Real-time ultrasound-guided infraorbital nerve block to treat trigeminal neuralgia using a high concentration of tetracaine dissolved in bupivacaine.

Background Trigeminal neuralgia is a neuropathic disorder characterized by episodes of intense pain in the face. Drug therapy is the first choice of treatment. However, in cases where drug therapy are contraindicated due to side effects, patients can get pain relief from lengthy neurosurgical procedures.

[Refractory Hypotension Induced by Continuous Phonation during Spinal Anesthesia in a Patient Suffering from Severe Aortic Stenosis.].

An 85-year-old man suffering from severe aortic ste- nosis underwent transurethral resection of the prostate (TUR-P) under spinal anesthesia producing analgesia below T7. TUR-P was performed uneventfully with repeated injections of phenylephrine 0.05 to 0.

The ameliorative effects of a hypnotic bromvalerylurea in sepsis.

Sepsis is a severe pathologic event, frequently causing death in critically ill patients. However, there are no approved drugs to treat sepsis, despite clinical trials of many agents that have distinct targets. Therefore, a novel effective treatment should be developed based on the pathogenesis of sepsis.

Changes in Energy Levels by Dexamethasone in Ischemic Hearts and Brains in Male Mice.

Background: Glucocorticoids have been shown to alleviate ischemia-induced myocardial injury, while aggravating neuronal damage caused by ischemia. As energy failure is a predominant factor in cellular viability, we examined the effects of glucocorticoids on energy utilization in the mouse heart and brain.

Methods: Seventy-two male ddY mice were assigned to 1 of 3 groups: saline (S), dexamethasone (a glucocorticoid without mineralocorticoid activity, 5 mg/kg) (D), and metyrapone (a potent inhibitor of the synthesis of glucocorticoids, 100 mg/kg) (M) groups (n=24 in each).

Usefulness of cordotomy in patients with cancer who experience bilateral pain: implications of increased pain and new pain.

Background: Although mirror pain occurs after cordotomy in patients experiencing unilateral pain via a referred pain mechanism, no studies have examined whether this pain mechanism operates in patients who have bilateral pain.

Objective: To assess the usefulness of cordotomy for bilateral pain from the viewpoint of increased pain or new pain caused by a referred pain mechanism.

Methods: Twenty-six patients who underwent percutaneous cordotomy through C1-C2 for severe bilateral cancer pain in the lumbosacral nerve region were enrolled.

[The looks of Gendai Kamada].

We realized the looks of Gendai Kamada. At first, we found in a figure, in "Seishu Hanaoka and His Surgery" by Syuzo Kure, that the portrait described as that of Gendai is his father's. And we discovered the illustrations that illustrate the looks of Gendai in "Gekakihaizufu", which was a textbook of clinical anesthesia and surgery, printed in 1840.

[Stricture of oxygen outlet of the central piping identified by a decrease in the oxygen supply pressure into the anesthesia machine].

We experienced an incident of the stricture caused by the degradation of an O-ring in the oxygen outlet of the central piping. The event was identified by the intermittent decrease of the central piping oxygen supply pressure into the anesthesia machine. In this case, pressure was judged normal by periodical checking.

[Incorrect descriptions about Seicho Kamata in "Seishu Hanaoka and his surgery"].

"Seishu Hanaoka and his surgery" by Shuzo Kure is one of the most important books for the study of Seishu Hanaoka. However, several incorrect descriptions have been pointed out in the book. Therefore, we checked the content about Seicho Kamata, a distinguished disciple of Seishu Hanaoka (p.

Massive subcutaneous emphysema developing before surgery for mandibular fracture: a case report.

Preoperative massive subcutaneous emphysema before intubation is extremely rare. However, this complication may be potentially lethal, depend on the condition of air spreading. Subcutaneous emphysema which occurs intra- or postoperative period is sometimes iatrogenic because the air is introduced into the tissue space through the hole injured by the operation.

Case reports: management of intractable upper extremity pain with continuous subarachnoid block at the low cervical level without impairment of upper extremity function.

We present a case of continuous subarachnoid block for the treatment of refractory cancer pain in the shoulder and upper extremity on the right side of the patient. The catheter tip was placed in the subarachnoid space close to the nerve roots on the right side at the height of C5 corresponding to the painful region. Until the patient died, his pain was controlled with infusions of bupivacaine (30-58.

[A case of neuropathic cancer pain in the lower extremities successfully treated with spinal cord stimulation].

A 76-year-old man was referred to our pain clinic for the treatment of bilateral lower extremity pain due to metastasis of renal cell carcinoma to the sacrum. The pain could not be controlled with narcotics, antidepressant or the epidural block. The characteristics of pain were like those of benign disease, being spontaneous, not exacerbated by body movement, and having a dysesthetic nature with chill sensations.

[Successful oral fiberoptic intubation by a double-lumen tube under the ventilation only via nostrils with a child size mask in a patient with limited mouth opening].

A 36-year-old woman was scheduled for the right lower lobe resection under the left one-lung ventilation with a double-lumen tube (DLT). Difficult intubation due to limited (1.5 cm) mouth opening was recognized following the induction of anesthesia.

[Nerve block for the treatment of chronic pain].

Nerve block is useful for the treatment of acute pain and cancer pain; however the treatment's effectiveness with regard to non-cancer chronic pain is controversial. Of the non-cancer diseases, trigeminal neuralgia and spinal facet joint pain, in which long-term pain relief can be obtained by the nerve block without serious complications in most of patients, are well suited for the nerve block. Systemic reviews for the treatment of radicular pain from spine disorders with the nerve block showed contradictory long-term results.

Alleviation of ischemia-induced brain edema by activation of the central histaminergic system in rats.

We have reported that facilitation of central histaminergic activity prevents the development of ischemia-induced brain injury. Since cerebral edema is a major cause of brain damage, we studied effects on brain edema of postischemic administration of L-histidine, a precursor of histamine, and thioperamide, a histamine H(3)-receptor antagonist, both of which enhance central histaminergic activity. Focal cerebral ischemia for 2 h was provoked by transient occlusion of the right middle cerebral artery in rats, and the water content and infarct size were determined 24 h after reperfusion.

Bilateral brachial plexus injury after liver transplantation.

We report a case of bilateral brachial plexus injury following living-donor liver transplantation. A 35-year-old man with hepatitis C cirrhosis underwent liver transplantation under general anesthesia, performed in the supine position with 90 degrees arm abduction. The surgery lasted for 14 h, and the anesthesia for 16 h.

Suppression of ischaemia-induced cytokine release by dimaprit and amelioration of liver injury in rats.

Inflammatory reactions play an important role in ischaemia/reperfusion injury in various organs. Since histamine H(4) action has been shown to prevent the development of ischaemia/reperfusion liver injury, we examined the effects of dimaprit, a histamine H(2)/H(4) receptor agonist, on ischaemia-induced cytokine release and liver damage. Male Wistar rats (300 g) were subjected to warm ischaemia for 30 min.

Recovery of brain dopamine metabolism by branched-chain amino acids in rats with acute hepatic failure.

A decrease in the serum ratio of branched-chain amino acids (BCAAs) to aromatic amino acids (Fischer ratio) reflects the severity of hepatic encephalopathy, and clinical improvement by dietary augmentation with BCAAs has been demonstrated. As behavioral alteration results from changes in central neurotransmission, we investigated the role of BCAA administration on changes in the levels of central neurotransmitters in acute liver injury. Male Wistar rats were subjected to liver ischemia by occluding the left portal vein and hepatic artery for 90 minutes.

Histaminergic involvement in neuropathic pain produced by partial ligation of the sciatic nerve in rats.

Background And Objectives: Because the histaminergic system in the brain is involved in regulation of pain, the relationship between central histaminergic activity and neuropathic pain is of interest.

Methods: Neuropathic pain was induced in rats by partial ligation of the left sciatic nerve, and changes in the extracellular concentration of histamine in the right striatum were examined by a microdialysis procedure 2 weeks later. The nociceptive threshold was determined with von Frey tests, and effects of histaminergic ligands were examined.

[Cancer pain treatment with nerve blocks and neuroablative procedures].

The management of opioid resistant cancer pain is a significant issue for palliative medicine. Certain types of pain can be relieved effectively using nerve blocks without exacerbating and sometimes improving daily activity as long as proper patient selection and technique are employed. Continuous epidural and subarachnoid block, celiac plexus block, superior hypogastric plexus block, subarachnoid phenol block and percutaneous cervical cordotomy are common pain treatment procedures.

Suppression of inflammatory cell recruitment by histamine receptor stimulation in ischemic rat brains.

Inflammation is a crucial factor in the development of ischemia-induced brain injury. Since facilitation of central histaminergic activity ameliorates reperfusion injury, effects of postischemic administration of L-histidine, a precursor of histamine, and thioperamide, a histamine H3 receptor antagonist, on inflammatory cell infiltration were evaluated in a rat model of transient occlusion of the middle cerebral artery. After reperfusion for 12, 24, or 72 h following 2 h of occlusion, brain slices were immunohistochemically stained with antibodies against myeloperoxidase and CD68, which were markers of polymorphonuclear leukocytes and macrophages/microglia, respectively.

Fluoroscopically guided epidural block in the thoracic and lumbar regions.

Background And Objectives: Epidural block in the midthoracic region is difficult, even with fluoroscopically guided methods, because of the inability to view the interlaminar space on radiographs. We have, therefore, proposed fluoroscopically guided epidural block for the midthoracic region, as well as other thoracic and lumbar regions, by use of the pedicle as a landmark to show the height of the interlaminar space.

Methods: Twenty patients scheduled to receive an indwelling epidural catheter at Th6-7, Th9-10, Th12-L1, or L3-4 were studied.