequency components of a signal, showed 2 peaks during isoflurane anesthesia. Hayashi et al. (Br J Anaesth 2007;99:389-95) also revealed that the peak frequency of bicoherence around 10 Hz increased when ketamine was added.

[Case of a schizophrenic patient refusing emergent operation for ovarian torsion].

We report a case of a schizophrenic patient who rejected an emergent operation for ovarian torsion. A 48-year-old woman with ovarian torsion strictly turned down emergent surgery against the recommendation of her gynecologist, who could not communicate with her. In response to his request, a psychiatrist examined and diagnosed her as schizophrenia.

[Cesarean section in a morbidly obese parturient with borderline personality disorder under combined spinal and epidural anesthesia].

A 21-year-old morbidly obese parturient with a body mass index of 45.5 kg x m(-2) underwent an emergent cesarean section for obstructed labor under combined spinal and epidural anesthesia. At age 15, she was diagnosed as borderline personality disorder.

Vocal cord paralysis after surgery to the descending thoracic aorta via left posterolateral thoracotomy.

Vocal cord paralysis is one of the frequently encountered complications after aortic surgery. However, reports of vocal cord paralysis after aortic surgery have been limited. In a retrospective cohort study of vocal cord paralysis after aortic surgery at a general hospital, we sought factors related to its development after aortic surgery to the descending thoracic aorta via left posterolateral thoracotomy.

Vocal cord paralysis after aortic arch surgery: predictors and clinical outcome.

Objective: This study is retrospective cohort study of data on vocal cord paralysis after aortic arch surgery collected during 14 years at a general hospital. We investigated factors in the development of vocal cord paralysis after aortic arch surgery and the effect of vocal cord paralysis on clinical course and outcome.

Methods: We reviewed data for 182 patients who underwent aortic arch surgery for aortic arch aneurysm and aortic dissection between 1989 and 2003, of whom 58 patients had proximal aortic repair, 62 had distal arch repair, and 62 had total arch repair.

[Anesthetic management of two patients with Brugada-type ECG and of different clinical severity].

Brugada syndrome is an arrhythmia syndrome characterized by typical electrocardiogram (Brugada-type ECG) and development of ventricular fibrillation (Vf) without any distinct structural heart diseases. The essential goal in the management of Brugada syndrome is to avoid the development of Vf. However, there has been no established consensus on pre-operative risk assessment of patients with Brugada-type ECG.

Electroencephalographic bicoherence is sensitive to noxious stimuli during isoflurane or sevoflurane anesthesia.

Background: The authors previously reported changes in electroencephalographic bicoherence during isoflurane anesthesia combined with epidural anesthesia. Here, they examined the influence of noxious stimuli on electroencephalographic bicoherence as well as on the Bispectral Index (BIS) and the 95% spectral edge frequency (SEF95).

Methods: The authors enrolled 48 elective abdominal surgery patients (aged 22-77 years; American Society of Anesthesiologists physical status I or II).

[Occupational exposure of operating room staff to anesthetic gases during inhaled induction--a comparison with intravenous anesthesia induction].

Background: The risk of occupational exposure to waste anesthetic gases still remains during inhaled induction. In this study we investigated how much we were occupationally exposed to anesthetic gases during induction period.

Methods: Twenty-six adult patients were induced with sevoflurane 5% using a face mask for three minutes and maintained with sevoflurane 1% after end-tracheal intubations (IH-Group).

[Intensive care management of acute pulmonary thromboembolism].

Three patients with acute pulmonary thromboembolism, who had fallen into cardiopulmonary arrest or severe respiratory failure, were treated and saved in our intensive care unit. Two patients were resuscitated with percutaneous cardiopulmonary support device. Two patients underwent surgical embolectomy and we carefully applied positive pressure ventilation to prevent postoperative reperfusion pulmonary edema.

Changes of electroencephalographic bicoherence during isoflurane anesthesia combined with epidural anesthesia.

Background: The authors previously reported that, during isoflurane anesthesia, electroencephalographic bicoherence values changed in a fairly restricted region of frequency versus frequency space. The aim of the current study was to clarify the relation between electroencephalographic bicoherence and the isoflurane concentration.

Methods: Thirty elective abdominal surgery patients (male and female, aged 34-77 yr, American Society of Anesthesiologists physical status I-II) were enrolled.