Masui. The Japanese journal of anesthesiology
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Comparative Study
[Utility of an infrared ear thermometer as an intraoperative core temperature monitor].
We investigated the utility of an infrared ear thermometer (M 10, Terumo) as an intraoperative core temperature monitor. Temperatures of the axilla and inner ear were measured before and after anesthesia. Bladder, rectal, and forehead deep temperatures were continuously measured using a core temperature monitor (CTM-205, Terumo) during anesthesia. ⋯ The inner ear temperature showed a close correlation with rectal, bladder, forehead deep, and axillary temperatures (r = 0.72-0.79, P < 0.01). The smallest temperature difference in this study was found to be that between the inner ear and forehead deep temperatures (-0.10), and the limit of agreement between these temperatures was also the smallest (0.81). In conclusion, we recommended the use of an infrared ear thermometer as an intraoperative core temperature monitor, especially in lower abdominal surgery, in which neither rectal nor bladder temperature monitoring is reliable.
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Case Reports
[Differential lung ventilation using Fogarty catheter after accidental damage of bronchial blocker cuff].
We performed differential lung ventilation using a Fogarty catheter after accidental damage of a bronchial blocker. A 57-year-old-man underwent thoracoscopic surgery for right pneumothorax. Anesthesia was induced with fentanyl and midazolam, and maintained with propofol and continuous epidural block with 2% mepivacaine. ⋯ Its balloon was inflated for differential lung ventilation. The procedure was performed successfully and uneventfully. We conclude that Fogarty catheter is an effective replacement for a damaged bronchial blocker cuff during differential lung ventilation.
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Randomized Controlled Trial Clinical Trial
[The effect of olprinone administered after cardio-pulmonary bypass during open heart surgery, evaluated by its plasma concentrations and hemodynamic changes].
Plasma concentrations and hemodynamic effects of olprinone were evaluated in seventeen patients undergoing open heart surgery. The patients were randomized into the bolus group (15 micrograms.kg-1 bolus dose +0.1 microgram.kg-1.min-1 infusion, n = 9) and the non-bolus group (0.1 microgram.kg-1.min-1 infusion, n = 8). ⋯ In the bolus group, increases in the cardiac index and stroke volume index were significantly higher compared with the non-bolus group. From these results we conclude that olprinone given in bolus (15 micrograms.kg-1) followed by continuous infusion (0.1 microgram.kg-1.min-1) is efficacious and safe during weaning from CPB.
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Randomized Controlled Trial Clinical Trial
[Postoperative hoarseness and sore throat after tracheal intubation: effect of a low intracuff pressure of endotracheal tube and the usefulness of cuff pressure indicator].
Many clinical reports have described postoperative hoarseness and sore throat after general anesthesia. In most cases, these symptoms were attributed to high pressure of the endotracheal tube cuff. The recommended cuff pressure is less than 25 mmHg, as excessive pressure produces ischemia of the tracheal mucosa. ⋯ We investigated the incidence of postoperative hoarseness and sore throat at 24 hours after intubation and on the seventh postoperative day. The incidence of postoperative hoarseness and sore throat was significantly decreased in the low pressure group at 24 hours after intubation as compared with the high pressure group, but there was no significant difference between the two groups on the seventh postoperative day. These results suggest that keeping the cuff pressure under 15 mmHg can prevent postoperative hoarseness or sore throat at 24 hours after intubation, and that a cuff pressure gauge is thought to be one of the indispensable monitors during anesthesia.
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A 56-year-old-male with malignant pleural mesothelioma of the left lung underwent pneumonectomy and pleurectomy. Fiberoptic bronchoscopy was not done preoperatively. Anesthesia was induced rapidly and a double-lumen endobronchial tube was inserted. ⋯ Thereafter, the surgery was completed safely and his postoperative course was uneventful. Routine bronchoscopy is essential just after intubation and before extubation of the endobronchial tube in safe airway management. How to use a fiberoptic bronchoscope to check the position of a double-lumen endobronchial tube is also discussed.