Journal of anesthesia
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Journal of anesthesia · Jan 2006
Case ReportsSpinal anesthesia using a continuous spinal catheter for cesarean section in a parturient with prior surgical correction of scoliosis.
This case report demonstrates the successful anesthetic management of cesarean section for a 29-year-old primiparous parturient with a past history of a scoliosis operation at 13 years of age. An Isola hook and screw-rod system had been implanted as posterior spinal instrumentation at the level of T3-L3. We titrated hyperbaric bupivacaine 7 mg combined with fentanyl 15 microg through a continuous spinal catheter, placed with a catheter-over-needle technique in order to avoid unintentional wide spread of anesthetic agents. ⋯ Her surgery was carried out without any problems. Headache, as a dural tap-related complication, was not observed. Spinal anesthesia with the titration of anesthetic agents for cesarean section is considered to be one of the choices for a parturient who has had spinal instrumentation.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffect of peak inspiratory flow on gas exchange, pulmonary mechanics, and lung histology in rabbits with injured lungs.
The aim of this study was to evaluate, using a rabbit model, the little-known effect of different levels of peak inspiratory flow on acutely injured lungs. ⋯ In rabbits with injured lungs, high peak inspiratory flow with high tidal volume (V(T)) reduces the Pa(O(2))/FI(O(2)) ratio and increases the lung wet-to-dry ratio.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialEffects of a protease inhibitor, ulinastatin, on coagulation and fibrinolysis in abdominal surgery.
Ulinastatin is well known to inhibit the activity of polymorphonuclear leukocyte elastase (PMNE). The PMNE concentration correlates with the activities of coagulation and fibrinolysis. The purpose of the present study was to investigate the effects of ulinastatin, a protease inhibitor, on coagulation and fibrinolysis in abdominal surgery. ⋯ Ulinastatin could inhibit coagulation and fibrinolysis in abdominal surgery.
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Journal of anesthesia · Jan 2006
Randomized Controlled TrialFlexible, tapered-tip tube facilitates conventional orotracheal intubation by novice intubators.
Orotracheal intubation is the standard technique for airway management, but several untoward airway complications are possible with this method. To avoid airway trauma caused by the tube tip during intubation, the Parker Flex-Tip tube (PFT), which has a flexible, tapered tip, was developed. It has been reported that the PFT facilitates fiberoptic orotracheal intubation and introducer-guided tracheal intubation. ⋯ PFT did not shorten the time required for intubation and did not reduce the incidence of sore throat and hoarseness. However, a detailed analysis revealed that the PFT decreased the time required for intubation in the anesthesia trainee group. The PFT may help novice intubators to conduct a smooth intubation.
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Journal of anesthesia · Jan 2006
Case ReportsAberrant halt of syringe pump motion: an improved system to prevent false setting of the syringe.
A syringe pump is used to inject precise doses of drugs having a strong action; for example, vasoactive drugs. Unexpected and undetected halt of a syringe pump can lead to potentially life-threatening complications. We experienced a sudden halt in the movement of a syringe pump (Terufusion syringe pump; Terumo, Tokyo, Japan) in two patients while administering norepinephrine in the intensive care unit (ICU). ⋯ Once we had determined how a false setting of the syringe could occur without the syringe pump giving off an alarm from the onset, we collaborated with the Terumo Company to revise their current instruction manual to incorporate this as a warning. We also helped in the development of a new model, including a new safety feature that would prevent a false setting of the syringe from occurring at all. This new model was released in December 2003.