1.Review of Spinal Anesthesia Using Opioids for Cesarean Section
Junko KATO ; Toshiharu OHTA ; Saburou YAMAGIWA
Journal of the Japanese Association of Rural Medicine 2013;61(4):632-635
Background and Objective: The cesarean section is preformed commonly in modern society, where safety is regarded as of utmost importance and maternal age at childbirth is on the rise. While the risk of pulmonary embolism is high and getting out of sickbed early is recommended after a cesarean delivery, a woman in labor suffers wound pain and uterine contraction pain. We reviewed several reports that spinal anesthesia with opioids offered a good analgesic effect and inquired the validity and safety of this procedure.
Methods: Subjects were 88 full-term pregnant women ronging in age from 19 to 41 years. They recieved a cesarean section without complications and nonreassuring fetal status. The subjects were divided into 2 groups: Group A underwent spinal anesthesia with 0.5% high-density bupivacaine (n=51) and Group B is received bupivacaine with 0.1mg morphine and 0.01mg fentanyl added (n=37). Comparison was made between the two groups with respect to the amount of intravenous ephedrine for hypotention, revelation of nausea, the frequency of use of a postoperative painkiller, NRS (Numerical Rating Scale) and Apgar score of newborns.
Results: In Group B, the quantity of ephedrine used was significantly less than in Group A to assure anesthesia. The significant difference was observed in the occurrence of nausea. (p=0.002). The times in Group B. the painkiller was used could be reduced. The pain was reduced by half or over from the average value of NRS. There was no difference in Apgar score.
Conclusions:In the rural area which is short of medical workers, high-quality care during the perioperative period can be obtained performed only by spinal anesthesia with the addition of opioids.
2.Association between occurrence of multiple white and flat elevated gastric lesions and oral proton pump inhibitor intake
Rino HASEGAWA ; Kenshi YAO ; Takao KANEMITSU ; Hisatomi ARIMA ; Takayuki HIRASE ; Yuuya HIRATSUKA ; Kazuhiro TAKEDA ; Kentaro IMAMURA ; Kensei OHTSU ; Yoichiro ONO ; Masaki MIYAOKA ; Takashi HISABE ; Toshiharu UEKI ; Hiroshi TANABE ; Atsuko OHTA ; Satoshi NIMURA
Clinical Endoscopy 2024;57(1):65-72
Background/Aims:
Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL.
Methods:
The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake.
Results:
In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06–16.2).
Conclusions
Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).