Neurological prognosis of 6 cases after chest compression during general anesthesia.

Introduction: Data on the outcomes after chest compression (CC) of patients who are under general anesthesia (GA) are limited. The present study aimed to evaluate the neurological outcomes in patients who received CC while under GA.

Methods: The patients who received CC while under GA, between 2010 and 2015, in Kyoto Medical Center were surveyed retrospectively.

Inter-rater reliability of the American Society of Anesthesiologists physical status rating for emergency gastrointestinal surgery.

Aim: The American Society of Anesthesiologists Physical Status (ASA-PS) classification system is used worldwide and has also been incorporated into various prediction rules. However, concerns have been raised regarding inter-rater agreement in various surgical fields. Although emergency gastrointestinal surgery is relatively common and associated with high postoperative mortality, a reliability study has not yet been undertaken in this field.

[Misplacement of a guidewire into the right vertebral vein through the right internal jugular vein under real-time ultrasound guidance in Trousseau syndrome patient--a case report].

Trousseau syndrome is a venous thromboembolic complication found in abdominal cancer patients. A 46-year-old woman diagnosed with and treated for pulmonary embolism due to Trousseau syndrome with a huge ovalian tumor was planned to undergo oophorectomy. She presented with pulmonary hypertension and her inferior vena cava was compressed by the tumor.

Postoperative continuous intravenous infusion of fentanyl is associated with the development of orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery.

Purpose: Early ambulation is essential for rapid functional recovery after surgery; however, orthostatic intolerance may delay recovery and cause syncope, leading to potential serious complications such as falls. Opioids may contribute to orthostatic intolerance because of reduced arterial pressure and associated reduction in cerebral blood flow and oxygenation. This study aimed to examine the effect of postoperative continuous infusion of fentanyl on orthostatic intolerance and delayed ambulation in patients after gynecologic laparoscopic surgery.

Dopamine D2-like receptor in the nucleus accumbens is involved in the antinociceptive effect of nitrous oxide.

Background: The mechanism of the antinociceptive effects of nitrous oxide (N(2)O) has not been completely elucidated. On the other hand, numerous studies have indicated that mesolimbic dopaminergic neurons, which are thought to be involved in rewarding and reinforcement processes, play important roles in the supraspinal pain-suppression system. We hypothesized that the mesolimbic dopaminergic system is involved in the antinociceptive effect of N(2)O.

Nitrous oxide increases serotonin release in the rat spinal cord.

The mechanism of the antinociceptive action of nitrous oxide (N(2)O) is not fully understood. It was reported that N(2)O induces opioid peptide release in the rat midbrain, which can activate the descending inhibitory system in the spinal cord. Although effects of N(2)O on the noradrenergic descending inhibitory system have been established, effects of N(2)O on the serotonergic descending inhibitory system have not been extensively investigated.

Activity of the serotonergic system during isoflurane anesthesia.

Background: Microdialysis studies have demonstrated that the release of serotonin (5-hydroxytryptamine, 5-HT) in the serotonergic projection areas increases during waking and decreases during sleep in rat and cat, suggesting that 5-HT plays an important role in modulation of sleep. Although it might be expected that 5-HT release is also decreased during general anesthesia, the functional contribution of serotonergic neurons in pharmacological effects of volatile anesthetics has not been fully investigated.

Methods: Using an in vivo microdialysis technique, we measured extracellular 5-HT in rat frontal cortex during waking, slow-wave sleep, and isoflurane anesthesia.

The involvement of the nociceptin receptor in the antinociceptive action of nitrous oxide.

Nociceptin and its receptor are widely expressed in the central nervous system and are involved in the modulation of nociception. We have previously reported that the minimum anesthetic alveolar concentrations for volatile anesthetics do not differ between nociceptin receptor knockout (NOP-/-) mice and wild-type (NOP+/+) mice. In the present study, we investigated whether the nociceptin system is involved in the antinociceptive action of nitrous oxide.

Omission of fentanyl during sevoflurane anesthesia decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in major breast cancer surgery.

Purpose: Our purpose was to investigate the effect of omission of fentanyl during sevoflurane anesthesia on the incidences of postoperative nausea and vomiting and on postanesthesia recovery in female patients undergoing major breast cancer surgery.

Methods: Female patients (American Society of Anesthesiologists [ASA] physical status [PS] class I-II; age, 28-84 years) undergoing major breast cancer surgery were randomized to one of two anesthesia maintenance groups: sevoflurane-fentanyl anesthesia (SF; n = 25) or fentanyl-free sevoflurane anesthesia (S; n = 26). All patients were administered with propofol 2 mg x kg(-1) intravenously for anesthesia induction, a laryngeal mask airway was placed, and they received rectal diclofenac and local infiltration anesthesia.

[Severe pulmonary hypertension during double lung transplantation].

We report a case of severe intraoperative pulmonary hypertension during double lung transplantation. A 31-year-old woman with severe primary pulmonary hypertension underwent double lung transplantation. Although a marked increase in pulmonary arterial pressure (180/80 mmHg) exceeding the level of systemic arterial pressure occurred after anesthetic induction, the operation could be performed with scheduled cardiopulmonary bypass without using urgent percutaneous cardiopulmonary support.

[Anesthetic management of a boy with 7 q trisomy syndrome].

A 5-year-old boy with 7 q trisomy received general anesthesia for tracheostomy. He was born with multiple morphological malformations including anomalies of ears, eyes, face and vertebral, accompanying difficulty in tracheal intubation. At first we inserted a laryngoscope under awake condition to estimate the difficulty in intubation.