The impact of the pore position of a self-coiling catheter for continuous interscalene brachial plexus block on postoperative pain in patients undergoing arthroscopic rotator cuff repair surgery: a prospective observational study.

This prospective observational study aimed to investigate the usefulness of the self-coiling catheter for continuous interscalene brachial plexus block (CISB) in patients undergoing arthroscopic rotator cuff repair (ARCR). In 22 patients, the self-coiling tip of catheter was placed anterior to the C5 and C6 roots under ultrasound guidance. The primary outcome is the relationship between the distance from the distal side pore of the catheter to the C5/C6 nerve roots and the visual analogue scale (VAS) of postoperative pain.

Sympathetic hyperactivity, hypertension, and tachycardia induced by stimulation of the ponto-medullary junction in humans.

Objective: The purpose of this study is to investigate changes in autonomic activities and systemic circulation generated by surgical manipulation or electrical stimulation to the human brain stem.

Methods: We constructed a system that simultaneously recorded microsurgical field videos and heart rate variability (HRV) that represent autonomic activities. In 20 brain stem surgeries recorded, HRV features and sites of surgical manipulation were analyzed in 19 hypertensive epochs, defined as the periods with transient increases in the blood pressure.

McGRATH MAC video laryngoscope assistance during transesophageal echocardiography may reduce the risk of complications: a manikin study.

Background: Although transesophageal echocardiography (TEE) is considered a relatively safe diagnostic monitoring method, blind probe insertion is associated with pharyngeal trauma. Through visual observation of the esophageal inlet with the McGRATH video laryngoscope, it may be possible to insert the TEE probe at an appropriate angle and prevent pharyngeal trauma. We conducted a manikin study to investigate whether the use of the McGRATH video laryngoscope for TEE probe insertion reduced the pressure on the posterior pharyngeal wall.

[A Case of Penetrating Injury of the Neck in Which It Was Difficult to Secure the Airway].

A 76-year-old man sustained a penetrating neck injury caused by a metal rake following an accidental fall. On admission, he showed clear consciousness and no dyspnea. CT revealed that the tips of three prongs of the rake were located close to the vertebral artery and trachea.

Failure of a "foolproof" pin-index medical pipeline system.

Background: The pin-index medical gas pipeline system, which complies with Japan Industrial Standard (JIS), is considered to be "foolproof" and is widely used in Japan to avoid medical gas misconnections.

Case Presentation: The wall-mounted gas outlet used in our hospital (NSV outlet, CENTRAL UNI, Co., Ltd.

[Usefullness of Beta-blocker for Hemodynamic Changes Induced by Uterotonic Drug in a Patient with Hypertrophic Obstructive Cardiomyopathy Undergoing Elective Cesarean Section].

Combined spinal-epidural anesthesia (CSEA) was given to a 27-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) for a selective cesarean section. After the injection of uterotonic drug via uterine muscle and a vein after delivery, the patient developed dyspnea, tachycardia, ST-change on elecrocardiogram and hypotension. It is important in HOCM patients to control heart rate and left ventricular contractile force.

Successful esophageal bypass surgery in a patient with a large tracheoesophageal fistula following endotracheal stenting and chemoradiotherapy for advanced esophageal cancer: case report.

A 63-year-old man with esophageal achalasia for more than 20 years complained of respiratory distress. He was admitted as an emergency to the referral hospital three months previously. Computed tomography revealed tracheobronchial stenosis due to advanced esophageal cancer with tracheal invasion.

[Successful internal jugular vein puncture with ultrasound guidance for a terminal life stage patient in sitting position].

We experienced an internal jugular vein cannulation of a terminal life stage patient suffering from serious peritonitis carcinomatosa with severely edematous limbs. He could not lie down on a bed because of dyspnea due to high abdominal pressure caused by massive ascites. We examined his internal jugular vein with ultrasound device, and found that it kept high venous pressure even in his inspiratory phase, although in sitting position.

[A Kumamoto model of clinical training in tracheal intubation for paramedics].

Background: Since July 2004, the Japanese Ministry of Health, Labor and Welfare approved certified paramedics to perform emergency prehospital tracheal intubation. A specialized training system in tracheal intubation has been established in Kumamoto Prefecture.

Methods: The Kumamoto Prefectural Medical Control Organization, a tracheal intubation task force was established: consisting of the departments of Anesthesiology at Kumamoto University and 11 other major hospitals, along with Kumamoto Prefecture and the 14 prefectural fire-departments.

Mental strain in medical students during simulator training measured by forehead sweating.

Forehead sweating developed in 78% of medical students when they attempted tracheal intubation on a simulator, and increased during subsequent attempts if the first attempt was not successful. Thus, forehead sweating may be a useful index of mental strain.