Masui. The Japanese journal of anesthesiology
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A 67-year-old male patient with chronic tympanitis was scheduled for elective tympanoplasty. Propofol and fentanyl were used for induction and the patient was ventilated with sevoflurane, oxygen and nitrous oxide for general anesthesia. ⋯ The surgery was discontinued for the safety of the patient, in spite of the recovery of ventilation with a facemask. It is suspected that the ventilatory difficulty was caused by the following reasons; first, the laryngeal mask airway was shifted by change of the body position, second, the mask tip was inserted at the inlet of the larynx because the internal cuff pressure had risen with nitrous oxide.
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We experienced anesthetic management for a patient with platypnea-orthodeoxia syndrome. This syndrome is relatively uncommon and accompanies dyspnea and hypoxemia on changing to a sitting or standing from recumbent position. A 75-year-old man with the syndrome underwent atrial septal defect closure on cardiopulmonary bypass. ⋯ The perioperative and postoperative course was uneventful, except for hypoxemia during induction. Although the exact mechanisms of platypneaorthodeoxia remains to be solved, right-to-left shunt by an anatomical abnormality and by change of the atrial septum is considered one of the hypoxic mechanisms. We suggest that it is necessary to prevent right-to-left shunt and hypoxemia in anesthetic management of a patient with platypneaorthodeoxia syndrome.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of 8 mg and 10 mg hyperbaric bupivacaine during spinal anesthesia for cesarean section in Japanese parturients].
Hypotension after spinal anesthesia for cesarean section is common and may result in serious complications despite the use of uterine displacement and volume preloading. Adequate amount of hyperbaric bupivacaine for Japanese parturients whose frames are generally smaller than those of Caucasian counterparts have not yet been examined. We compared the analgesic efficacy and the incidence of hypotension with 8 mg versus 10 mg hyperbaric bupivacaine during spinal anesthesia for cesarean section in Japanese parturients. ⋯ Injection of 8 mg hyperbaric bupivacaine is preferable than 10 mg in spinal anesthesia for cesarean section to obtain adequate analgesic efficacy and to avoid maternal hypotension.
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Comparative Study Clinical Trial Controlled Clinical Trial
[Evaluation of a lockable combined spinal-epidural device for use with needle-through-needle technique].
Recently, a new combined spinal-epidural (CSE) device has been introduced which allows the spinal needle to be extended a maximum of 15 mm beyond the Tuohy needle and locked onto the epidural needle after dural puncture. The aim of this study was to compare this lockable CSE device with the conventional CSE device, which allows the spinal needle to be extended 9 mm beyond the Tuohy needle, and to measure the length of the protrusion of the spinal needle beyond the Tuohy needle (top-to-top distance: TTD). ⋯ The lockable CSE device improves the success rate of spinal anesthesia in needle-through-needle CSE anesthesia.
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Randomized Controlled Trial Clinical Trial
[Effects of olprinone hydrochloride after coronary artery bypass grafting].
We have examined the effect of olprinone hydrochloride on hemodynamics and peripheral circulation after cardiopulmonary bypass (CPB) in 56 patients who underwent coronary artery bypass grfting. ⋯ Olprinone increased CI and decreased SVRI, and it led to easy weaning from CPB, providing excellent hemodynamics after CABG. These results suggest that olprinone hydrochloride 15 micrograms.kg-1 bolus plus 0.1 microgram.kg-1.min-1 continuous administration may be effective for improvement of hemodynamics and peripheral circulation after CPB.