Masui. The Japanese journal of anesthesiology
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Clinical Trial Controlled Clinical Trial
[Nicorandil reduces incidence and severity of pain on propofol injection].
Propofol is commonly used for induction and maintenance of anesthesia, but the pain during injection of propofol remains a clinical problem. We studied whether nicorandil prevents the pain on propofol injection. ⋯ Nicorandil reduces the incidence and severity of pain on propofol injection.
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Comparative Study
[The cracks of polycarbonate three-way stopcocks are enhanced by the lubricating action of fat emulsion of propofol].
The possible mechanism of cracks in the polycarbonate three-way stopcocks was investigated in the presence of propofol. We compared the crack formations with various insertion force and contact surface conditions. We could successfully reproduce overt cracks with leakage in three-way stopcocks when the male adaptors were strongly inserted and the contact surface was damped with propofol. ⋯ The male connector is more deeply inserted into the female three-way stopcock at the same insertion force when contact surface is damped with propofol. When propofol is present, the release force is not enhanced further while insertion force is increased. We conclude that the cracks in three-way stopcocks are enhanced by the increased expansion force by the lubricating action of propofol fat emulsion.
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Comparative Study
[Comparison of requirement for postoperative analgesics after inhalation and total intravenous anesthesia].
We evaluated the requirement for postoperative analgesics in 88 patients undergoing abdominal total hysterectomy with inhalation anesthesia or with total intravenous anesthesia. ⋯ The postoperative pain can be reduced with TIVA.
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After total correction of tetralogy of Fallot, pulmonary atresia and major aorto-pulmonary collateral arteries, a 31-year-old man developed life-threatening pulmonary hypertension and reperfusion pulmonary edema, leading to pulmonary hemorrhage, right heart failure and hypoxia. Because of difficulty in weaning from cardiopulmonary bypass and in controlling hemorrhage from pulmonary arteries, we applied percutaneous cardiopulmonary support (PCPS) for 281 hours with strategy of delayed sternal closure (17 days) and a large quantity of transfusion. ⋯ As the result, he was discharged alive without any major complications. We report our postoperative managements, in terms of 1) lung protective ventilatory strategy, 2) surgical control of pulmonary blood flow, and 3) evaluation of the cardiopulmonary function during PCPS for early weaning from PCPS.
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We report here a case of obstruction of an reinforced endotracheal tube during laryngomicrosurgery under total intravenous anesthesia. In this case, we used a 6.0 mm ID reinforced endotracheal tube that had been used previously for other patients and sterilized two times by ethylene oxide gas. During the operation, the peak airway pressure increased gradually and eventually reached to 35 cmH2O. ⋯ Several cases of reinforced tube obstruction have already been reported and in most of these cases the obstruction was related to their repeated use and nitrous oxide anesthesia. However, the present case showed that dissection of reinforced endotracheal tube could also occur during general anesthesia without using nitrous oxide. We should bear in mind that repeated use of reinforced endotracheal tube could induce a critical airway obstruction.