Journal of anesthesia
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Journal of anesthesia · Oct 2011
Case ReportsEpidural anesthesia with intravenous dexmedetomidine sedation in the successful anesthetic management of MRI-guided focused ultrasound ablation of early prostatic cancer.
We report on five patients who underwent MRI-guided focused ultrasound ablation of prostatic cancer under epidural anesthesia with intravenous dexmedetomidine sedation. This pioneering procedure requires an immobile therapeutic field with adequate sedation and analgesia provided to the patients. ⋯ In combination with epidural anesthesia, dexmedetomidine was used to provide moderate levels of sedation without causing respiratory depression or hemodynamic instability, and was useful in preventing shivering. The pharmacological properties of dexmedetomidine contribute to make this technique safe and effective.
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Journal of anesthesia · Oct 2011
Fiberoptic-guided tracheal tube placement through the air-Q® Intubating Laryngeal Airway: a performance study in a manikin.
This study characterizes the performance and success rate for fiberoptic-guided tracheal tube placement through the air-Q(®) Intubating Laryngeal Airway (air-Q). ⋯ Fiberoptic-guided tracheal tube placement through the air-Q can be performed in a clinically acceptable period of time with high success by operators skilled in fiberoptic-guided intubation. Tracheal tube dislodgement during air-Q removal remains a potential risk that should be emphasized.
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Journal of anesthesia · Oct 2011
Case ReportsGiant coronary artery aneurysm with coronary arteriovenous fistula draining into the coronary sinus.
A 77-year-old patient suffering from a giant right coronary artery aneurysm with coronary arteriovenous fistula was admitted to our hospital. The fistula could not be documented preoperatively by computed tomography or coronary angiography but was documented intraoperatively by transesophageal echocardiography (TEE). However, TEE was unable to visualize the draining site of the fistula. ⋯ The postoperative course of the patient was uneventful. Giant aneurysms occasionally displace cardiac structures. In such cases, combined imaging technologies, including TEE, may be needed for precise assessment of the giant aneurysm and fistula.