1.Occurrence of Ventricular Tachycardia After Adrenaline Local Injection During Laparoscopic Ovarian Cystectomy
Hidenori UMEKI ; Aya OSONOI ; Atsushi FUSEGI ; Chiaki OKAMOTO ; Mikiko TSUGATA ; Yoshiaki SOMEKAWA
Journal of the Japanese Association of Rural Medicine 2015;63(5):758-763
A 32-year-old woman underwent the laparoscopic ovarian cystectomy. During the operation, adrenaline was injected into her right ovary, because the amount of bleeding decreased. Soon after the injection, ventricular tachycardia occurred and her blood pressure increased to 190/125. The use of lidocaine induced the electrocardiogram to return to normal and brought down the blood pressure to a normal range. The operation was finished without hitch. Vasopressin has both an excellent hemostatic effect and cardiovascular side effects, and is often used at many medical facilities in Japan. But the treatment with vasopressin is neither covered by health insurance nor the relief system for sufferers from adverse drug reactions. So we usually use adrenaline which is insurable at laparoscopic operations. Adrenaline has also a hemostatic property, and causes severe cardiovascular adverse events such as ventricular tachycardia when used together with halogenated inhalation anesthetic. The Japanese Society of Anesthesiologists concludes that no serious side effects will arise from using adrenalin and sevoflurane or isoflurane based on its own findings. We had a case with ventricular tachycardia which occurred after an adrenaline local injection. But we recommend a careful use of adrenaline for local injection during a laparoscopic operation.
2.Convenience of “Loco-check” Combination in Quick Screening of Latent Preliminary Group of Locomotive Syndrome by Measurement of Handgrip Strength: Secondary Analysis of the Previous Report
Koji TOKUMO ; Toshimichi KAJIHARA ; Tsuyoshi ISHIBASHI ; Takehiko TAKAMOTO ; Chiaki ISHII ; Masakazu HIROSE ; Jun KAMISHIKIRYO ; Shuso TAKEDA ; Yuko SARUHASHI ; Nobuhiro NAGASAKI ; Tetsuro TANAKA ; Eijiro KOJIMA ; Kengo BANSHOYA ; Masahiro YAMADA ; Itsuko YOKOTA ; Shinya OKAMOTO ; Masahiro OKADA ; Narumi SUGIHARA
Japanese Journal of Social Pharmacy 2022;41(2):133-140
As a screening tool for detecting latent pre-locomotive syndrome (latent pre-LS) in women over the age of 40, measuring handgrip strength with a cut-off value of 26 kg was proposed in a previous report. However, this screening method missed 22% of latent pre-LS. It would be beneficial to screen almost persons with latent pre-LS in community pharmacies. In this study, it was investigated whether screening using the combination of measuring handgrip strength and the questionnaire, “Loco-check,” which was proposed by the Japanese Orthopaedic Association, improved the detection of latent pre-LS in the same group mentioned above. Combining only one of the “Loco-check” questions, “I cannot put on a pair of socks while standing on one leg,” with the measurement of handgrip strength with the cut-off value of 26 kg, the detection of latent pre-LS was increased to 90.2%. The odds ratio was 9.72 in logistic regression analysis. Using the combination of the measurement of handgrip strength and the response to one question is both rapid and convenient. Therefore, in this study, this screening combination is proposed to be a useful tool in community pharmacies for detecting early latent pre-LS.