1.Ultrasound-guided rectus sheath block for improvement of feelings of abdominal distension
Kaoru Nishijima ; Norio Hashimoto ; Miwako Kobayashi ; Takako Morimoto ; Noriko Sakaguchi ; Akiko Nakanishi ; Yuko Tanaka ; Fumiko Koyama ; Shinichiro Zushi ; Kunitaka Shibata
Palliative Care Research 2012;7(1):526-529
We report a case in which feelings of abdominal distension and discomfort of the abdominal wall caused by malignant ascites were relieved by ultrasound-guided rectus sheath block. Case report: A 59-year-old man developed gastric cancer with malignant ascites and experienced feelings of abdominal distension, but no nausea, dyspnea, poor mobility, or limb edema. Symptom control was inadequate with diuretic therapy and abdominal paracentesis. Feelings of distension improved temporarily with ultrasound-guided rectus sheath block. A percutaneous catheter was then used to administer an infusion of 0.25% ropivacaine triweekly until his death 20 days later. Conclusion: Feelings of abdominal distension is one of various symptoms of severe ascites and is difficult to manage. Ultrasound-guided rectus sheath block can be used to relieve this symptom on a case-by-case basis.
2.Successful elimination of intractable lower limb neuropathic pain by pelvic tumor invasion using ultrasound-guided sciatic nerve block
Norio Hashimoto ; Kaoru Nishijima ; Miwako Kobayashi ; Chieko Kuwahara ; Takako Morimoto ; Noriko Sakaguchi ; Akiko Nakanishi ; Yuko Tanaka ; Fumiko Koyama ; Shinichiro Zushi ; Kunitaka Shibata
Palliative Care Research 2010;6(1):313-315
We report a case whose left lower limb neuropathic pain accompanied by pelvic tumor invasion was remarkably eliminated by ultrasound-guided sciatic nerve block. Case report: The subject was a sixty year old male. Pharmacological therapy was given according to the WHO analgesic ladder, but his left lower limb pain failed to respond to drugs. His intractable lower limb neuropathic pain was alleviated by ultrasound-guided sciatic nerve block. Drug delivery can be achieved with a percutaneous catheter and a disposable infusion pump. Infusions were run at 5mlh-1 with 0.1% ropivacaine. Conclusion: Neuropahic pain is sometimes hard to be controlled only by opioids or adjuvant analgesics, but there is a possibility of providing pain relief by combination use with nerve blocks. Interventional techniques can be highly effective but also have the potentiality to produce significant adverse effects. Many patients have factors which would be considered a near absolute contra-indication to the use of nerve blocks such as immuno-compromise or impairment of coagulation. Skillful application of peripheral neural blockade with ultrasound imaging broadens the options for providing optimal pain management. Palliat Care Res 2011; 6(1): 313-315
3.Differences in gestational weight gain in accordance with Japanese and Institute of Medicine guidelines between Japanese and non-Japanese Asian pregnant women at a perinatal medical center in Japan
Chie KOH ; Takako CHIBA ; Ryoko YOSHIDA ; Misato KATO ; Maho MORI ; Akiko MORIMOTO ; Yukari NAKAJIMA ; Kanako YAMADA ; Miho FURUYAMA ; Minako SAHO ; Kaori WATANABE
Journal of International Health 2022;37(4):179-188
Objectives High gestational weight gain (GWG) is associated with perinatal risks to mother and child. Research shows that non-Japanese Asian women have higher GWG than Japanese women. However, no studies have compared GWG in these two populations using GWG recommendations in accordance with Japanese and Institute of Medicine (IOM) guidelines. The study aim was to compare GWG in non-Japanese Asian and Japanese pregnant women.Methods This was a retrospective observational study. All participants were aged ≥20 years and gave birth between September 2019 and the end of October 2020 at one perinatal medical center in Japan. Medical record data were analyzed for 170 non-Japanese Asian and 316 Japanese pregnant women. We used t-tests and chi-square tests to examine differences in age, parity, smoking status, antenatal checkups, pre-pregnancy body mass index, and GWG. Logistic regression analysis was used to estimate odds ratios (95% confidence intervals) for above- and below-recommended GWG by non-Japanese Asian and Japanese status. We also analyzed differences in delivery type, abnormal blood loss, and birth size according to GWG.Results After adjustment for confounding factors, the multivariable-adjusted OR and 95% CI for GWG above the Japanese guidelines recommendations was 1.86 (1.23-2.81) and that for GWG above IOM guidelines recommendations was 2.46 (1.45-4.16) for non-Japanese Asian women, as compared with Japanese women. Conversely, the multivariable-adjusted OR and 95% CI for GWG below Japanese guidelines recommendations was 1.55 (1.03-2.32) and that for GWG below IOM guidelines recommendations was 1.87 (1.26-2.76) for Japanese women, compared with non-Japanese Asian women. Conclusion Because Japanese women tend to be below recommended GWG and non-Japanese Asian women tend to be above recommended GWG, midwives need to provide careful guidance to reduce perinatal risks.