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Takahiro Nakamoto,Kiichi Hirota,Teppei Iwai,Koh Shingu 대한마취통증의학회 2015 Korean Journal of Anesthesiology Vol.68 No.2
Involuntary movement during and after neuraxial anesthesia, such as spinal and epidural anesthesia, is rarely observed. In this report, we describe a case of myoclonus-like involuntary movement of the upper extremities in a patient undergoinga planned repeat cesarean section under spinal anesthesia with bupivacaine that completely subsided after administrationof 2 mg of midazolam. The myoclonus-like movement did not recur or cause any apparent neurological sideeffects.
Impact of hydroxyethyl starch 70/0.5 on acute kidney injury after gastroenterological surgery
Takeshi Umegaki,Takeo Uba,Chisato Sumi,Sachiyo Sakamoto,Sachiko Jomura,Kiichi Hirota,Koh Shingu 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.5
Background: Previous studies reported a higher mortality risk and a greater need for renal replacement therapy in patients administered hydroxyethyl starch (HES) rather than other fluid resuscitation preparations. In this study, we investigated the association between 6% HES 70/0.5 use and postoperative acute kidney injury (AKI) in gastroenterological surgery patients. Methods: We conducted retrospective full-cohort and propensity-score-based analyses of patients who underwent gastroenterological surgery between June 2011 and August 2013 in a Japanese university hospital. The study sample comprised 66 AKI and 2,152 non-AKI patients in the full-cohort analysis and 35 AKI and 1,269 non-AKI patients in the propensity-score-based analysis. Propensity scores were calculated using an ordered logistic regression model in which the dependent variable comprised three groups based on HES infusion volumes (0, 1–999, and ≥ 1,000 ml). The association between HES groups and postoperative AKI incidence was analyzed using multiple logistic regression models. Other candidate independent variables included patient characteristics and intraoperative measures. Results: In the full-cohort analysis, 40 (60.6%) AKI patients were diagnosed as “risk,” 15 (22.7%) as “injury,” and 11 (16.7%) as “failure.” In the propensity-score-based analysis, the corresponding values were 22 (62.9%), 8 (22.9%), and 5 (14.3%). There was no significant association between total infused HES and postoperative AKI incidence in either the full-cohort or the propensity-score-based analysis (P = 0.168 and P = 0.42, respectively). Conclusions: AKI incidence was not associated with clinical 6% HES 70/0.5 administration in gastroenterological surgery patients treated at a single center.