Search PubMed⌕ Search

Biomedical subjects

Tatsuru Arai

Publications and source records attributed to Tatsuru Arai.

26 records · Page 2Linked to original sources
PubMed2002

[Is local anesthesia necessary for venipuncture?].

We evaluated the necessity of local anesthesia for the venipuncture pain in 27 healthy adult volunteers by using a visual analogue scale (VAS) from 0 to 10. The pain scales were measured three times: at the time of percutaneous intravenous cannulation (20 G polyurethane catheter) without local anesthesia as well as the skin infiltration with local anesthetics (0.5% lidocaine 0.5 ml; 25 G needle), and after intravenous cannulation. The measurements were done twice, once by an expert staff and once by a novice staff with an interval of three days. VAS values were significantly higher (2.4 +/- 1.1) for the percutaneous intravenous cannulation without local anesthesia than both for the skin infiltration with local anesthetics (1.4 +/- 0.6) and for the evaluation after intravenous cannulation (0.7 +/- 0.8), independent of who inserted the catheter. VAS values were significantly lower (2.1 +/- 1.0) when the percutaneous intravenous cannulation without local anesthesia was performed by expert staff than when it was performed by novice staff (2.7 +/- 1.1; P < 0.05). We conclude that local anesthesia is necessary when novice staff performs the percutaneous intravenous catheterization.

Adult↗
PubMed1994

Percutaneous cervical cordotomy and subarachnoid phenol block using fluoroscopy in pain control of costopleural syndrome.

We examined the efficacy of percutaneous cervical cordotomy (PCC) and subarachnoid phenol block using fluoroscopy (SAPB-F) for control of chest and/or back pain from costopleural syndrome. The efficacy of each block was evaluated by changes in pain score (PS), analgesic dose and performance status 1 week after the block, as well as by the complications. Between 1980 and 1986, PCC was performed in 10 patients. SAPB-F was performed in 13 patients between 1987 and 1991. Pain was not well controlled by analgesics in any of these patients. For PCC the follow-up period was 94.7 +/- 71.1 days. PS (VAS, 0-10) reduced from 8.5 +/- 0.9 to 3.0 +/- 2.7. No analgesics were needed in 4 patients. Pain recurred in 1 patient. Hemiparesis occurred in 2 patients. General fatigue occurred in 6 patients. In 4 patients with these complications performance status deteriorated and did not recover during the follow-up period. For SAPB-F the follow-up period was 71.8 +/- 44.0 days. SAPB-F was designed to achieve selective phenol deposit at the targeted nerve root. PS decreased from 7.5 +/- 1.9 to 2.7 +/- 2.6. No analgesics were needed in 5 patients. Pain recurred in 3 patients. There were no complications and no changes in performance status. From this study we concluded that PCC is an effective method of pain control for costopleural syndrome, but a risk of serious complications is involved. SAPB-F is an effective and safe method and should be the first choice of nociceptive pathway block.

Aged↗
PubMed1993

Reference of pain following percutaneous cervical cordotomy.

In order to clarify the mechanism of reference of pain following cordotomy (ROPC), the authors investigated ROPC in 66 patients undergoing percutaneous cervical cordotomy (PCC) and examined the features of ROPC and the correlation between the occurrence of ROPC and the pre-operative pain states, as well as the results of PCC. ROPC was observed in 7 patients. It occurred immediately after PCC in 6 of 7 patients and 6 h after PCC in 1 patient. The pain was referred horizontally and cranially from the region rendered totally or largely analgesic by PCC to the normally innervated region. The region to which the pain was referred was not fixed. The referred pain disappeared by rendering the region where referred pain was felt analgesic with additional PCC. There was no correlation between the occurrence of ROPC and pre-operative pain states, or the results of PCC. From these results we postulate that: (1) ROPC occurs via a subsidiary pathway consisting of ascending chains of short neurons connecting dorsal horn neurons longitudinally and latitudinally; (2) the subsidiary pathway is inhibited under normal conditions by feedback inhibition from second-order neurons and/or higher central neurons of the nociceptive pathway; and (3) ROPC results from the release of the feedback inhibition by cordotomy.

Adolescent↗
PubMed1993

Ipsilateral referral of pain following cordotomy.

We report a patient who developed ipsilateral referred pain following unilateral percutaneous cervical cordotomy (PCC). A right-sided PCC was performed on a 44-year-old woman who had been suffering from left groin and thigh pain caused by a fibrosarcoma. PCC produced analgesia below T7 on the left side, and the pain disappeared. A novel spontaneous pain with prominent allodynia occurred postoperatively in the right infraclavicular region (C3-C4). Strong pressure on the left groin where severe spontaneous pain and tenderness had been before PCC increased the new pain, and an epidural block which produced analgesia below T10 relieved the new pain. These facts indicate that the new pain was induced by afferent inputs from the originally painful region.

Adult↗
PubMed1987

A mechanism of new pain following cordotomy; reference of sensation.

An antero-lateral cordotomy was performed on a 62-year-old man who had been suffering from intractable right chest pain caused by lung cancer. Six hours after the cordotomy a new pain occurred in an analogous part of the body on the opposite side; the intensity increased gradually and it became as severe as the original within 1 week. Reference of sensation from analgesic area of cordotomy to the opposite side of the body was induced by noxious stimuli. Intrathecal phenol block to the nerves conveying the cancer pain abolished the new pain and the reference of sensation from this blocked area, though it remained unchanged in other analgesic areas of cordotomy. This substantiates that the new pain was a reference of the original cancer pain.

Electrocoagulation↗
PubMedDate not supplied

Fluoroscopically guided epidural block in the thoracic and lumbar regions.

BACKGROUND AND OBJECTIVES: Epidural block in the midthoracic region is difficult, even with fluoroscopically guided methods, because of the inability to view the interlaminar space on radiographs. We have, therefore, proposed fluoroscopically guided epidural block for the midthoracic region, as well as other thoracic and lumbar regions, by use of the pedicle as a landmark to show the height of the interlaminar space. METHODS: Twenty patients scheduled to receive an indwelling epidural catheter at Th6-7, Th9-10, Th12-L1, or L3-4 were studied. The skin insertion site was at the junction of a line parallel to the vertebral column that passed through the middle of the pedicle and the lower border of vertebral body, immediately inferior to the target interlaminar space on an anteroposterior radiograph. The needle was walked up the lamina, and the interlaminar space was sought near the midline of the vertebra at the height of the pedicle. RESULTS: Epidural block was easily performed in all cases. No difference was observed in the angulation of the epidural needle among the groups; the mean inward and upward angulation were 38 degrees and 63 degrees , respectively, although the skin insertion site relative to the spinous process was different among the groups. CONCLUSIONS: This study showed the usefulness of our fluoroscopically guided method for the midthoracic region, and other thoracic and lumbar regions. We propose an alternative method for a blind epidural approach at Th6-7, Th9-10, Th12-L1, or L3-4.

Aged↗