THE CURRENT STATE OF THE ANESTHESIA CLINIC AT NARA MEDICAL UNIVERSITY HOSPITAL

Since its introduction in 1996, pre- and post-anesthetic consultation at the anesthesia clinic has been conducted for the surgical patients in Nara Medical University Hospital. Then, we evaluated many information obtained from those patients. Regarding pre-anesthetic problems, 39.2％ of patients had anesthesia-related complications such as indication of ICU, taking anticoagulant agents, having cardiac complications, etc. Only 55.4％ of patients visited with their families. Eighty-five percent of patients visited the anesthesia clinic after their operation. Additionally, we retrospectively evaluated post-anesthetic complications and satisfaction under general, epidural and splnal anesthesia from 1999 to 2001. Patients with dissatisfaction on splnal anesthesia were of a higher incidence than those on general anesthesia. The common undesirable complications in every anesthetic method were post-operative pain and nausea/vomiting. We concluded that explanations of anesthesia at pre- and post-anesthesia clinic were useful methods for anesthesia patients

A case of Cushing’s syndrome due to an adrenal black adenoma not visualized by adosterol scintigraphy

40歳女性。満月様顔貌，中心性肥満，赤色皮膚線条といったCushing徴候あり，血中ACTH抑制，コルチゾール高値で，左副腎に28mm大の腫瘍を認め，副腎性Cushing症候群と診断された。しかし，アドステロールシンチグラフィで集積なく，また尿中カテコラミンが軽度上昇し，MIBGシンチグラフィで甲状腺右側に有意に集積があり，精査目的で当院紹介となった。シンチグラフィ陰性の原因として副腎癌やblack adenomaが鑑別として考えられた。MIBGシンチグラフィの集積は，甲状腺髄様癌や傍神経節腫瘍は否定的で，腺腫様甲状腺腫による影響と考えられた。当院外科にて腹腔鏡下左副腎摘除術が施行された。腫瘍の割面は暗褐色調を呈し，病理組織所見からblack adenomaと診断された。アドステロールシンチグラフィ陰性で，副腎癌との鑑別を要した副腎black adenomaの症例を経験したので報告する。departmental bulletin pape

THE CURRENT STATE OF THE ANESTHESIA CLINIC AT NARA MEDICAL UNIVERSITY HOSPITAL

Since its introduction in 1996, pre- and post-anesthetic consultation at the anesthesia clinic has been conducted for the surgical patients in Nara Medical University Hospital. Then, we evaluated many information obtained from those patients. Regarding pre-anesthetic problems, 39.2％ of patients had anesthesia-related complications such as indication of ICU, taking anticoagulant agents, having cardiac complications, etc. Only 55.4％ of patients visited with their families. Eighty-five percent of patients visited the anesthesia clinic after their operation. Additionally, we retrospectively evaluated post-anesthetic complications and satisfaction under general, epidural and splnal anesthesia from 1999 to 2001. Patients with dissatisfaction on splnal anesthesia were of a higher incidence than those on general anesthesia. The common undesirable complications in every anesthetic method were post-operative pain and nausea/vomiting. We concluded that explanations of anesthesia at pre- and post-anesthesia clinic were useful methods for anesthesia patients