Journal of anesthesia
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Journal of anesthesia · Jun 2012
Case ReportsAnesthetic management during tracheotomy in a child with respiratory distress caused by severe intubation-induced glottic stenosis.
We provided anesthetic management during a tracheotomy procedure for a child who demonstrated labored respiration during inspiration because of severe glottic stenosis and bilateral vocal cord paralysis caused by tracheal intubation. A 4-year-old boy developed acute respiratory depression associated with influenza pneumonia and had been under respiratory management with mechanical ventilation with tracheal intubation for 3 days. ⋯ For anesthetic management, we used a combination of ketamine with low-concentration sevoflurane inhalation. The tracheotomy was performed safely without respiratory complications by employing manual-assisted ventilation, while spontaneous breathing was preserved by use of a face mask.
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Journal of anesthesia · Jun 2012
Experiences with epidural anesthesia of Japanese women who had childbirth in the United States.
Cultural views are purported to be critical barriers to the use of epidural anesthesia during childbirth in Japan, even though it is not routinely available. We sought to understand the importance of the asserted cultural barriers for Japanese women living in Michigan in the United States where access to epidural anesthesia is routine. ⋯ While Japanese women in this United States setting considered previously reported cultural barriers to epidural anesthesia for birth pain, many chose to have it during their labor. This finding implicates limited access as a barrier at least as important as cultural barriers to epidural anesthesia use in Japan.
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Journal of anesthesia · Jun 2012
Case ReportsAnesthetic management of three pediatric cases with Pena-Shokeir syndrome.
Pena-Shokeir syndrome is a rare, early lethal disease. It is characterized by fetal growth restriction; craniofacial deformities, for example micrognathia and microcephaly; multiple ankyloses; and pulmonary hypoplasia. ⋯ Anesthetic procedures including mask ventilation, tracheal intubation, and extubation were successfully performed without complications during and after surgery. In patients with Pena-Shokeir syndrome, inhalational anesthetics can be safely used for induction and maintenance of anesthesia, although it is important to assume that difficult airway management might be encountered.
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Journal of anesthesia · Jun 2012
Case ReportsStridor due to an innominate artery compression and posterior mediastinal mass in a pediatric patient.
There are many causes for stridor in a pediatric patient. We present an interesting case of a pediatric patient who had stridor due to an innominate artery compression and posterior mediastinal mass. We discuss the anesthetic complication and management of patients with stridor.
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Journal of anesthesia · Jun 2012
Clinical experience with a new endobrochial blocker: the EZ-blocker.
In some thoracic surgical procedures, the insertion of a double-lumen tube (DLT) is not feasible, or the altered use of a DLT and a single-lumen tube (SLT) is justified during the surgery. In the present article we report our experience with a new bronchial blocker, the EZ-blocker, in clinical use. ⋯ Use of the EZ-blocker is easy and safe. The short insertion time and short lung deflation time through the lumen of the SLT allows its use in emergency situations or in cases of a difficult airway.