Masui. The Japanese journal of anesthesiology
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Apneic anesthesia with intermittent ventilation (AAIV) under inhalational anesthesia has been reported to improve visualization of the larynx with lack of vocal cord motion in laryngeal microsurgery. In this study, we evaluated AAIV using total intravenous anesthesia with propofol and fentanyl instead of inhalational anesthesia in 11 patients undergoing microsurgery of the larynx, and examined the effects of AAIV on respiration and circulation. Anesthesia was maintained with infusion of propofol 4-10 mg.kg-1.h-1 and intermittent administration of fentanyl and vecuronium intravenously. ⋯ End-tidal carbon dioxide level increased for 14.9 mmHg immediately after apneic periods. Propofol vielded stable and adequate levels of anesthesia during apneic periods. We conclude that AAIV using constant monitoring of Spo2 is a useful and safe technique, and that propofol is a suitable anesthetic agent for AAIV.
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Patil-Syracuse mask, recently introduced in Japan, has a port for fiberscopy. A fiberoptic bronchoscope and an endotracheal tube can be passed through the port with little air leakage. ⋯ With a modified endoscopy mask technique, the mean expiratory tidal volume of 10 ml.kg-1 could be obtained during fiberoptic orotracheal intubation. We describe a fiberoptic intubation technique using this mask, and discuss the complications and limitations of this method.