Asaka Watanabe’s research while affiliated with Juntendo University and other places

We experienced pheochromocytoma resection and coronary artery bypass grafting under cardiopulmonary bypass (CPB). The patient was a 69-year-old man who was first diagnosed with atherosclerotic angina. During operation, his blood pressure increased at induction and manipulation of the tumor under CPB, associated with an increased serum noradrenaline concentration. Starting operation, we monitored using transesophageal echocardiography (TEE), and used that view for diagnosis and anesthetic or hemodynamic management. It was especially useful after tumor resection. Surgical and hemodynamic management was facilitated by TEE. TEE was useful to make a diagnosis of cardiac pheochromocytoma, to determine the area of resection, to determine the surgical repair, and to make a decision of hemodynamic management in this complicated patient. We suggest that perfoming these cases under CPB and TEE is recommended for stabilization of hemodynamic states.

Since children often have difficulty in expressing pains accurately, it is more important in child than in adult that physicians and nurses share the awareness of postoperative pains in children and provide care by paying attention to the methods of evaluating pains and analgesia. Awareness and current status of postoperative pains in children were surveyed by a questionnaire to nurses working at a university hospital. More than 90% of nurses answered positively towards the necessity of postoperative analgesia in children. In terms of satisfaction as to postoperative analgesia, more than 80% of nurses answered that they were able to provide it "as much as they could". However, when analgesic measures that were indeed provided were asked, it turned out that the contents of analgesic methods "as much as they could" differed among wards. Despite the high awareness of postoperative pains in children, it turned out that putting them into practical use was difficult in some wards of the university hospital. Since major educative institutes for nurses are university hospitals in Japan, it was thought to be important for physicians and nurses working there to try to further share the awareness of postoperative pains in children.