No abstract

Advantages of thoracic paravertebral analgesia (TPA) include placement of the catheter closer to the surgical field; however, the catheter can become damaged during the operation. We experienced a case of intraoperative TPA catheter breakage that prompted us to perform an experiment to investigate possible causes. A 50-year-old male underwent a thoracoscopic lower lobectomy under general anesthesia with TPA via an intercostal approach. Following surgery, it was discovered that the catheter had become occluded, as well as cut and fused, so we reopened the incision and removed the residual catheter. From that experience, we performed an experiment to examine electrocautery-induced damage in normal (Portex™, Smith's Medical), radiopaque (Perifix SoftTip™, BBraun), and reinforced (Perifix FX™, BBraun) epidural catheters (n = 8 each). Chicken meat was penetrated by each catheter and then cut by electrocautery. In the normal group, breakage occurred in 8 and occlusion in 6 of the catheters, and in the radiopaque group breakage occurred in 8 and occlusion in 7. In contrast, breakage occurred in only 3 and occlusion in none in the reinforced group, with the 5 without breakage remaining connected only by the spring coil. Furthermore, in 7 of the reinforced catheters, electric arc-induced thermal damage was observed at the tip of the catheter. A TPA catheter for thoracic surgery should be inserted via the median approach, or it should be inserted after surgery to avoid catheter damage during surgery.

No abstract

We evaluated the accuracy of patient's body weight estimated by their relatives, focusing on differences in patients' and relatives' gender.Two hundred and thirty patients scheduled for elective surgery were included in this study. The correlation coefficients （r 2 ） and mean difference ±1.96 standard deviation between estimated and measured body weight were 0.81, -2.3±10.2 kg, 0.94, -0.3±5.5 kg, 0.81, -0.5±6.1 kg, and 0.87, -0.8±6.5 kg in male relatives -male patient, female relatives -male patient, male relatives -female patient, female relatives -female patient respectively.These data indicate that patient's weight estimated by their relatives was generally reliable. Body weights estimated by female relatives seem to be more accurate than those by male relatives.